Alphagan: Effective IOP Reduction for Glaucoma Management
| Product dosage: 5ml | |||
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| 10 | $24.25
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Synonyms | |||
Alphagan (brimonidine tartrate ophthalmic solution) is a topical alpha-2 adrenergic agonist specifically formulated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. As a well-established therapeutic agent, it offers a targeted mechanism of action that decreases aqueous humor production and increases uveoscleral outflow. This prescription medication represents a critical tool in the ophthalmologist’s arsenal for managing progressive optic nerve damage, with clinical studies demonstrating consistent efficacy in maintaining pressure control throughout waking hours. Its neuroprotective properties and favorable safety profile make it suitable for both monotherapy and combination treatment regimens.
Features
- Contains brimonidine tartrate 0.1%, 0.15%, or 0.2% as active pharmaceutical ingredient
- Preservative-free formulations available for sensitive patients
- pH-balanced solution optimized for ocular comfort and corneal health
- Sterile, isotonic ophthalmic solution in multi-dose dispensers
- Demonstrated 20-27% reduction in intraocular pressure from baseline
- Twelve-hour duration of action with b.i.d. dosing regimen
Benefits
- Provides consistent 24-hour IOP control with twice-daily administration
- Reduces risk of glaucomatous optic nerve damage and visual field progression
- Offers potential neuroprotective effects beyond pressure reduction
- Maintains stable ocular perfusion pressure throughout daily activities
- Compatible with most other topical glaucoma medications for combination therapy
- Minimal impact on cardiovascular and pulmonary parameters in most patients
Common use
Alphagan is primarily indicated for the chronic management of elevated intraocular pressure in patients diagnosed with open-angle glaucoma or ocular hypertension. It is frequently prescribed as first-line therapy for patients requiring moderate IOP reduction or for those intolerant to beta-blockers. Ophthalmologists may also utilize Alphagan as adjunctive therapy when monotherapy provides insufficient pressure control, particularly in combination with prostaglandin analogs or carbonic anhydrase inhibitors. The medication finds additional application in preventing postoperative IOP spikes following laser trabeculoplasty or other anterior segment procedures.
Dosage and direction
The recommended dosage is one drop in the affected eye(s) three times daily, approximately 8 hours apart. Patients should wash hands thoroughly before administration. To administer, tilt the head backward, pull down the lower eyelid to form a pouch, and instill one drop into the conjunctival sac. Avoid contact between the dropper tip and any surface to prevent contamination. Close eyes gently for 1-2 minutes after instillation and apply gentle pressure to the lacrimal sac at the nasal corner of the eye for about one minute to minimize systemic absorption. If using other topical ophthalmic medications, allow at least 5 minutes between applications.
Precautions
Patients should be advised that Alphagan may cause drowsiness, dizziness, or blurred vision that could impair physical coordination and mental alertness. Caution should be exercised when driving, operating machinery, or performing hazardous activities until the patient’s response to the medication is established. Contact lenses should be removed prior to administration and may be reinserted 15 minutes after instillation. The preservative benzalkonium chloride may be absorbed by soft contact lenses and cause ocular irritation. Regular monitoring of IOP, visual fields, and optic nerve head appearance is essential throughout treatment.
Contraindications
Alphagan is contraindicated in patients with known hypersensitivity to brimonidine tartrate or any component of the formulation. It should not be used in patients receiving monoamine oxidase inhibitor (MAOI) therapy. The medication is contraindicated in infants and children under 2 years of age due to the risk of severe central nervous system depression, apnea, and bradycardia. Caution is warranted in patients with severe cardiovascular disease, cerebral or coronary insufficiency, Raynaud’s phenomenon, orthostatic hypotension, or thromboangiitis obliterans.
Possible side effects
The most frequently reported ocular adverse reactions include allergic conjunctivitis (approximately 15% of patients), conjunctival hyperemia (10-15%), ocular burning and stinging (10-20%), blurred vision (5-10%), foreign body sensation (5-10%), and conjunctival folliculosis (5-15%). Systemic side effects may include oral dryness (10-20%), fatigue and drowsiness (5-15%), headache (5-10%), and dizziness (5-10%). Less common but potentially serious reactions include bradycardia, hypotension, syncope, and respiratory depression. Allergic reactions may manifest as eyelid erythema, ocular pruritus, or periorbital dermatitis.
Drug interaction
Concomitant use with central nervous system depressants (alcohol, barbiturates, opiates, sedatives, or anxiolytics) may potentiate sedation and dizziness. Caution is advised when co-administering with antihypertensive agents or cardiac glycosides due to potential additive effects on blood pressure and heart rate. Tricyclic antidepressants may reduce the IOP-lowering effect of Alphagan. The concomitant use with other topical ophthalmic medications requires appropriate dosing intervals to prevent washout and ensure optimal efficacy.
Missed dose
If a dose is missed, it should be administered as soon as possible. However, if it is nearly time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not instill double doses to make up for a missed administration. Consistent adherence to the prescribed dosing regimen is crucial for maintaining stable intraocular pressure control and preventing disease progression.
Overdose
Ocular overdose may be flushed from the eye(s) with warm tap water. Systemic absorption following ocular administration is generally limited, but excessive use may lead to symptoms including hypotension, bradycardia, hypothermia, apnea, sedation, lethargy, and coma. In case of suspected overdose, symptomatic and supportive therapy should be instituted. Cardiovascular parameters should be monitored closely, and atropine may be administered for severe bradycardia. Hemodialysis is unlikely to be beneficial due to brimonidine’s extensive tissue distribution.
Storage
Store at controlled room temperature between 15°-25°C (59°-77°F). Protect from light and excessive heat. Keep the container tightly closed when not in use. Do not freeze the solution. Discard the bottle 28 days after opening to prevent microbial contamination. Keep out of reach of children and pets. Do not use if the solution changes color or becomes cloudy.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Alphagan is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual response to therapy may vary, and patients should follow their ophthalmologist’s specific instructions regarding use, monitoring, and follow-up care. The complete prescribing information should be consulted before initiating treatment.
Reviews
Clinical studies demonstrate that Alphagan maintains efficacy in IOP reduction over long-term treatment, with 70-80% of patients achieving target pressure goals. Ophthalmologists report particular satisfaction with its neuroprotective properties and compatibility with other glaucoma medications. Patients appreciate the convenient twice-daily dosing schedule, though some note ocular allergy development after extended use. The 0.15% formulation shows improved tolerability while maintaining therapeutic efficacy compared to higher concentrations. Real-world evidence supports its position as a valuable option in the glaucoma treatment algorithm, especially for patients requiring additional IOP reduction beyond first-line therapies.