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Angeles Vision
Clinic
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Conditions page or Glaucoma
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ALPHAGAN
AND
ALPHAGAN P (.15%)
(Brimonidine)
HOW ALPHAGAN WORKS:
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:
ADVERSE REACTIONS:
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:
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.
ADVANTAGES:
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.
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