What is Simbrinza?

Brimonidine and brinzolamide ophthalmic (eye) drops is used to treat increased pressure in the eye caused by open-angle glaucoma or a condition called ocular hypertension. Both eye conditions are caused by high pressure in your eye and can lead to pain from pressure in your eye and then can eventually harm your vision. This medicine can help you keep your sight by reducing the pressure in your eye and stopping eye pain.

This medicine is available only with your doctor's prescription.

Your eye doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.

If you normally wear soft contact lenses, remove them before you use this medicine. Wait at least 15 minutes before putting the contact lenses back in.

To use the eye drops:

• Wash your hands with soap and water.
• Shake the eye drops well just before each use.
• Lie down or tilt your head back. With your index finger, pull down the lower lid of your eye to form a pocket.
• Hold the dropper close to your eye with the other hand. Drop the correct number of drops into the pocket made between your lower lid and eyeball.
• Gently close your eyes. Place your index finger over the inner corner of your eye for 1 minute.
• If you think you did not get the drop of medicine into your eye properly, repeat the process with another drop.
• Do not rinse or wipe the dropper or allow it to touch anything, including your eye.
• Put the cap on the bottle right away.
• Wash your hands after using the eye drops to remove any medicine.
• Do not use this medicine if the solution changes color or becomes cloudy.
• Never touch the applicator tip to any surface, including the eye, and keep the container tightly closed. This will keep the medicine as germ-free as possible.

If your doctor ordered two different eye drops to be used together, wait at least 5 minutes between the times you apply the medicines. This will help to keep the second medicine from “washing out” the first one.

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For ophthalmic dosage form (eye drops):
  • For glaucoma or hypertension of the eye:
    • Adults—Use one drop in the affected eye three times a day.
    • Children 2 years of age and older—Use and dose must be determined by your doctor.
    • Children younger than 2 years of age—Use is not recommended.

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

You may also keep the medicine in the refrigerator. Do not freeze.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Use of Simbrinza™ is not recommended in children younger than 2 years of age.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Simbrinza™ in the elderly.

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

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.

• Ceritinib
• Idelalisib
• Iobenguane I 131
• Memantine

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergy to sulfa drugs—Use with caution. May increase risk for more serious side effects.

• Bacterial eye infection (eg, keratitis) or
• Cerebral or coronary insufficiency or
• Cornea (part of the eye) problems, history of or
• Depression or
• Eye infection or
• Eye surgery, recent or
• Heart or blood vessel disease (eg, thromboangiitis obliterans) or
• Liver disease or
• Orthostatic hypotension or
• Raynaud's phenomenon—Use with caution. May make these conditions worse.

• Kidney disease, severe—Should not be used in patients with this condition.

It is important that your doctor check your or your child's progress at regular visits to make sure that this medicine is working properly and is not causing unwanted effects.

If itching, redness, swelling, or other signs of eye or eyelid irritation occur, check with your doctor. These signs may mean that you are allergic to brimonidine or brinzolamide.

Serious allergic reactions may occur while using this medicine. Check with your doctor right away if you or your child have any of the following symptoms: black, tarry stools, blistering, peeling, or loosening of the skin, chills, dark urine, joint or muscle pain, rash, red skin lesions, often with a purple center, sores, ulcers, or white spots in the mouth or on the lips, unusual bleeding or bruising, unusual tiredness or weakness, or yellow eyes or skin.

If you hurt your eye, develop an eye infection, or need to have an eye surgery, talk with your doctor right away. Your doctor may want you or your child to use a new bottle of eye drops to help prevent an eye infection or keep an infection from getting worse.

You should not use this medicine together with acetazolamide (Ak-Zol®, Diamox®), dorzolamide (Cosopt®, Trusopt®), or methazolamide (Neptazane®). Using these medicines together may increase risk for unwanted effects.

This medicine may cause some people to have blurred vision for a short time. Be careful when driving, using machines, or doing anything else that could be dangerous if you cannot see properly.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.