Alphagan 2 mg/mL eye drops, solution – brimonidine for open-angle glaucoma and ocular hypertension

Alphagan is an eye drop containing brimonidine tartrate, a medicine from the group of alpha-2 adrenergic receptor agonists that lowers raised pressure inside the eye. In Serbia it is authorised as a 2 mg/mL solution in a 5 mL dropper bottle.

According to the official leaflet, Alphagan is used to lower raised eye pressure in patients with open-angle glaucoma or ocular hypertension – alone when beta-blocker eye drops are contraindicated, or with other eye drops when one medicine is not enough.

What is Alphagan (brimonidine) used for and how are the drops applied correctly?

Key facts about the medicine

What is Alphagan used for?

According to the official leaflet, Alphagan is used to lower raised pressure in the eye in patients with:

• open-angle glaucoma;
• ocular hypertension.

It can be used alone when beta-blocker eye drops are contraindicated, or together with other eye drops when one medicine is not enough to lower raised eye pressure.

How is it used and dosed?

• Adults: one drop twice daily into the affected eye(s), about 12 hours apart.
• The drops are for use in the eye only; wash your hands before use.
• If you also use other eye drops, wait 5–15 minutes between different drops.
• Do not change the dose or stop using the drops before talking to your doctor.

How to apply: tilt your head back and look up, gently pull the lower eyelid down, instil one drop, close the eye and press the inner corner of the eye (next to the nose) with a finger for about 1 minute. The tip of the bottle must not touch the eye or any surface; close the bottle tightly after use.

Special patient groups

• Newborns and children under 2 years: the medicine must not be used.
• Children aged 2 to 12 years: use is not recommended.
• Adolescents aged 12 to 17 years: the medicine should usually not be used, as no clinical studies have been carried out.
• Kidney or liver impairment: talk to your doctor before use.

Contraindications – when the medicine must not be used

• allergy to brimonidine tartrate or any of the excipients;
• concomitant use of monoamine oxidase (MAO) inhibitors or certain other antidepressants;
• breastfeeding;
• newborns and children under 2 years.

Precautions and warnings

• Depression, reduced mental capacity, reduced blood supply to the brain, heart problems, poor circulation in the limbs or blood pressure disorders – tell your doctor before use.
• Kidney or liver problems – medical advice is needed.
• The medicine contains benzalkonium chloride (0.05 mg/mL), which can be absorbed by soft contact lenses and discolour them: remove lenses before applying and wait at least 15 minutes before putting them back.
• Benzalkonium chloride may cause eye irritation, especially with dry eyes or disorders of the cornea.

Interactions with other medicines, food and drink

Tell your doctor or pharmacist if you take:

• painkillers, sedatives, opiates, barbiturates, or if you drink alcohol daily;
• anaesthetics;
• medicines for the heart or for lowering blood pressure;
• chlorpromazine, methylphenidate or reserpine;
• isoprenaline or prazosin (they act on the same receptors);
• MAO inhibitors and other antidepressants.

Also tell your doctor when the dose of a medicine you already take is changed, as this may affect treatment with Alphagan.

Pregnancy and breastfeeding

Do not use Alphagan during pregnancy unless your doctor considers it necessary. The medicine should not be used while breastfeeding.

Driving and using machines

Alphagan may cause blurred or abnormal vision, more pronounced at night or in poor light, as well as drowsiness or tiredness. If these symptoms occur, do not drive or use machines until they have passed.

Possible side effects

• Eyes – very common: eye irritation (redness, burning, stinging, foreign-body sensation, itching, blisters or white spots on the surface of the eye), blurred vision, allergic reaction in the eye.
• Eyes – common: inflammation and swelling of the eyelids, watery or sticky eyes, sensitivity to light, dry eyes, visual disturbance.
• Other – very common: headache, dry mouth, tiredness/drowsiness.
• Other – common: dizziness, cold-like symptoms, digestive complaints, taste disturbance, general weakness.
• Uncommon: depression, palpitations, fast or slow heartbeat, dry nasal lining, general allergic reactions. Rare: shortness of breath. Very rare: insomnia, brief loss of consciousness, high or low blood pressure.

Report any suspected side effect to your doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• If you have used too many drops or the medicine was swallowed by accident, contact a doctor immediately. In adults who swallowed the medicine, blood pressure dropped and then rose; in children drowsiness, floppiness, low body temperature, paleness and breathing difficulties were reported.
• Missed dose: apply it as soon as you remember; if the next dose is nearly due, skip the missed one. Do not use a double dose.
• Stopping: the medicine must be used every day to work – do not stop until your doctor tells you to.

Related information

• Artificial tears – when to use them and which are the best?

Composition, packaging and manufacturer

• Active substance: brimonidine tartrate, 2.0 mg per 1 mL (equivalent to 1.3 mg brimonidine).
• Excipients: benzalkonium chloride (preservative), polyvinyl alcohol, sodium chloride, sodium citrate dihydrate, citric acid monohydrate, sodium hydroxide or hydrochloric acid (for pH adjustment), purified water.
• Appearance: clear, greenish-yellow to light greenish-yellow solution.
• Pack: opaque white dropper bottle with cap, 5 mL.
• Marketing authorisation holder: ABBVIE D.O.O. BEOGRAD, Bulevar Mihaila Pupina 115E, Belgrade – Novi Beograd.
• Manufacturer: ALLERGAN PHARMACEUTICALS IRELAND UNLIMITED COMPANY, Castlebar Road, Westport, Ireland.

Storage

• Store below 25 °C.
• Discard the bottle 28 days after opening, even if solution remains.
• Do not use the bottle if the tamper-evident seal is broken before first use.
• Keep out of the sight and reach of children.

Frequently asked questions

How many times a day is Alphagan applied?

One drop into the affected eye twice daily, about 12 hours apart.

Can I wear contact lenses?

Remove soft lenses before applying and put them back after at least 15 minutes, because the preservative benzalkonium chloride can discolour lenses.

Can Alphagan be combined with other glaucoma drops?

Yes, if your doctor prescribes it – wait 5–15 minutes between different drops.

Why is Alphagan dangerous for young children?

Children who accidentally swallowed the drops experienced drowsiness, floppiness, low temperature and breathing difficulties, and the medicine must not be used in children under 2 years.

Sources

• ALIMS – Package leaflet Alphagan®, 2 mg/mL, eye drops, solution (October 2025, in Serbian)
• ALIMS – Summary of Product Characteristics Alphagan®, 2 mg/mL, eye drops, solution (in Serbian)

Date sources were checked: 24.10.2026.