Alphagan P

Introduction

Written by Alex Brewer, PharmD, MBA
Medically reviewed by Dena Westphalen
Updated on July 19, 2023

Brimonidine (bri MOE ni deen) is a generic medication prescribed for lowering high blood pressure in the eye. It’s also prescribed for the skin condition rosacea. Brimonidine belongs to a group of drugs called alpha-agonists.

The Food and Drug Administration (FDA) has approved brimonidine to:

• lower high blood pressure in the eye in adults and some children
• treat facial redness or discoloration caused by rosacea in adults

These approved uses differ based on the form of brimonidine your doctor prescribes.

This article describes brimonidine’s uses, side effects, and more. You’ll also find some coupon options to help save on the cost of brimonidine.

Uses of brimonidine

The Food and Drug Administration (FDA) approves prescription drugs such as brimonidine for certain conditions. Approved uses for brimonidine are described below. These uses differ based on the form of brimonidine prescribed.

Use for eye problems

Doctors may prescribe brimonidine eye drops for treating high blood pressure in the eye. It’s used for this purpose in adults and children ages 2 years and older. It’s usually prescribed as a long-term treatment.

Specifically, brimonidine is prescribed for treating high blood pressure in the eye caused by either of the following conditions:

• Open-angle glaucoma. Open-angle glaucoma often doesn’t cause symptoms in the beginning. But over time, you may notice symptoms such as vision loss and swelling in your cornea (the clear covering of the front of your eye).
• Ocular hypertension. Ocular hypertension typically doesn’t cause noticeable symptoms. It’s usually found through an eye exam.

Use for rosacea

Doctors may prescribe brimonidine topical* gel for treating redness or discoloration on the face caused by rosacea. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

Rosacea is a skin condition that causes skin redness or discoloration. Other symptoms include raised bumps on your face and blushing easily.

Brimonidine topical gel should only be applied to the skin. Do not apply the gel to your eyes or lips.

* Topical means applied to the skin.

Side effects of brimonidine

Brimonidine may cause mild or serious side effects. More common mild side effects of brimonidine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about brimonidine’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for brimonidine listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of brimonidine are listed below. These side effects may differ based on the form of brimonidine you use.

This article doesn’t include all possible mild side effects of the drug. To learn more about brimonidine’s side effects based on the form, refer to the prescribing information for brimonidine listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Brimonidine eye drops’ mild side effects include:

• dry eyes
• red eyes
• burning or stinging in your eye after applying a drop
• headache
• mild allergic reaction*

Brimonidine topical† gel’s mild side effects include:

• skin redness or discoloration
• flushing (temporary warmth, redness, or deepening of skin color)
• burning sensation on the skin after applying brimonidine gel
• skin rash in areas where you apply brimonidine gel
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for brimonidine” section.
† Topical means applied to the skin.

Serious side effects

Serious side effects of brimonidine are listed below. These side effects may differ based on the form of brimonidine you use.

This article doesn’t include all possible serious side effects of the drug. To learn more about brimonidine’s side effects based on the form, refer to the prescribing information for brimonidine listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, brimonidine’s serious side effects include:

• irregular heart rhythm
• problems with blood circulation
• severe allergic reaction*

For brimonidine eye drops, the following serious side effects may also occur:

• serious eye-related side effects, including broken blood vessels in the eye and vision changes

* For details about this side effect, see the “Interactions and warnings for brimonidine” section.

Common questions about brimonidine

Below you’ll find answers to a few commonly asked questions about brimonidine.

How does brimonidine work? And how long does it take to start working?

Brimonidine is a type of drug called an alpha-agonist. Its mechanism of action (how the drug works) is as follows:

• To lower high blood pressure in the eye, brimonidine works by decreasing the amount of fluid made in your eye. It also increases the amount of fluid that drains from your eye.
• To treat facial redness or discoloration caused by rosacea, it’s thought that brimonidine works by narrowing blood vessels in your face.

If you’d like to know more about how brimonidine works, talk with your doctor or pharmacist.

What brand names are available for brimonidine?

Brimonidine is available as the following brand names:

• Mirvaso, a brand-name topical* gel
• Alphagan P, Qoliana, and Lumify, which are brand-name eye drops

If you’d like to know more about brand-name forms of brimonidine, talk with your pharmacist or doctor.

* Topical means applied to the skin.

Are brimonidine eye drops considered a beta-blocker?

No, brimonidine eye drops aren’t a beta-blocker. Brimonidine is a type of drug called an alpha-agonist. These are two different types of medications used to treat high blood pressure. They work in different ways.

However, doctors sometimes prescribe brimonidine with a beta-blocker. In fact, brimonidine and the beta-blocker drug timolol come as two medications in one eye drop. This combination is available as the brand-name drug Combigan, as well as generic brimonidine/timolol.

Talk with your doctor or pharmacist if you have more questions about using brimonidine with a beta-blocker.

Interactions and warnings for brimonidine

Below you’ll find information about brimonidine’s possible interactions and warnings.

Interactions of brimonidine

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take brimonidine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for brimonidine” section below.

Warnings for brimonidine

Some people should not use brimonidine, and others should use it cautiously.

Brimonidine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether brimonidine is a safe option for you. These warnings may differ based on the form of brimonidine you use.

Ask your doctor about specific warnings for brimonidine, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Brimonidine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to brimonidine or any of its ingredients, your doctor will likely not prescribe brimonidine. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to brimonidine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of brimonidine

If you use brimonidine, you should not use more brimonidine than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve used too much brimonidine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and brimonidine

Information about brimonidine and pregnancy and breastfeeding is described below.

Brimonidine and pregnancy

It’s not known whether brimonidine should be used during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before using this medication.

Brimonidine and breastfeeding

Brimonidine should not be used while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before using this medication. Your doctor may recommend other ways to feed your child during treatment with brimonidine.

What to ask your doctor

This article describes brimonidine’s uses and side effects, ways to save on cost, and more. Let your doctor know if you have questions about brimonidine or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• How does brimonidine compare with other drugs for treating my condition?
• If I can’t afford my prescription, what are my options?
• Does my health history raise my risk of side effects from brimonidine?
• How can I lower my risk of eye infections while using brimonidine eye drops?
• If I’m prescribed brimonidine gel, do I need to wait to apply moisturizer or other products to my skin after using brimonidine?

Resources

• Brimonidine- brimonidine gel. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/9f17bf0c-d880-4328-bf92-00ac81d02fd1/spl-doc
• Brimonidine tartrate – brimonidine tartrate solution/ drops. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/cdb8620f-adfa-4433-b285-9c42334f8600/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.