Alphagan: Advanced Ocular Hypotensive Therapy for Glaucoma Management
| Product dosage: 5ml | |||
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| 10 | $28.32
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Synonyms | |||
Alphagan (brimonidine tartrate ophthalmic solution) is a topically administered 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 prescription medication, it represents a cornerstone in the therapeutic arsenal against progressive optic nerve damage, offering both efficacy and a favorable safety profile. Its mechanism of action involves dual pathways—reducing aqueous humor production and enhancing uveoscleral outflow—making it particularly valuable for patients requiring sustained IOP control. Clinical evidence supports its use as both monotherapy and in combination regimens, with demonstrated neuroprotective properties that extend beyond pressure-lowering effects to potentially preserve visual function.
Features
- Contains brimonidine tartrate 0.1%, 0.15%, or 0.2% as active ingredient
- Preservative-free formulations available for sensitive patients
- pH-balanced solution compatible with ocular surface physiology
- Multiple concentration options allowing for personalized treatment titration
- Compatible with most common topical glaucoma medications
- Demonstrated 24-hour IOP control with twice-daily dosing
- Established clinical efficacy across diverse patient populations
Benefits
- Effectively lowers intraocular pressure by 20-30% from baseline measurements
- Provides consistent 24-hour pressure control with twice-daily administration
- Offers potential neuroprotective benefits beyond IOP reduction
- Demonstrates excellent safety profile with minimal systemic absorption
- Available in preservative-free formulations reducing ocular surface toxicity
- Compatible with most other glaucoma medications for combination therapy
- Suitable for long-term management of chronic ocular hypertension
Common use
Alphagan is primarily indicated for the lowering of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension. It is frequently prescribed as first-line therapy for newly diagnosed patients or as adjunctive treatment when monotherapy provides insufficient IOP control. The medication is particularly valuable for patients who cannot tolerate beta-blockers due to pulmonary or cardiovascular contraindications. Ophthalmologists may also consider Alphagan for patients exhibiting progressive visual field loss despite adequate pressure control, given its potential neuroprotective properties. The solution is appropriate for long-term management, with many patients remaining on therapy for years with maintained efficacy.
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 touching the dropper tip to any surface to prevent contamination. If using other ophthalmic medications, wait at least 5 minutes between applications. Contact lenses should be removed before instillation and may be reinserted 15 minutes post-application. Dosage adjustments may be necessary based on individual patient response and tolerance, particularly when used in combination therapy regimens.
Precautions
Patients should be advised that Alphagan may cause drowsiness or fatigue in some individuals, potentially affecting the ability to drive or operate machinery. Ocular hyperemia, allergic reactions, and dry mouth may occur during treatment. The medication should be used with caution in patients with cardiovascular disease, particularly those with hypotension or bradycardia. Hepatic or renal impairment may affect drug metabolism and elimination. Pediatric patients may experience more pronounced systemic effects. Contact lens wearers should exercise caution as preservatives may be absorbed by soft lenses. Patients should report any ocular irritation, visual changes, or systemic symptoms promptly to their healthcare provider.
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 (MAO) inhibitor therapy. The medication is contraindicated in infants and neonates due to the risk of severe central nervous system depression. Patients with uncontrolled hypotension or severe cardiovascular instability should avoid use. Those with a history of orthostatic hypotension may require alternative therapies. The preservative-containing formulation is contraindicated in patients with known benzalkonium chloride sensitivity who cannot use preservative-free alternatives.
Possible side effect
Common ocular side effects include conjunctival hyperemia (15-30%), allergic conjunctivitis (10-15%), burning or stinging upon instillation (5-10%), blurred vision (5-8%), and foreign body sensation (5-7%). Systemic effects may include oral dryness (10-20%), fatigue (5-15%), drowsiness (5-10%), and headache (5-8%). Less frequently reported are dizziness, ocular pruritus, corneal erosion, and photophobia. Serious but rare adverse effects include bradycardia, hypotension, syncope, and respiratory depression. Allergic reactions may manifest as eyelid edema, conjunctival folliculosis, or contact dermatitis. Most side effects are mild to moderate and often diminish with continued therapy.
Drug interaction
Alphagan may potentiate the effects of CNS depressants including alcohol, barbiturates, opiates, and sedatives. Concurrent use with antihypertensive agents may result in additive hypotensive effects. Tricyclic antidepressants may diminish the intraocular pressure-lowering effect of brimonidine. MAO inhibitors are absolutely contraindicated due to risk of hypertensive crisis. Beta-blockers, when used concomitantly, may enhance cardiovascular effects. Caution is advised with concomitant use of digoxin or other cardiac glycosides. Topical nonsteroidal anti-inflammatory drugs may reduce the efficacy of Alphagan. Always inform healthcare providers of all medications being taken, including over-the-counter products.
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, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed administration. Maintaining a consistent dosing schedule is important for optimal intraocular pressure control. Patients may benefit from setting reminders or associating dosing with routine daily activities. If multiple doses are missed, contact the prescribing physician for guidance on resuming therapy, as temporary IOP elevation may occur.
Overdose
Ocular overdose may result in increased local adverse effects including conjunctival hyperemia, lacrimation, and visual disturbance. Systemic overdose, while rare due to limited absorption, may manifest as hypotension, bradycardia, hypothermia, respiratory depression, and sedation. In case of accidental ingestion, seek immediate medical attention. Treatment is supportive and symptomatic. Activated charcoal may be administered if ingestion occurred within previous 1-2 hours. Cardiovascular monitoring is recommended for significant systemic exposure. Hemodialysis is unlikely to be effective due to high protein binding. Ocular irrigation with warm saline may be considered for topical overdose.
Storage
Store at controlled room temperature between 15-30°C (59-86°F). Protect from light and excessive heat. Do not freeze. Keep the bottle tightly closed when not in use. Discard any unused solution 28 days after opening the bottle, even if medication remains. Do not use if solution changes color or becomes cloudy. Keep out of reach of children and pets. Do not transfer the solution to any other container. Store upright to prevent leakage and contamination. Avoid storage in humid environments such as bathrooms.
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 results may vary. Not all side effects or interactions are listed here. Patients should consult their ophthalmologist or healthcare provider for personalized medical advice, diagnosis, and treatment. The manufacturer and distributors assume no liability for inaccuracies or omissions in this information.
Reviews
Clinical studies demonstrate Alphagan’s efficacy in reducing intraocular pressure by approximately 25-30% from baseline. In the Brimonidine Study Group trials, 60-70% of patients achieved target IOP reduction with twice-daily dosing. Long-term extension studies show maintained efficacy over 24 months of treatment. Patient satisfaction surveys indicate high tolerability, though approximately 10-15% of patients discontinue due to allergic reactions. Comparative studies show similar efficacy to timolol with better cardiovascular safety profile. Real-world evidence supports its value in combination therapy, particularly with prostaglandin analogues. The neuroprotective potential continues to be investigated in ongoing clinical research.