Alphagan (brimonidine)

How does it work?

Alphagan eye drops contain the active ingredient brimonidine, which is a type of medicine called an alpha agonist. It works by stimulating alpha receptors found on blood vessels in the eye.

The pressure within the eyeball is naturally maintained by a continuous flow of liquid called aqueous humour through the eyeball. Aqueous humour is produced by a part of the eye called the ciliary body. It drains out of the eyeball through channels called the trabecular meshwork. If the outflow of aqueous humour is blocked, as in glaucoma, the aqueous humour builds up inside the eye, increasing the pressure within the eyeball. This pressure needs to be reduced, as otherwise it can damage the optic nerve and impair vision as a result.

Brimonidine stimulates alpha receptors found on the blood vessels that supply the ciliary body. This causes the blood vessels to constrict, and reduces the amount of watery fluid that filters out of the blood vessels to form aqueous humour.

Brimonidine therefore works by reducing the inflow of aqueous humour into the eyeball, which decreases the pressure within the eye. It is used to treat conditions where there is raised pressure in the eye, such as glaucoma.

Brimonidine eye drops are used to treat glaucoma in people who cannot use beta-blocker eye drops. They may also be used in conjunction with other types of eye drop, for example beta-blockers or prostglandin analogues, to treat glaucoma in people whose eye pressure has not been lowered sufficiently with one medicine.

Eye drops are used to produce a local effect in the eye, with minimal effect on other parts of the body. You can further minimise the amount of medicine that is absorbed into your bloodstream and increase the local action in the eye by pressing on your tear duct (the corner of the eye closest to the nose) while putting in the eye drops and for a minute after.

What is it used for?

Raised pressure in the eye (ocular hypertension)

Open angle glaucoma.

Warning!

This medicine is not to be taken by mouth.

When using these eye drops you should take care to not touch the dropper tip to any surface, or to your eye, in order to avoid contaminating the eye drops.

Alphagan eye drops contain the preservative benzalkonium chloride, which can be absorbed by soft contact lenses and cause eye irritation. If you wear soft contact lenses, you should remove them before putting in these eye drops. You should wait at least 15 minutes after using the drops before putting your contact lenses back in.

This medicine may cause blurred or abnormal vision, which could affect your ability to drive or operate machinary, especially at night or in reduced lighting. You should also take into account that this medicine can sometimes drowsiness or fatigue, which may also affect your ability to drive or operate machinary.

Alphagan eye drops are sterile until opened. The bottles contain a preservative that helps keep the eye drops sterile once they are in use. However, any medicine remaining in the bottle after it has been open for four weeks or more is likely to be contaminated with germs and should no longer be used. Dispose of carefully, preferably by returning to your pharmacy. You may find it helpful to write the date of first opening on the packet.

While using this medicine you should have regular eye examinations.

Use with caution in

Disease involving the heart and blood vessels

Decreased blood supply to the heart (coronary insufficiency), eg people with angina

Decreased blood supply to the brain (cerebral insufficiency), eg people who have had a stroke or mini-stroke (transient ischaemic attack)

People who experience drops in blood pressure when going from lying down to sitting or standing, that result in dizziness and light-headedness (postural hypotension)

Narrowing of the blood vessels in the hands, causing numb and painful fingers (Raynaud's disease)

Progressive disease involving narrowing of the blood vessels in the legs (thromboangiitis obliterans)

Depression

Decreased kidney function

Decreased liver function.

Not to be used in

Babies less than one month old (neonates)

People taking monoamine oxidase inhibitor (MAOI) or tricyclic antidepressants or mianserin

Breastfeeding.

This medicine is not recommended for children.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine during pregnancy has not been established. It should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the foetus. Seek medical advice from your doctor.

It is not known if this medicine passes into breast milk. It should not be used by breastfeeding mothers. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Red eye due to increased blood supply (hyperaemia)

Eye burning or stinging

Dry mouth

Eye irritation

Eye itching

Fluid-filled sacs in the conjunctiva of the eye (conjunctival follicles)

Sensation of something being in the eye

Blurred vision

Eye pain

Headache

Fatigue

Drowsiness

Inflammation of the eyelids (blepharitis)

Inflammation of the membrane that lines the inside of the eyelids and outside of the eyeball, causing redness and discharge (conjunctivitis)

Dislike of light (photophobia)

Corneal erosion

Dry eyes

Dizziness

Abnormal taste

Increase or decrease in heart rate or abnormal heart beats

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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