Brimonidine (Alphagan P): Basics, Side Effects & Reviews
Brimonidine (Alphagan P)

Brimonidine (Alphagan P)

Basics, Side Effects, Reviews & More

Brimonidine (Alphagan P) helps lower pressure in the eye and treats glaucoma, but it can cause bothersome side effects like dry mouth, headache, or fatigue. It is available as a milder, over-the-counter version for treating red eye.


Alphagan P, Qoliana, Lumify (OTC)


Alpha agonist


Not a controlled medication


Lower-cost generic available


Prescription or over-the-counter

Reviewed by:

Aileen Chu, PharmD, BCPS

Christina Aungst, PharmD

Last reviewed on:

December 10, 2020


What is brimonidine (Alphagan P)?

How brimonidine (Alphagan P) works

Brimonidine (Alphagan P) 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. The milder, over-the-counter version only lowers the amount fluid in the blood vessels around the eye, reducing eye redness.

What is brimonidine (Alphagan P) used for?

  • High pressure in the eye caused by open-angle glaucoma (the most common type of glaucoma) or ocular hypertension (high pressure inside the eye) - 0.1%, 0.15%, or 0.2% strengths, prescription only
  • Red eye from minor irritation - 0.025% strength, available over-the-counter

Typical dosing for brimonidine (Alphagan P)

  • High pressure in the eye, including open-angle glaucoma: Place 1 drop in the affected eye(s) 3 times daily about 8 hours apart.
  • Eye redness: Adults and children over 5 years of age, place 1 drop in the affected eye(s) every 6 to 8 hours no more than 4 times daily.

Frequently asked questions about brimonidine (Alphagan P)

Pros and cons of brimonidine (Alphagan P)


Thumbs UpGood at treating high eye pressure

Thumbs UpAvailable in combination with other eye pressure medications, making it more convenient to use multiple eye medications at once

Thumbs UpAvailable without a prescription for eye redness

Thumbs UpCan be used in children as young as 2 years old (5 years old for OTC Lumify)


Thumbs DownCan cause dry mouth, headache, fatigue, and drowsiness

Thumbs DownMust be used 3 times daily

Thumbs DownCertain strengths can be expensive even though a generic is available

Thumbs DownStops working as well over time for some people

Pharmacist tips for brimonidine (Alphagan P)

Capsule IconWash your hands before putting brimonidine (Alphagan P) 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.

Capsule IconIf you wear contacts, remove them before each dose of prescription-strength brimonidine (Alphagan P) and wait 15 minutes after using to put them back in your eyes. If you are using the over-the-counter version of this medication, you can put your contacts back in after 10 minutes.

Capsule IconAfter 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.

Capsule IconIf you are using brimonidine (Alphagan P) at the same time as other eye medications, wait 5 minutes between each drop to give your eyes time to absorb each medication.

Capsule IconAvoid driving and doing tasks that require you to be alert or have clear vision, until you know how brimonidine (Alphagan P) affects you. Some people experience sleepiness and blurry vision from this medication.

Capsule IconIt's not easy to tell if your eye pressure is improving at home. Make sure to use the prescription version of brimonidine (Alphagan P) as prescribed, even if you don't immediately notice any difference in your symptoms or vision.

Prices for brimonidine (Alphagan P) start at just $43.97 with a GoodRx coupon. They’re fast, easy-to-use and free!

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What are the side effects of brimonidine (Alphagan P)?

With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.

Warning Small Contact your doctor immediately if you experience any of the following:

  • Low bloodflow to the brain, heart, or hands and feet
  • Allergic reactions

Caution Small The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.

Common side effects

The following side effects are from the prescription strength brimonidine (Alphagan P):

  • 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%)

Side effects are not common with the over-the-counter form of brimonidine (Alphagan P).

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

Source: 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


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


bloody eye

blurred vision or other change in vision

change in color vision


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


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

muscle pain


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



swelling of the eye

tightness in the chest

unusual tiredness or weakness


watery eyes

Incidence not known

Bluish lips or skin

chest pain or discomfort


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


slow or irregular heartbeat

weak or feeble pulse

weight gain

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


body aches or pain

change in taste




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



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



sleepiness or unusual drowsiness


sore throat

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.

What are the risks and warnings for brimonidine (Alphagan P)?

Brimonidine (Alphagan P) 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 factors: Depression | Low bloodflow to the brain or heart | Raynaud's phenomenon | Low blood pressure upon standing (orthostatic hypotension) | Blood clots in the hands and/or feet due to tobacco use (thromboangiitis obliterans, or Buerger's disease) | Severe cardiovascular disease

If Brimonidine (Alphagan P) is absorbed into your bloodstream, it can lower your blood pressure. This can be a problem for people who already have issues with low bloodflow 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 brimonidine (Alphagan P).


  • Risk factors: Corneal disease | Injury or damage to the surface of the eye

Use of brimonidine (Alphagan P) 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.


The preservative in brimonidine (Alphagan P), benzalkonium chloride, can be absorbed by soft contact lenses and cause damage. If you wear soft contacts, remove them before using a dose of brimonidine (Alphagan P). Wait at least 15 minutes after your dose (or 10 minutes after using the 0.025% over-the-counter product) before putting your contacts back in.


Brimonidine (Alphagan P) should only be put on the surface of the eye. Do not swallow it or use this as an injection.


Most people do not experience side effects when using the over-the-counter version of brimonidine (Alphagan P). If you experience eye pain, more eye redness, or eye irritation after using this medication, stop using it and contact your provider, as this could be a sign of an allergic reaction. If you have been using this product for 3 days and have not seen any improvement or if your symptoms have gotten worse, you should also contact your provider. The over-the-counter version of brimonidine (Alphagan P) is designed to work right away, so if you're not feeling any better after using it, you may have an infection.

Interactions between brimonidine (Alphagan P) and other medications

Brimonidine (Alphagan P) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with brimonidine (Alphagan P). Please note that only the generic name of each medication is listed below.

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 brimonidine (Alphagan P) cost?

Brimonidine (Alphagan P) is available as a generic medication and may be significantly cheaper compared to the brand version. Unless there is a specific reason you need the brand, the generic medication will be a better value. For even more savings, use a GoodRx coupon and pay just a fraction of the retail price.

Lowest GoodRx Price
Alphagan P, Qoliana, Lumify (OTC) (brand)


Lowest GoodRx Price
brimonidine (generic)


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Pricing based on most commonly-filled versions:

What are alternatives to brimonidine (Alphagan P)?

There are a number of medications that your doctor can prescribe in place of brimonidine (Alphagan P). Compare a few possible alternatives below.

Brimonidine (Alphagan P)
Drug Class:Alpha agonist


lowest GoodRx price

View Prices
Dorzolamide (Trusopt)
Drug Class:Carbonic anhydrase inhibitor


lowest GoodRx price

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Timolol (Timoptic)
Drug Class:Beta-blocker


lowest GoodRx price

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