Alphagan: Advanced Ocular Hypotensive Therapy for Glaucoma Management
| Product dosage: 5ml | |||
|---|---|---|---|
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| 2 | $32.62 | $65.25 (0%) | 🛒 Add to cart |
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| 10 | $28.31
Best per bottle | $326.24 $283.08 (13%) | 🛒 Add to cart |
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 critical component in the therapeutic arsenal against optic nerve damage, working through both reduced aqueous humor production and enhanced uveoscleral outflow. Its well-established efficacy profile and favorable safety characteristics make it a first-line option for many ophthalmologists managing chronic IOP elevation. Clinical studies consistently demonstrate its capacity to significantly lower IOP levels, thereby helping to preserve visual field integrity over the long term.
Features
- Contains brimonidine tartrate 0.1%, 0.15%, or 0.2% as active ingredient
- Available in preserved and preservative-free formulations
- Clear, isotonic ophthalmic solution with pH optimized for ocular comfort
- Multi-dose bottle with controlled dropper tip for accurate administration
- Demonstrated IOP-lowering effect lasting up to 12 hours post-instillation
- Compatible with many other topical ocular hypotensive agents
Benefits
- Effectively reduces intraocular pressure by approximately 20-27% from baseline
- Provides dual mechanism of action: decreases aqueous production and increases uveoscleral outflow
- Offers neuroprotective properties that may help preserve retinal ganglion cells
- Generally well-tolerated with minimal systemic absorption when used properly
- Flexible dosing options allow for individualized treatment regimens
- Preservative-free formulation available for patients with benzalkonium chloride sensitivity
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 employed as monotherapy in newly diagnosed cases or as adjunctive therapy when additional IOP reduction is required beyond what is achieved with primary medications such as prostaglandin analogs or beta-blockers. The medication may also be used pre- and post-operatively in certain ocular surgeries to manage IOP spikes. Off-label uses include treatment of ocular redness and as a preventive measure against intraocular pressure elevation following laser 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, instill one drop into the conjunctival sac, and close the eye gently for 1-2 minutes while applying light pressure to the nasolacrimal duct to minimize systemic absorption. Avoid touching the dropper tip to any surface to prevent contamination. If using other topical ophthalmic medications, administer them at least 5 minutes apart.
Precautions
Patients should be advised that Alphagan may cause drowsiness, dizziness, or blurred vision, which could impair their ability to drive or operate machinery. Use with caution in patients with cardiovascular disease, cerebral or coronary insufficiency, Raynaud’s phenomenon, orthostatic hypotension, or thromboangiitis obliterans. Monitor patients with depression carefully as alpha-2 agonists may exacerbate symptoms. Ocular considerations include careful monitoring for allergic reactions, particularly with long-term use. Contact lenses should be removed before instillation and may be reinserted 15 minutes after administration.
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 children under 2 years of age due to the risk of severe central nervous system depression, apnea, and bradycardia. Use in neonates is absolutely contraindicated. Caution is advised in patients with severe cardiovascular disease, and it is generally not recommended in those with uncontrolled hypertension or hypotension.
Possible side effects
The most common ocular adverse reactions include allergic conjunctivitis (approximately 10-15% of patients after 3 months), conjunctival hyperemia (15-30%), burning or stinging upon instillation (5-15%), blurred vision (5-10%), foreign body sensation (5-10%), and dry mouth (10-20%). Less frequent ocular effects include ocular itching, conjunctival folliculosis, corneal erosion, and photophobia. Systemic side effects may include fatigue/drowsiness (5-15%), headache (5-10%), dizziness (5-10%), and nasal dryness. Serious but rare adverse effects include hypotension, bradycardia, syncope, and apnea.
Drug interaction
Concomitant use with central nervous system depressants (alcohol, barbiturates, opiates, sedatives, or anxiolytics) may potentiate sedation effects. Caution is advised when 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. MAO inhibitors are absolutely contraindicated. Use with other topical ophthalmic medications requires appropriate dosing intervals to avoid washout effects.
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. Patients should not double the dose to make up for a missed administration. Consistent adherence to the prescribed regimen is important for maintaining stable intraocular pressure control.
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, dizziness, sedation, respiratory depression, and apnea. In case of suspected overdose, provide supportive care including monitoring of vital signs. Symptomatic treatment may include intravenous fluids for hypotension and atropine for bradycardia. Hemodialysis is unlikely to be effective due to brimonidine’s protein binding characteristics.
Storage
Store at controlled room temperature between 15-25°C (59-77°F). Protect from light and excessive heat. Do not freeze. Keep the bottle tightly closed when not in use. Discard the bottle 28 days after opening, even if medication remains, to prevent contamination and degradation. 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 results may vary, and not all patients will experience the same therapeutic effects or side effects. Always follow your ophthalmologist’s instructions regarding use, and report any adverse reactions promptly. This information is not exhaustive; consult the full prescribing information for complete details.
Reviews
Clinical studies consistently demonstrate Alphagan’s efficacy, with one multicenter trial showing mean IOP reduction of 26% from baseline at peak effect (2 hours post-dose) and 21% at trough (8 hours post-dose). In comparative studies, Alphagan 0.2% demonstrated similar efficacy to timolol 0.5% with better preservation of ocular perfusion. Long-term extension studies indicate maintained efficacy over 12 months of treatment, though approximately 13% of patients developed allergic reactions requiring discontinuation. Patient satisfaction surveys note high acceptability, with most users reporting minimal interference with daily activities despite the t.i.d. dosing schedule.