{"ok":true,"entry":{"slug":"brimonidine","kind":"medication","name":"brimonidine","aliases":["Alphagan"],"brands_sg":["Alphagan","Alphagan P","Brimochek","Rimonal","Combigan"],"class":"alpha-2 agonist (ophthalmic)","tags":["other"],"use_for":"lowering eye pressure in glaucoma or ocular hypertension","use_after":"sg label: one drop three times daily, about 8 h apart","use_duration":null,"take_with":"other eye drops spaced at least 5 minutes apart (sg label)","pros":["sg label: for open-angle glaucoma or high eye pressure","fda: can be used alongside other pressure drops","hsa: several brands registered, including generics"],"cons":["fda: allergic, red or itchy eyes in 10–20% of people","fda: dry mouth, tiredness and blurred vision","fda: contraindicated under 2 years old"],"dose_note":"the singapore package insert for alphagan p ophthalmic solution 0.15% w/v (SIN12336P), as published on the moh national drug formulary, states \"The recommended dose is one drop of ALPHAGAN® P (brimonidine tartrate ophthalmic solution) 0.15% in the affected eye(s) three times daily, approximately 8 hours apart\" — three times a day per affected eye is the label frequency, with no higher step listed, and the us fda label for alphagan p 0.1% and 0.15% carries the same line. the same sg insert adds \"If more than one topical ophthalmic drug is to be used, the different drugs should be instilled at least 5 minutes apart\". strengths on the sg register run 0.1%, 0.15% and 0.2%; in singapore the prescriber sets which one and how often.","dosage":null,"ul_status":null,"sg_class":"prescription-only","cautions":["children under 2 — an sg label contraindication","on a mao inhibitor — an sg label contraindication","depression, poor circulation, raynaud's or low bp on standing (fda)","severe heart disease — fda advises caution"],"clashes":[{"src":["fda_alpha_di"],"note":"fda: brimonidine may reduce blood pressure, so caution is advised with them","with":"blood pressure medicines and cardiac glycosides"},{"src":["fda_alpha_di"],"food":true,"note":"fda: an additive or potentiating effect should be considered","with":"cns depressants (alcohol, barbiturates, opioids, sedatives, anaesthetics)"},{"src":["fda_alpha_di"],"note":"fda: reported to blunt the hypotensive effect of systemic clonidine; caution advised","with":"tricyclic antidepressants"},{"src":["ndf_alpha_ci","fda_alpha_di"],"note":"sg label contraindicates it; fda: may interfere with metabolism and increase hypotension","with":"mao inhibitors"},{"src":["ndf_alpha_dose"],"note":"sg label: different topical ophthalmic drugs instilled at least 5 minutes apart","with":"other eye drops"}],"sources":[{"id":"hsa_register","url":"https://data.gov.sg/datasets/d_767279312753558cbf19d48344577084/view","label":"HSA — Listing of Registered Therapeutic Products (data.gov.sg dataset d_767279312753558cbf19d48344577084), Forensicclassification column; 5,511 rows cached at /tmp/hsa_all.json and filtered locally, never re-fetched — 10 brimonidine rows","quote":"All 10 registered brimonidine products read \"Prescription Only\" — ALPHAGAN 0.2% SIN09788P, ALPHAGAN P 0.15% SIN12336P and 0.1% SIN17198P, BRIMOCHEK 0.2%, RIMONAL 0.15%, plus COMBIGAN, BRIMOCHEK-T, SIMBRINZA, GLAALPHA and MIRVASO gel.","accessed":"2026-08-27"},{"id":"ndf_alpha_ind","url":"https://www.ndf.gov.sg/about-drugs/product-information/sin12336p/","label":"MOH National Drug Formulary — ALPHAGAN P OPHTHALMIC SOLUTION 0.15% W/V [SIN12336P], Indications and Usage (SG package insert)","quote":"ALPHAGAN® P is indicated for the lowering of intraocular pressure in patients with open-angle glaucoma or ocular hypertension.","accessed":"2026-08-27"},{"id":"ndf_alpha_dose","url":"https://www.ndf.gov.sg/about-drugs/product-information/sin12336p/","label":"MOH National Drug Formulary — ALPHAGAN P 0.15% [SIN12336P], Dosage and Administration","quote":"The recommended dose is one drop of ALPHAGAN® P (brimonidine tartrate ophthalmic solution) 0.15% in the affected eye(s) three times daily, approximately 8 hours apart … different drugs should be instilled at least 5 minutes apart.","accessed":"2026-08-27"},{"id":"ndf_alpha_ci","url":"https://www.ndf.gov.sg/about-drugs/product-information/sin12336p/","label":"MOH National Drug Formulary — ALPHAGAN P 0.15% [SIN12336P], Contraindications","quote":"ALPHAGAN® P is contraindicated in patients with hypersensitivity to brimonidine tartrate … also contraindicated in patients receiving monoamine oxidase (MAO) inhibitor therapy and contraindicated in neonates and infants (children under the age of 2 years).","accessed":"2026-08-27"},{"id":"ndf_alpha_class","url":"https://www.ndf.gov.sg/about-drugs/product-information/sin12336p/","label":"MOH National Drug Formulary — ALPHAGAN P 0.15% [SIN12336P], product information block","quote":"Forensic Classification: PRESCRIPTION ONLY MEDICINES · Anatomical Therapeutic Chemical (ATC) code S01EA05 · Prescription-only Medicines with Exemptions for Supply without Prescription: NA","accessed":"2026-08-27"},{"id":"fda_alpha_ind","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22ALPHAGAN%22&limit=3","label":"US FDA label for ALPHAGAN P (brimonidine tartrate ophthalmic solution) 0.1%/0.15%, section 1, via openFDA drug/label.json (effective 2025-09-18)","quote":"ALPHAGAN P is an alpha adrenergic agonist indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.","accessed":"2026-08-27"},{"id":"fda_alpha_dose","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22ALPHAGAN%22&limit=3","label":"US FDA label for ALPHAGAN P, section 2 Dosage and Administration, via openFDA","quote":"The recommended dosage is one drop of ALPHAGAN P in the affected eye(s) three times daily, approximately 8 hours apart. ALPHAGAN P may be used concomitantly with other topical ophthalmic drug products to lower intraocular pressure.","accessed":"2026-08-27"},{"id":"fda_alpha_ci","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22ALPHAGAN%22&limit=3","label":"US FDA label for ALPHAGAN P, section 4 Contraindications and 8.4 Pediatric Use, via openFDA","quote":"Neonates and Infants (Pediatric Patients Younger than 2 Years Old) … During postmarketing surveillance, apnea, bradycardia, coma, hypotension, hypothermia, hypotonia, lethargy, pallor, respiratory depression, and somnolence have been reported in infants receiving brimonidine.","accessed":"2026-08-27"},{"id":"fda_alpha_warn","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22ALPHAGAN%22&limit=3","label":"US FDA label for ALPHAGAN P, section 5 Warnings and Precautions, via openFDA","quote":"ALPHAGAN P should be used with caution in patients with depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension, or thromboangiitis obliterans … caution should be exercised in treating patients with severe cardiovascular disease.","accessed":"2026-08-27"},{"id":"fda_alpha_ae","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22ALPHAGAN%22&limit=3","label":"US FDA label for ALPHAGAN P, section 6 Adverse Reactions, via openFDA","quote":"Most common adverse reactions occurring in approximately 5% to 20% of patients receiving brimonidine ophthalmic solution (0.1% to 0.2%) included allergic conjunctivitis, burning sensation, conjunctival folliculosis, conjunctival hyperemia, eye pruritus, hypertension, ocular allergic reaction, oral dryness, and visual disturbance.","accessed":"2026-08-27"},{"id":"fda_alpha_di","url":"https://api.fda.gov/drug/label.json?search=openfda.brand_name:%22ALPHAGAN%22&limit=3","label":"US FDA label for ALPHAGAN P, section 7 Drug Interactions, via openFDA","quote":"Antihypertensives/cardiac glycosides may lower blood pressure. Use with CNS depressants may result in an additive or potentiating effect. Tricyclic antidepressants may potentially blunt the hypotensive effect of systemic clonidine. Monoamine oxidase inhibitors may result in increased hypotension.","accessed":"2026-08-27"}],"brand_certs":null,"updated_at":"2026-08-29T16:16:14.713299+08:00"},"disclaimer":"kozen-x is not a medical device and does not give medical advice. it lists what published sources have written down. absence of a record is not the same as safe."}