Alphagan is one of a new class of drugs called alpha-2 adrenergic receptor agonist. Elevated eye pressure is a major risk factor in visual field loss. The higher the eye pressure the greater the likelihood of optic nerve damage and visual field loss. Alphagan works in a dual method:
• By decreasing the production of aqueous humor (fluid in the eye).
• By increasing the flow of fluid out of the eye.
Alphagan is contraindicated in patients with hypersensitivity to brimonidine tartrate or any component of this medication. It is also contraindicated in patients taking certain types of antidepressant drugs such as monoamine oxidase inhibitor therapy (MAO). Alphagan should be used with caution in patients with severe cardiovascular disease, depression, and Raynaud’s Phenomenon.
Most common ocular complaints:
• Blurring or stinging upon instillation. Much less with Alphagan P.
• Excess tear production.
• Redness of eyes or inner lining of the eyelids.
• Swelling of eye or eyelid.
Most of the above are related to being allergic to the medication. Alphagan’s effect can diminish with time so regular follow-up from your eye care provider is important. The Alphagan P formulation has decreased the above effects.
Most common systemic complaint:
• Dry Mouth.
• Fatigue and or drowsiness.
• Dizziness.
Less Common side effects:
Headache, blurring or other changes in vision, dizziness, mental depression, insomnia, muscle pain or weakness, nausea, increased blood pressure, vomiting, anxiety, pounding heartbeat, change in taste, discoloration of eyeball, paleness of inner lining of eyelid, dry eyes, sensitivity of eyes to light.
Unlike topical beta-blockers, there are no contraindications for patients with pulmonary or cardiovascular disease, an important advantage. Side effects of this medication are far fewer than most other glaucoma medications. Alphagan can be nicely added to other glaucoma medications.
Pregnancy/ Breast Feeding:
Alphagan is a category B drug. It is relatively safe to use in pregnancy. However, it can be related to bradycardia, hypertension and apnea in children younger than 2 months, with the potential for toxicity in human breast milk; should be used cautiously in lactating mothers. Caution is advised, consult your doctor for advice.
Infants and Children:
The safety and effectiveness of Brimonidine in infants and children have not been established.
Alphagan P (brimonidine tartrate 0.15%),
This new formulation includes the preservative Purite (sodium chlorite) which brings this formulation closer to the eye’s natural pH. The company’s clinical studies show that Allergan’s newly approved Alphagan P (brimonidine tartrate ophthalmic solution, 0.15%) greatly reduces incidence of ocular allergy in glaucoma patients while maintaining the same efficacy as the original Alphagan (brimonidine tartrate ophthalmic solution, 0.2%) for lowering intraocular pressure. This office has changed all of its patients to the new formulation.