Brinzolamide + Brimonidine Tartrate

Brinzolamide 1% + Brimonidine Tartrate 0.2% Eye Prep is a combination medication used for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension. It contains Brinzolamide (a carbonic anhydrase inhibitor) and Brimonidine Tartrate (an alpha-2 adrenergic receptor agonist).

Brinzolamide inhibits carbonic anhydrase in the ciliary processes, decreasing aqueous humour secretion, presumably by slowing bicarbonate ion formation with subsequent reduction in sodium and fluid transport. Brimonidine Tartrate reduces aqueous humour production and increases uveoscleral outflow, lowering IOP. Brinzolamide has a peak ocular hypotensive effect at 2-3 hours, while Brimonidine peaks at 2 hours post-dosing.

• Open-angle glaucoma
• Ocular hypertension

Adults: Instill 1 drop in the affected eye(s) three times daily. Shake well before use.

Children (2 years and older): Instill 1 drop in the affected eye(s) 2-3 times daily.

Children under 2 years: Contraindicated.

Note: If more than one topical ophthalmic drug is being used, administer at least 5 minutes apart. Apply pressure on the corner of the eye (close to the nose) for about 1 minute after instillation (to reduce systemic absorption). Use within 1 month of opening.

Common (approximately 3-5% of patients): Blurred vision, eye irritation, dysgeusia (bad taste), dry mouth, eye allergy.

Brinzolamide-related (5-10%): Blurred vision, bitter/sour/unusual taste. (1-5%): Blepharitis, dermatitis, dry eye, foreign body sensation, headache, hyperemia, ocular discharge, ocular discomfort, keratitis, eye pain, pruritus, rhinitis.

Brimonidine-related (10-30%): Dry mouth, ocular hyperemia, burning and stinging, headache, blurred vision, foreign body sensation, fatigue/drowsiness, conjunctival follicles, ocular allergic reactions, ocular pruritus.

Avoid driving or operating machinery until you know how this medicine affects you.

• May cause blurred or abnormal vision after use (especially at night or in reduced lighting); do not drive or operate machinery until vision is clear.
• Apply pressure on the corner of the eye (close to the nose) for about 1 minute after instillation (to reduce systemic absorption and minimize drug transfer to breast milk).
• Use within 1 month of opening.
• Remove soft contact lenses before use and wait at least 15 minutes before reinserting.
• Brinzolamide is a sulfonamide; although administered topically, it is absorbed systemically. Serious sulfonamide-related reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia) may occur.
• Brimonidine may potentiate syndromes associated with vascular insufficiency (depression, cerebral/coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension, thromboangiitis obliterans); caution required.
• Not recommended in severe renal impairment.

• Hypersensitivity to brinzolamide, brimonidine tartrate, or any ingredient
• Neonates and infants (under 2 years of age)

• High-dose salicylate therapy: May cause toxicity.
• CNS depressants (alcohol, barbiturates, opiates, sedatives, anesthetics): Additive or potentiating effects (caution required).
• Antihypertensives, cardiac glycosides: Caution required.
• Tricyclic antidepressants (TCAs): May affect the metabolism and uptake of circulating amines.
• MAO inhibitors: Interactions may occur.
• Oral carbonic anhydrase inhibitors: Additive systemic effects.