Brimonidine eye drops for glaucoma

Brimonidine eye drops are used to reduce increased eye pressure.

If you normally wear soft contact lenses, please let your doctor know.

Remember to use the drops regularly, twice a day.

Type of medicine Alpha-agonist eye drops
Used for To reduce raised eye pressure
Also called

Alphagan®
Combigan® (brimonidine with timolol)

Available as Eye drops

A raised 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 eye drops such as brimonidine 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 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 a beta-blocker called timolol (which also helps to reduce the amount of fluid your eye makes).

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

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have a heart or blood vessel disorder.
  • If you have circulation problems (particularly if you have Raynaud's syndrome).
  • If you feel dizzy when you sit up or stand up quickly.
  • If you have depression.
  • If you have liver or kidney problems.
  • 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 before you use the drops.
  2. Remove the cap.
  3. Tilt your head back a little and pull the lower lid of your eye out 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 these eye drops, read the manufacturer's printed information leaflet from the pack. The leaflet will give you more information about the eye drops and a full list of possible side-effects from using them.
  • Use one drop into the eye (or eyes) affected twice a day, 12 hours apart. Your dose will also be on the label of your 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 using the other drops.
  • When first put in, eye drops may sometimes cause blurred vision. If this happens it should quickly clear, but make sure you can see clearly 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 so that your progress can be checked.
  • If you are having an operation or any medical treatment, remember to tell the person carrying out the treatment that you are using these eye drops.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Side-effects of brimonidine eye drops - some of these can be very common affecting more than 1 in 10 people who use them What can I do if I experience this?
Dry eye, blurred vision, eye redness, stinging and irritation, sensitivity to light These 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, drowsy or dizzy If this happens, do not drive or use tools or machines until the feeling passes
Headache Ask your pharmacist to recommend a suitable painkiller. If the headache continues, speak with your doctor
Dry mouth Try chewing sugar-free gum, or sucking sugar-free sweets
Cold-like symptoms, stomach upset, unusual taste If any of these become troublesome, speak with your doctor
  • Eye drops can be used for four weeks once the bottle has been opened. After this time use a new bottle, even if there is still some solution remaining.
  • 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 other 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 September 2010.
  • British National Formulary; 64th Edition (Sep 2012) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Original Author: Helen Allen Current Version: Peer Reviewer: Dr John Cox
Last Checked: 31/10/2012 Document ID: 3772  Version: 24 © EMIS

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.