Brinzolamide-Brimonidine

Brinzolamide-Brimonidine is a combination medication used for reduction of elevated intraocular pressure in people with primary open-angle glaucoma.

• Brinzolamide-Brimonidine is available under the following different brand names: Simbrinza

Common side effects of Brinzolamide-Brimonidine include:

• blurred vision,
• eye irritation,
• bad taste in the mouth,
• dry mouth,
• drowsiness,
• watery eyes,
• itchy eyes,
• red eyes, and
• allergic reaction

Serious side effects of Brinzolamide-Brimonidine include:

• fast or pounding heartbeat,
• eye or eyelid pain, burning, or swelling,
• extreme sensitivity to light,
• vision changes,
• fainting,
• slow or irregular heartbeat,
• rash,
• itching,
• swelling of the face, tongue, or throat,
• severe dizziness, and
• trouble breathing

Rare side effects of Brinzolamide-Brimonidine include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out. 

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Ophthalmic suspension

• 1%/0.2%

Glaucoma

Adult dosage

• Instill 1 drop in affected eye(s) thrice daily

Pediatric dosage

• Aged below 2 years: Safety and efficacy not established
• Aged above 2 years: Instill 1 drop in the affected eye(s) thrice daily

Ocular Hypertension

Adult dosage

• Instill 1 drop in affected eye(s) thrice daily

Pediatric dosage

• Aged below 2 years: Safety and efficacy not established
• Aged above 2 years: Instill 1 drop in the  affected eye(s) thrice daily

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Brinzolamide-Brimonidine has severe interactions with the following drugs:
  • isocarboxazid
  • linezolid
  • phenelzine
  • procarbazine
  • rasagiline
  • selegiline
  • selegiline transdermal
  • tranylcypromine
• Brinzolamide-Brimonidine has serious interactions with no other drugs.
• Brinzolamide-Brimonidine has moderate interactions with at least 29 other drugs.
• Brinzolamide-Brimonidine has minor interactions with at least 150 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity
• Neonates and infants (younger than 2 yr)

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Brinzolamide-Brimonidine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Brinzolamide-Brimonidine?”

Cautions

• Contains brinzolamide, a sulfonamide; caution with a history of sulfonamide allergy
• Carbonic anhydrase activity is observed in both the cytoplasm and around the plasma membranes of the corneal endothelium, and therefore there is an increased potential for developing corneal edema in patients with low endothelial cell counts
• Brinzolamide and its metabolite are excreted predominantly by the kidney and are not recommended in patients with severe renal impairment
• Not studied in patients with acute angle-closure glaucoma
• Contains benzalkonium chloride (preservative); remove contact lenses during instillation to avoid absorption by soft lenses (may reinsert 15 minutes after instillation)
• Brimonidine elicits below 5% mean decrease in blood pressure 2 hr after instillation; caution with severe cardiovascular disease
• Not studied with severe hepatic impairment
• Brimonidine may potentiate syndromes associated with vascular insufficiency (eg, depression, cerebral or coronary insufficiency, Raynaud’s phenomenon, orthostatic hypotension, thromboangiitis obliterans)
• Bacterial keratitis reported from inadvertent contamination of multiple-dose containers of topical ophthalmics

Pregnancy and Lactation

• Use with caution if benefits outweigh risks during pregnancy
• Lactation
  • Unknown whether distributed in human breast milk; do not breastfeed