Brimonidine belongs to the family of medications known as alpha-2-adrenergic receptor agonists. It is used to reduce eye redness caused by minor irritants, such as allergies, dryness and fatigue. In higher prescription strengths, it is used to treat glaucoma (increased pressure in the eye).

Brimonidine works by causing the blood vessels in the eye to narrow, decreasing the redness in the eye.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The usual recommended dose for adults is one drop in the affected eye(s) every 6 to 8 hours. Do not use this medication more than 4 times a day.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

To use the eye drops:

1. Wash your hands before using the eye drops.
2. Remove the cap and place it in a clean location. To avoid possible contamination, keep the tip of the container away from contact with any surface.
3. Tilt your head back and look towards the ceiling.
4. With your index finger, gently pull the lower eyelid down and away from the eye to form a pouch.
5. Apply one drop into the pouch but do not allow the tip of the container to touch the eye or areas around the eye.
6. Gently apply pressure to the inner corner of the eye (at the bridge of the nose) for about 30 seconds (this is called nasolacrimal occlusion). This prevents the medication from dripping down through the tear duct and entering the bloodstream, which could cause you to experience some side effects.
7. Repeat with the other eye, if prescribed by your physician.
8. Wash your hands again to remove any medication.

Do not allow the dropper tip of the bottle to touch the eye or the area around your eye. This can contaminate the tip with common bacteria known to cause eye infections. Serious damage to the eye may result if you use eye drop solutions that have become contaminated.

If you wear contact lenses, remove them before using brimonidine eye drops. You may put your contact lenses back in 15 minutes after using the medication.

It is important to take this medication exactly as prescribed by your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children. Any solution remaining in the bottle should be discarded no more than 4 months (121 days) after opening.

Do not take this medication if you:

• are allergic to brimonidine or any ingredients of the medication
• are taking medications in the class of monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, selegiline, rasagiline, tranylcypromine)

Do not give this medication to infants and children under 2 years of age.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• dry eyes
• eye irritation
• eye pain
• eye redness
• feeling of something in the eye
• headache
• sensitivity to light

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• dizziness or lightheadedness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Contact lenses: The preservative in brimonidine eye drops, benzalkonium chloride, can be absorbed onto soft contact lenses. People who wear contact lenses should remove the lenses before using the eye drops and wait at least 15 minutes before reinserting them.

Heart disease: This medication has not been studied for use by people with heart disease. If you have heart problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if brimonidine passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

There may be an interaction between brimonidine and any of the following:

• alcohol
• alpha agonists (e.g., clonidine, methyldopa)
• antihistamines (e.g., azelastine, cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine, rupatadine)
• antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• barbiturates (e.g., butalbital, phenobarbital)
• benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
• beta-adrenergic blockers (e.g., atenolol, carvedilol, propranolol, sotalol)
• buprenorphine
• cannabis
• chloral hydrate
• decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
• dimenhydrinate
• diphenoxylate
• efavirenz
• entacapone
• esketamine
• kava kava
• lemborexant
• linezolid
• meclizine
• methadone
• metoclopramide
• mirtazapine
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, rasagiline, selegiline, tranylcypromine)
• muscle relaxants (e.g., baclofen, cyclobenzaprine, methocarbamol, orphenadrine)
• nabilone
• narcotic pain relievers (e.g., codeine, fentanyl, hydromorphone, morphine, oxycodone, tapentadol, tramadol)
• pizotifen
• pomalidomide
• pramipexole
• pregabalin
• prochlorperazine
• ropinirole
• rotigotine
• scopolamine
• seizure medications (e.g., carbamazepine, gabapentin, levetiracetam, phenytoin, rufinamide, topiramate)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
• tetrabenazine
• tizanidine
• trazodone
• valerian
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• zolpidem
• zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.