Alphagan - Comprehensive Usage Guide: instructions, indications, composition, side effects

Active Ingredient: Brimonidine tartrate
Excipients: May include benzalkonium chloride, purified water, sodium chloride, and other inactive ingredients depending on the formulation.

Eye Drops: Available in various concentrations, including 0.1% and 0.15% brimonidine tartrate.

Alphagan belongs to the pharmacological group of alpha-2 adrenergic agonists (ATC code: S01EA05).

Pharmacodynamics: Brimonidine tartrate lowers intraocular pressure by reducing aqueous humor production and increasing uveoscleral outflow.

Pharmacokinetics: Following ocular administration, brimonidine is absorbed systemically, with peak plasma concentrations reached within 1 to 4 hours. It undergoes hepatic metabolism and is excreted mainly via urine.

Alphagan is indicated for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.

Alphagan is contraindicated in individuals with:

• Hypersensitivity to brimonidine tartrate or any component of the formulation.
• Severe cardiovascular disease (e.g., severe coronary insufficiency, cardiac failure, bradycardia).
• Severe renal impairment (creatinine clearance < 30 mL/min).

Brimonidine may interact with other medications, including:

• Monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, or other central nervous system depressants, potentially leading to additive effects on the central nervous system.
• Alpha-adrenergic agonists or sympathomimetic agents, increasing the risk of systemic side effects.

• Alphagan eye drops should be instilled into the affected eye(s) according to the prescribed dosage regimen.
• Shake the bottle well before each use and avoid touching the dropper tip to any surface to prevent contamination.
• Contact lenses should be removed before administration and may be reinserted after 15 minutes.

• Alphagan should be used during pregnancy only if the potential benefits outweigh the potential risks to the fetus.
• It is not recommended during breastfeeding due to limited data on its excretion into breast milk.

The recommended dosage is one drop of Alphagan in the affected eye(s) three times daily, approximately 8 hours apart.

In case of overdose, supportive measures should be initiated, and medical attention should be sought immediately. Symptoms of overdose may include systemic side effects such as hypotension, bradycardia, and central nervous system depression.

Common side effects of Alphagan may include:

• Ocular irritation (e.g., burning, stinging, itching)
• Conjunctival hyperemia (redness)
• Blurred vision
• Dry mouth
• Fatigue
• Headache

Less common but more severe adverse reactions may include:

• Allergic reactions (e.g., rash, itching, swelling)
• Conjunctival follicles
• Conjunctival hemorrhage
• Corneal erosion
• Corneal infiltrates
• Dizziness
• Dyspnea
• Eye discharge
• Eye pain
• Foreign body sensation
• Hypersensitivity reactions (e.g., bronchospasm, anaphylaxis)
• Photophobia
• Visual disturbances

If any of these side effects persist or worsen, patients should discontinue use and consult their healthcare provider promptly. Additionally, patients should seek medical attention if they experience any signs of systemic absorption, such as changes in heart rate, blood pressure, or mental status.