Brimonidine eye drops for glaucoma (Alphagan, Brymont)

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Brimonidine eye drops are used to control increased pressure within your eye (glaucoma).

Remember to use the drops regularly, twice a day.

If you normally wear soft contact lenses, please make sure your doctor knows about this.

Type of medicineAn alpha2-adrenoceptor agonist eye drop
Used forTo reduce raised eye pressure
Also calledAlphagan®; Brymont®
Combination brands: Combigan® (brimonidine with timolol); Simbrinza® (brimonidine with brinzolamide)
Available asEye drops

An increase in pressure within your eye can lead to damage to the optic nerve at the back of your eye. When this occurs it is called glaucoma. Glaucoma can lead to a loss of vision if it is not treated. If you have an increased pressure within your eye but without any damage to the optic nerve, this is called ocular hypertension. People with ocular hypertension have an increased risk of later developing glaucoma. Treatment with brimonidine eye drops helps to reduce eye pressure in people with ocular hypertension, and to prevent further eye damage in people with glaucoma.

Brimonidine eye drops are thought to work by reducing the amount of fluid that you make in the front part of your eye (called aqueous humour) and by increasing the drainage of fluid from your eye. These two actions help to lower the pressure within your eye.

Sometimes, more than one type of eye drop is needed to keep the pressure in the eye low. If this is the case for you, you may be asked to use two different eye drops, or you may be given drops which combine more than one type. Brimonidine is available as a combination eye drop with timolol (a beta-blocker) in a brand called Combigan®, and with brinzolamide (a carbonic anhydrase inhibitor) in a brand called Simbrinza®.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start using the eye drops, it is important that your doctor knows:

  • If you wear soft contact lenses.
  • If you are pregnant or breast-feeding.
  • If you have a heart condition or blood vessel disorder.
  • If you have a blood circulation problem (particularly if you have Raynaud's syndrome).
  • If you feel dizzy when you sit up or stand up quickly.
  • If you have a depressive illness.
  • If you have any problems with the way your liver works, or any problems with the way your kidneys work.
  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.
  1. Wash your hands well before you use the drops.
  2. Remove the cap.
  3. Tilt your head back a little and pull the lower lid of your eye downwards to form a pocket.
  4. Hold the bottle upside down near to your eye. Try not to touch your eye as you do this.
  5. Apply enough pressure to the bottle to release one drop into your eye. (Do not use more than one drop - using several drops does not improve your glaucoma but will increase the risk of side-effects.)
  6. Close your eye for a minute or two and press gently on the side of your nose where the corner of your eye meets your nose. This helps to stop the drop from draining away and keeps it in your eye.
  7. Repeat the process in your other eye if you have been told to use the drops in both eyes.
  8. Replace the cap.
  • Before you start using the eye drops, read the manufacturer's printed information leaflet from the pack. It will give you more information about the eye drops and will provide you with a full list of the side-effects which you may experience from using them.
  • Use one drop into the eye (or eyes) affected. The drops are used twice each day, 12 hours apart. Your dose will also be printed on the label of the bottle to remind you.
  • Remember to use the drops at regular intervals and try not to miss any doses. If you do forget, use them as soon as you remember (unless it is nearly time for your next dose, in which case just use the drops when they are next due). Do not 'double up' to make up for a missed dose.
  • Take care not to touch the tip of the dropper with your eye, fingers, or any other surface. This is to prevent the drops from becoming contaminated.
  • If you are using any other eye drops, leave 5-10 minutes between applying each one. This is to prevent more liquid going into your eye than it can handle. Otherwise the drops will overflow from your eye and not have the intended effect.
  • When first put in, eye drops can make your eyes water and may sometimes cause blurred vision. If this happens, it should quickly clear. Make sure you can see clearly again before you drive, or use tools or machines.
  • Do not wear soft contact lenses unless your doctor has advised you otherwise. This is because bottles of eye drops contain preservatives which can affect soft contact lenses.
  • Keep your regular appointments with your doctor and eye clinic so that your progress can be checked.

Along with their useful effects, eye drops can cause unwanted side-effects although not everyone experiences them. The table below contains the most common ones associated with brimonidine. You will find a full list in the manufacturer's information leaflet supplied with the drops. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist for further advice if any of the following continue or become troublesome.

Side-effects of brimonidine eye drops (some of these can be very common affecting more than 1 in 10 people)What can I do if I experience this?
Dry eye, blurred vision, eye redness, stinging and irritation, sensitivity to lightThese symptoms should soon pass, but make sure you can see clearly before driving or using tools or machines. If this continues or becomes troublesome, speak with your doctor
Feeling tired, sleepy or dizzyIf this happens, do not drive or use tools or machines until the feeling passes
HeadacheAsk your pharmacist to recommend a suitable painkiller. If the headache continues, speak with your doctor
Dry mouthTry chewing sugar-free gum, or sucking sugar-free sweets
Cold-like symptoms, stomach upset, unusual tasteIf any of these become troublesome, speak with your doctor

Bottles of eye drops contain preservatives which some people can develop an allergic reaction to. If your eye becomes red or inflamed after using the drops, contact your doctor for advice.

  • Eye drops can be used for four weeks once the bottle has been opened. Even if there is still some solution remaining after this time, throw it away and use a new bottle. This will help to prevent the risk of eye infections.
  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

If you buy any medicines check with a pharmacist that they are safe to take with your prescribed medicines.

This preparation is for use in the eyes only. If someone swallows some of it, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • Manufacturer's PIL, Alphagan®; Allergan Ltd, The electronic Medicines Compendium. Dated November 2014.
  • British National Formulary; 70th Edition (Sep 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr John Cox
Document ID:
3772 (v25)
Last Checked:
Next Review:
The Information Standard - certified member

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