brimonidine
Alphagan P (brimonidine) is a prescription eye drop that helps lower pressure in the eye and treats glaucoma. It's typically applied three times a day. Some common side effects include blurry vision, slight stinging in the eyes, and headaches. Alphagan P (brimonidine) is available as both a brand name and a generic medication.
What is Alphagan P (brimonidine)?
What is Alphagan P (brimonidine) used for?
High pressure in the eye caused by:
How Alphagan P (brimonidine) works
Alphagan P (brimonidine) is an alpha-2 agonist eye drop that lowers the amount of fluid in the eye. When there is less fluid inside the eye, the eye pressure goes down.
Drug Facts
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What are the side effects of Alphagan P (brimonidine)?
Common Side Effects
- Dry mouth (up to 30%)
- Red eye (up to 30%)
- Eye burning and stinging (up to 30%)
- Headache (up to 30%)
- Blurry vision (up to 30%)
- Feeling like there's something in your eye (up to 30%)
- Sleepiness (up to 30%)
- Small white patches on the inside of the eyelids (up to 30%)
- Allergic reactions in the eye (up to 30%)
- Itchy eyes (up to 30%)
Other Side Effects
- Color change to or thinning of the cornea
- Light sensitivity
- Red eyelids
- Eye pain
- Tearing
- Flu-like symptoms
- Swollen or crusty eyelids
- Dizziness
- Eyelid inflammation
- Eye irritation
- Stomach upset
- Weakness
- Pale or white eyelids
- Abnormal vision
- Muscle pain
Serious Side Effects
- Allergic reactions: burning, stinging, irritation of the eye
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Blurred or loss of vision
burning, dry, or itching eyes
discharge or excessive tearing
disturbed color perception
double vision
halos around lights
headache
itching of the eye
night blindness
overbright appearance of lights
redness of the eye or inner lining of the eyelid
swelling of the eyelid
tearing of the eye
tunnel vision
Less common
Ache or pain in the eye
blindness
bloody eye
blurred vision or other change in vision
change in color vision
confusion
decreased vision
difficult or labored breathing
difficulty seeing at night
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
drainage from the eye
fainting
fast heartbeat
feeling of something in the eye
gradual blurring or loss of vision
increased blood pressure
increased sensitivity of the eye to light
mental depression
oozing in the eye
redness, swelling, or itching of the eye or eyelid
runny or stuffy nose
seeing flashes or sparks of light
seeing floating dark spots or material before eyes
seeing floating spots before the eyes or a veil or curtain appearing across part of vision
skin rash
sweating
swelling of the eye
tightness in the chest
unusual tiredness or weakness
vomiting
watery eyes
Incidence not known
Bluish lips or skin
chest pain or discomfort
confusion
fast, pounding, or irregular heartbeat or pulse
feeling of warmth or heat
flushing or redness of the skin, especially on the face and neck
irregular, fast, slow, or shallow breathing
low body temperature
muscle aches or weakness
shivering
slow or irregular heartbeat
weak or feeble pulse
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Burning, stinging, or tearing of the eye
drowsiness or tiredness
dryness of the mouth
Less common
bad, unusual, or unpleasant (after) taste
belching
body aches or pain
change in taste
chills
congestion
cough producing mucus
crusting on the eyelid or on the corner of the eye
difficulty breathing
discoloration of the white part of the eye
dryness of the eye
dryness or soreness of the throat
general feeling of discomfort or illness
hoarseness
indigestion
joint pain
lack or loss of strength
large amounts of cholesterol in the blood
lid disorder
loss of appetite
muscle aches and pains
pain or tenderness around the eyes and cheekbones
paleness of the eye or inner lining of the eyelid
passing of gas
pounding heartbeat
rash
shivering
sleepiness or unusual drowsiness
stomach discomfort, fullness, upset, or pain
tender, swollen glands in the neck
trouble with sleeping
trouble with swallowing
troubled breathing
unable to sleep
voice changes
Incidence not known
Constricted, pinpoint, or small pupils (black part of the eye)
redness of the skin
sensitivity to light
throbbing pain
unusual drowsiness, dullness, or feeling of sluggishness
unusual weak feeling
unusually warm skin
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Alphagan P (brimonidine)
Pros
Good at treating high eye pressure
Start working to lower eye pressure in as quickly as 1 hour
Can be stored at room temperature
Cons
Can cause dry mouth, headache, and drowsiness
Applied 3 times daily
Must take out contact lenses out before applying
Pharmacist tips for Alphagan P (brimonidine)
Wash your hands before putting Alphagan P (brimonidine) drops in your eyes. Don't touch the dropper tip with your eye, hands, or any other surface. This will help you avoid eye infections by preventing contamination of the solution.
If you wear contacts, remove them before each dose of prescription-strength Alphagan P (brimonidine) and wait 15 minutes after using to put them back in your eyes.
After placing a drop in the eye, close your eye and press one finger to the inner corner of your eye by the nose and press lightly for 1 minute. This helps make sure your eye absorbs the drop.
If you are using Alphagan P (brimonidine) at the same time as other eye medications, wait 5 minutes between each drop to give your eyes time to absorb each medication.
Avoid driving and doing tasks that require you to be alert or have clear vision, until you know how Alphagan P (brimonidine) affects you. Some people experience sleepiness and blurry vision from this medication.
It's not easy to tell if your eye pressure is improving at home. Make sure to use the prescription version of Alphagan P (brimonidine) as prescribed, even if you don't notice any difference in your symptoms or vision right away.
Frequently asked questions about Alphagan P (brimonidine)
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What are the risks and warnings for Alphagan P (brimonidine)?
Alphagan P (brimonidine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of worsening of low blood flow
Risk factors: Depression | Low blood flow to the brain or heart | Raynaud's phenomenon | Low blood pressure upon standing (orthostatic hypotension) | Blood vessel problems | Serious heart problems
Based on how Alphagan P (brimonidine) works, there's a very small risk that it can worsen blood flow or lower blood pressure. This might be a problem for people who already have issues with low blood flow to the brain, heart, hands, feet, or other important parts of the body. If you have any of the above risk factors, speak with your provider before starting Alphagan P (brimonidine).
Risk of infections (from contamination)
Risk factors: Corneal disease | Injury or damage to the surface of the eye
Use of Alphagan P (brimonidine) can cause bacterial keratitis, a bacterial infection of the cornea (the protective covering on the front of the eye). These infections tend to happen if your bottle of eyedrops gets contaminated with bacteria. It's important to wash your hands before each use, and be careful not to touch the dropper tip with your eye, hands, or any other surface.
No soft contact lenses
The preservative in Alphagan P (brimonidine), benzalkonium chloride, can be absorbed by soft contact lenses and cause damage. If you wear soft contacts, remove them before using a dose of Alphagan P (brimonidine). Wait at least 15 minutes after your dose before putting your contacts back in.
Only use in the eye
Only put Alphagan P (brimonidine) on the surface of the eye. Don't swallow it or use this as an injection because there's not much information on the risks of this and it can be very unsafe.
Alphagan P (brimonidine) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5ml of 0.1% | 1 eye dropper | $56.12 | $56.12 |
| 10ml of 0.1% | 1 eye dropper | $98.98 | $98.98 |
| 15ml of 0.1% | 1 eye dropper | $134.72 | $134.72 |
| 5ml of 0.15% | 1 eye dropper | $55.43 | $55.43 |
| 10ml of 0.15% | 1 eye dropper | $83.37 | $83.37 |
| 15ml of 0.15% | 1 eye dropper | $111.30 | $111.30 |
| 5ml of 0.2% | 1 eye dropper | $5.25 | $5.25 |
| 10ml of 0.2% | 1 eye dropper | $10.50 | $10.50 |
| 15ml of 0.2% | 1 eye dropper | $14.34 | $14.34 |
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 30g of 0.33% | 1 pump | $167.75 | $167.75 |
Typical dosing for Alphagan P (brimonidine)
The typical dose is to place 1 drop in the affected eye(s) 3 times daily about 8 hours apart.
Interactions between Alphagan P (brimonidine) and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Iobenguane I 131
How much does Alphagan P (brimonidine) cost?
Alphagan P (brimonidine) contraindications
Children under the age of 2
What are alternatives to Alphagan P (brimonidine)?
High pressure in the eye caused by:
High pressure in the eye caused by ocular hypertension (high pressure inside the eye) or open-angle glaucoma (the most common type of glaucoma)
What is the latest news about Alphagan P (brimonidine)?
Alphagan P (brimonidine) images
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References
Best studies we foundAllergan, Inc. (2013). ALPHAGAN P- brimonidine tartrate solution/ drops [package insert]. DailyMed.
Boyd, K. (2023). What is ocular hypertension? American Academy of Ophthalmology.
Cantor, L. B. (2006). Brimonidine in the treatment of glaucoma and ocular hypertension. Therapeutics and Clinical Risk Management.
Gudgel, D. T. (2023). How to put in eye drops. American Academy of Ophthalmology.
Manni, G., et al. (2004). Demographic and clinical factors associated with development of brimonidine tartrate 0.2%-induced ocular allergy. Journal of Glaucoma.
MedlinePlus. (2023). Brimonidine ophthalmic.
Merchel Piovesan Pereira, B., et al. (2019). Benzalkonium chlorides: Uses, regulatory status, and microbial resistance. Applied and Environmental Microbiology.
Tanihara, H., et al. (2023). Crossover randomized study of pharmacologic effects of ripasudil–brimonidine fixed-dose combination versus ripasudil or brimonidine. Advances in Therapy.
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