Brimonidine

The Basics

What is Brimonidine?

Used to lower pressure in the eyes in patients who have glaucoma and ocular hypertension.

Brand names for Brimonidine

Alphagan-P

How Brimonidine is classified

Adrenergic alpha-2 Receptor Agonists, Antiglaucoma Agents

Brimonidine During Pregnancy

Brimonidine pregnancy category

Category BNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Brimonidine while pregnant

Brimonidine tartrate was not teratogenic when given orally during gestation days 6 through 15 in rats and days 6 through 18 in rabbits. The highest doses of brimonidine tartrate in rats (2.5 mg/kg/day) and rabbits (5.0 mg/kg/day) achieved AUC exposure values 360- and 20-fold higher, or 260- and 15-fold higher, respectively, than similar values estimated in humans treated with ALPHAGAN® P (brimonidine tartrate) 0.1% or 0.15%, 1 drop in both eyes three times daily. There are no adequate and well-controlled studies in pregnant women; however, in animal studies, brimonidine crossed the placenta and entered into the fetal circulation to a limited extent. Because animal reproduction studies are not always predictive of human response, ALPHAGAN® P (brimonidine tartrate) should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.

Taking Brimonidine While Breastfeeding

What are recommendations for lactation if you're taking Brimonidine?

Limited information indicates that maternal use of brimonidine 0.2% ophthalmic drops do not adversely affect their nursing infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue. Topical brimonidine gel used to treat rosacea has not been studied during breastfeeding. It is unlikely that the topical gel would affect the breastfed infant, but the manufacturer states that it should not be used during nursing. Until more data are available, an alternative topical agent might be preferred

Maternal / infant drug levels

Limited information indicates that maternal use of brimonidine 0.2% ophthalmic drops do not adversely affect their nursing infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue. Topical brimonidine gel used to treat rosacea has not been studied during breastfeeding. It is unlikely that the topical gel would affect the breastfed infant, but the manufacturer states that it should not be used during nursing. Until more data are available, an alternative topical agent might be preferred

Possible effects of Brimonidine on milk supply

Relevant published information was not found as of the revision date.

Possible alternatives to Brimonidine

(Topical for Rosacea) Azelaic Acid; Metronidazole.