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Alphagan P – Brimonidine (Ophthalmic Route)


Description and Brand Names of Alphagan P – Brimonidine (Ophthalmic Route)

US Brand Name

  1. Alphagan P


Brimonidine ophthalmic (eye) drops is used alone or together with other medicines to treat increased pressure in the eye that is caused by open-angle glaucoma or a condition called hypertension of the eye (ocular hypertension). This medicine is an alpha-adrenergic agonist.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

  • Solution

Before Using Alphagan P – Brimonidine (Ophthalmic Route)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of brimonidine eye drops in children 2 years of age and older. Because of brimonidine’s toxicity, use in children younger than 2 years of age is not recommended.


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of brimonidine eye drops in the elderly.



There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Depression or
  • Heart attack, history of or
  • Heart disease or
  • Orthostatic hypotension (low blood pressure when standing up) or
  • Raynaud disease (blood vessel disease) or
  • Stroke, history of or
  • Thromboangiitis obliterans (blood vessel disease) – Use with caution. May make these conditions worse.

Proper Use of Alphagan P – Brimonidine (Ophthalmic Route)

Use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

If your doctor ordered two different eye drops to be used together, wait at least 5 minutes after you put the first medicine in your eye to use the second medicine. This will prevent the second medicine from “washing out†the first one.

To use the eye drops:

  • Wash your hands with soap and water before and after using this medicine.
  • Shake the eye drops well just before each use.
  • Tilt your head back and press your finger gently on the skin just beneath the lower eyelid. Pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 1 or 2 minutes to allow the medicine to be absorbed by the eye.
  • If you think you did not get the drop of medicine into your eye properly, repeat the directions with a second drop.
  • To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface, including the eye. Keep the container tightly closed when you are not using the drops.
  • If germs get in the bottle, your eye could become infected. Serious eye infections can cause blindness.
  • The eye drops will normally be a clear liquid with a greenish-yellow color. If the color changes or the liquid becomes cloudy, do not use the medicine. Get a new bottle from the pharmacy.


The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For ophthalmic dosage form (eye drops):

    • For glaucoma or ocular hypertension:

      • Adults, teenagers, and children 2 years of age and older – One drop in the affected eye 3 times a day, about 8 hours apart.
      • Children younger than 2 years of age – Use is not recommended.

Missed Dose

If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.


The eye doctor will want to examine your or your child’s eyes at regular visits to make sure the medicine is working properly and is not causing unwanted effects.

If itching, redness, swelling, or other signs of eye or eyelid irritation occur, stop using this medicine and check with your doctor. These symptoms may mean that you or your child are allergic to this medicine.

If you or your child have an eye injury or infection, or need to have eye surgery, talk with your doctor right away. You may need to change the medicine or stop using it.

This medicine may cause some people to become lightheaded, dizzy, drowsy, tired, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

This medicine may add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicines for allergies; sedatives or sleeping medicine; prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

Brimonidine may cause your eyes to become more sensitive to light than they are normally. Wearing sunglasses and avoiding too much exposure to bright light may help lessen the discomfort.

Side Effects of Alphagan P – Brimonidine (Ophthalmic Route)

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Blurred or loss of vision
  2. burning, dry, or itching eyes
  3. discharge or excessive tearing
  4. disturbed color perception
  5. double vision
  6. halos around lights
  7. headache
  8. itching of the eye
  9. night blindness
  10. overbright appearance of lights
  11. redness of the eye or inner lining of the eyelid
  12. swelling of the eyelid
  13. tearing of the eye
  14. tunnel vision

Less common

  1. Ache or pain in the eye
  2. blindness
  3. bloody eye
  4. blurred vision or other change in vision
  5. change in color vision
  6. confusion
  7. decreased vision
  8. difficult or labored breathing
  9. difficulty seeing at night
  10. dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  11. drainage from the eye
  12. fainting
  13. fast heartbeat
  14. feeling of something in the eye
  15. gradual blurring or loss of vision
  16. increased blood pressure
  17. increased sensitivity of the eye to light
  18. mental depression
  19. muscle pain
  20. nausea or vomiting
  21. oozing in the eye
  22. redness, swelling, or itching of the eye or eyelid
  23. runny or stuffy nose
  24. seeing flashes or sparks of light
  25. seeing floating dark spots or material before eyes
  26. seeing floating spots before the eyes or a veil or curtain appearing across part of vision
  27. shortness of breath
  28. skin rash
  29. sneezing
  30. sweating
  31. swelling of the eye
  32. tightness in the chest
  33. unusual tiredness or weakness
  34. watery eyes
  35. wheezing

Incidence not known

  1. Bluish lips or skin
  2. chest pain or discomfort
  3. confusion
  4. fast, pounding, or irregular heartbeat or pulse
  5. feeling of warmth or heat
  6. flushing or redness of the skin, especially on the face and neck
  7. irregular, fast, slow, or shallow breathing
  8. low body temperature
  9. muscle aches or weakness
  10. shivering
  11. slow or irregular heartbeat
  12. weak or feeble pulse
  13. weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  1. Burning, stinging, or tearing of the eye
  2. drowsiness or tiredness
  3. dryness of the mouth

Less common

  1. Acid or sour stomach
  2. anxiety
  3. bad, unusual, or unpleasant (after) taste
  4. belching
  5. body aches or pain
  6. change in taste
  7. chills
  8. congestion
  9. cough
  10. cough producing mucus
  11. crusting on eyelid or corner of eye
  12. diarrhea
  13. difficulty breathing
  14. discoloration of white part of the eye
  15. dryness of the eye
  16. dryness or soreness of the throat
  17. fever
  18. general feeling of discomfort or illness
  19. hoarseness
  20. indigestion
  21. joint pain
  22. lack or loss of strength
  23. large amounts of cholesterol in the blood
  24. lid disorder
  25. loss of appetite
  26. muscle aches and pains
  27. pain or tenderness around the eyes and cheekbones
  28. paleness of the eye or inner lining of the eyelid
  29. passing of gas
  30. pounding heartbeat
  31. rash
  32. shivering
  33. sleepiness or unusual drowsiness
  34. sleeplessness
  35. sneezing
  36. sore throat
  37. stomach discomfort, fullness, upset, or pain
  38. tender, swollen glands in the neck
  39. trouble with sleeping
  40. trouble with swallowing
  41. troubled breathing
  42. unable to sleep
  43. voice changes

Incidence not known

  1. Constricted, pinpoint, or small pupils (black part of the eye)
  2. redness of the skin
  3. sensitivity to light
  4. throbbing pain
  5. unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  6. unusual weak feeling
  7. unusually warm skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.