Names and pronunciation
(bri-moe′ni-deen) Alphagan P, Lumify, Mirvaso, Qoliana
PDF page 190
Loading InternPractice…
Drug reference
(bri-moe′ni-deen) Alphagan P, Lumify, Mirvaso, Qoliana
PDF page 190
Func. class.: Antiglaucoma
PDF page 190
Chem. class.: Selective α2 agonist
PDF page 190
Do not confuse: brimonidine/bimatoprost
PDF page 190
ACTION: Select α-agonist that decreases aqueous humor and increases outflows
PDF page 190
USES: Treatment of chronic open- angle glaucoma and ocular hyperten- sion
PDF page 190
CONTRAINDICATIONS: Hyper- sensitivity, AV block, heart failure, brady- cardia, sick sinus syndrome, within 14 days of MAOI therapy Precautions: Breastfeeding, depres- sion, cerebrovascular disease, hepatic/ renal impairment, Raynaud’s phenome- non, orthostatic hypotension, thrombo- angiitis obliterans
PDF page 190
SIDE EFFECTS RESP: Cough, dyspnea, bronchitis, pharyngitis CNS: Headache, dizziness, somnolence CV: Hyper/hypotension, hypercholester- olemia EENT: Eye stinging/burning, tearing, pho- tophobia, change in vision, sinus infection, blurred vision, pruritus, photophobia, eye- lid erythema, ocular pain, nasal dryness
PDF page 190
INTERACTIONS Increase: intraocular pressure reduc- tion—apraclonidine, dorzolamide, pilo- carpine, timolol Increase: effects of—CNS depressants Decrease: B/P—beta-blockers, antihy- pertensives Decrease: brimonidine effect—tricyclic antidepressants, may cause HTN crisis MAOIs, linezolid
PDF page 190
DOSAGE AND ROUTES Reduce IOP/ocular HNT or open- angle glaucoma • Adult/child >2 yr: Instill 1 drop in the affected eye(s) tid Persistent erythmea of rosacea (Mirvaso) Adult: Gel Apply pea-size amount of several areas of the face daily Redness in eye from irritation Adult/child ≥5 yr: Opthalmic solu- tion 1 drop in affected eye q6-8h, no more than qid
PDF page 190
Available forms: Ophthalmic solution 0.1%, 0.15%, 0.2%
PDF page 190
Assess: • Glaucoma: monitor intraocular pres- sure • Redness, flushing, whitening after gel, will resolve after discontinuation, do not use gel on wounds
PDF page 191
Evaluate: • Decreasing intraocular pressure
PDF page 191
CLINICAL CONSIDERATIONS
PDF page 191
Patient and caregiver information: • That drug is for ophthalmic use only • Not to touch the tip of the dropper to the eye, fingertips, or other surface to prevent contamination • Not to use alcohol • To wait 15 min before inserting soft contact lenses • To avoid hazardous activities until re- sponse is known • To wash hands prior to and after use; to teach proper use • That if more than one topical ophthal- mic drug product is being used, the drugs should be administered at least 5 min apart • To avoid contamination or the spread of infection by not using dropper for more than one person See Appendix B
PDF page 191
PHARMACOKINETICS Peak 1/2-2 hr, half-life 2 hr
PDF page 190
• Adult/child >2 yr: Instill 1 drop in the affected eye(s) tid Persistent erythmea of rosacea (Mirvaso) Adult: Gel Apply pea-size amount of several areas of the face daily Redness in eye from irritation Adult/child ≥5 yr: Opthalmic solu- tion 1 drop in affected eye q6-8h, no more than qid
PDF page 190