Brimonal 0.2% (2 mg/mL) eye drops – brimonidine for lowering raised eye pressure

Brimonal 0.2% are eye drops containing brimonidine tartrate (2 mg per 1 mL of solution). Brimonidine is an alpha-2 adrenergic receptor agonist that lowers the pressure inside the eye by reducing the production of aqueous humour and increasing its outflow.

The medicine is used to lower raised intraocular (eye) pressure in open-angle glaucoma and ocular hypertension – on its own when beta-blocker eye drops must not be used, or added to other drops when one medicine is not enough. In Serbia it is available on prescription only.

What are Brimonal 0.2% eye drops used for and how should they be applied?

Key facts about the medicine

What is Brimonal 0.2% used for?

Brimonal 0.2% is used to reduce raised intraocular pressure in patients with open-angle glaucoma or ocular hypertension:

• as monotherapy – in patients in whom beta-blocker eye drops are contraindicated
• as add-on therapy to other pressure-lowering medicines when the target eye pressure is not reached with one medicine

How is it used and dosed?

• The medicine is for use in the eye only.
• Immediately after each drop, press a finger on the tear duct at the inner corner of the eye for about 1 minute – this reduces absorption into the bloodstream and systemic side effects.
• Do not let the dropper tip touch the eye or any other surface, to avoid contaminating the solution.
• If you use other eye drops or ointments, leave 5 to 15 minutes between them.
• Remove soft contact lenses before applying the drops and wait at least 15 minutes before putting them back in.

This is the general dosage from the Summary of Product Characteristics – your doctor decides on your treatment.

Special patient groups

• Elderly: no dose adjustment is needed.
• Liver or kidney impairment: the medicine has not been studied in these patients – increased caution is needed.
• Children: contraindicated under 2 years; in children aged 2 years and older (especially 2–7 years and/or 20 kg body weight or less) marked drowsiness can occur, so use is not recommended under 12 years.

Contraindications – when the medicine must not be used

• hypersensitivity to brimonidine or any of the excipients
• newborns and children under 2 years of age
• concomitant treatment with MAO inhibitors or antidepressants that affect noradrenergic transmission (e.g. tricyclic antidepressants and mianserin)

Warnings and precautions

• Severe, unstable or uncontrolled heart and blood vessel disease – use with caution.
• Caution in depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension and Buerger's disease.
• Allergic eye reactions occurred in about 12.7% of patients in studies (mostly between the 3rd and 9th month of treatment) – if an allergic reaction occurs, stop using the drops and see your doctor. Delayed ocular hypersensitivity, sometimes with a rise in eye pressure, has also been reported.
• The medicine contains benzalkonium chloride (0.05 mg/mL), which may cause eye irritation and dry eyes, affect the tear film and corneal surface and discolour soft contact lenses. Caution in dry eye and a compromised cornea.

Interactions with other medicines, food and drink

• Must not be combined with MAO inhibitors or antidepressants that affect noradrenergic transmission (tricyclic antidepressants, mianserin).
• Brimonidine may enhance the effect of central nervous system depressants – alcohol, barbiturates, opioids, sedatives and anaesthetics.
• Caution with blood pressure medicines (antihypertensives) and cardiac glycosides, as a slight fall in blood pressure has been observed.
• Caution with medicines that affect the metabolism or uptake of amines (e.g. chlorpromazine, methylphenidate, reserpine) and medicines acting on adrenergic receptors (e.g. isoprenaline, prazosin), especially when starting them or changing the dose.

Pregnancy and breast-feeding

Safety in pregnancy has not been established. Brimonal should not be used during pregnancy unless the doctor judges that the benefit for the mother outweighs the possible risk to the unborn baby. It should not be used while breast-feeding.

Driving and using machines

Brimonal may cause tiredness and/or drowsiness as well as blurred or abnormal vision, especially at night or in poor light. If you notice these symptoms, do not drive or use machines until they have completely gone.

Possible side effects

• Very common: dry mouth, headache, drowsiness, tiredness; eye irritation (redness, burning and stinging, itching, foreign body sensation, conjunctival follicles), blurred vision, allergic reactions of the eye and eyelids (blepharitis, conjunctivitis).
• Common: dizziness, taste disturbance, eyelid swelling and redness, eye pain and watering, sensitivity to light, dry eyes, corneal erosion and staining, pale conjunctiva, upper respiratory symptoms, gastrointestinal complaints, weakness.
• Uncommon: systemic allergic reactions, depression, palpitations and rhythm disturbances (slow or fast pulse), nasal dryness.
• Rare: shortness of breath. Very rare: insomnia, fainting, high or low blood pressure, inflammation of the iris (iritis), constricted pupils.
• Not known: anterior uveitis, itchy eyelids, skin reactions (redness, facial swelling, itching, rash).

The most common complaints (dry mouth, red and stinging eyes) are usually temporary. Report suspected side effects to your doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• In adults, putting too many drops in the eye causes the side effects already described.
• Accidental swallowing is dangerous, especially for children: CNS depression, temporary coma or reduced consciousness, drowsiness, slow pulse, low body temperature, pallor and slowed or stopped breathing have been reported – seek emergency help immediately. In adults a fall in blood pressure has been reported.
• Missed dose: apply it when you remember and the next one at the usual time; do not apply a double dose.
• Do not stop treatment without consulting your ophthalmologist – raised eye pressure often causes no symptoms.

Related information

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

For additional care and support with dry and irritated eyes, see also the Eye Drops – Artificial Tears, Allergy Eye Drops and Care for Irritated Eyes category – products in this category do not replace the medicine you have been prescribed.

Composition, pack and manufacturer

• Active substance: brimonidine tartrate 2 mg per 1 mL of solution.
• Excipients: benzalkonium chloride (preservative, 0.05 mg/mL), sodium chloride, hypromellose, tartaric acid, disodium tartrate dihydrate, sodium hydroxide, water for injections.
• Pack: LDPE dropper bottle with a white screw cap and blue tamper-evident ring, 10 mL of solution; carton with package leaflet.
• Marketing authorisation holder: PREDSTAVNIŠTVO UNIMED PHARMA S.R.O. BEOGRAD (NOVI BEOGRAD), Jurija Gagarina 231, lokal 329, Belgrade. Manufacturer: Unimed Pharma, spol. s r.o., Bratislava, Slovakia.

Storage

• Store below 25 °C in the original package to protect from light.
• Do not refrigerate or freeze.
• Close the bottle immediately after each use. Shelf life: 2 years; after first opening: 28 days.
• Keep out of the sight and reach of children. Return unused medicine to a pharmacy that collects unused medicines.

Frequently asked questions

How often is Brimonal applied?

Usually one drop in the affected eye twice a day, approximately every 12 hours, as directed by your doctor.

Can I wear contact lenses with Brimonal?

The medicine contains benzalkonium chloride, which discolours soft lenses. Remove lenses before applying the drops and put them back in no sooner than 15 minutes later.

Why do I get a dry mouth and feel sleepy after the drops?

Dry mouth, tiredness and drowsiness are very common side effects of brimonidine. Pressing the inner corner of the eye after each drop reduces absorption into the blood; if the symptoms bother you, tell your doctor.

Can Brimonal be used in children?

It must not be used in newborns and children under 2 years, and it is not recommended for children aged 2 to 12 years, in whom frequent and marked drowsiness has been reported.

Sources

• ALIMS – Summary of Product Characteristics Brimonal 0.2%, 2 mg/mL, eye drops, solution (January 2024, Serbian)
• ALIMS – Package leaflet Brimonal 0.2%, 2 mg/mL, eye drops, solution (January 2024, Serbian)

Sources checked on: 24 October 2026.