Adult Dosing

Elevated intraocular pressure

• 1 gtt in affected eye(s) tid

Pediatric Dosing

Elevated intraocular pressure

• Child = > 2 years: 1 gtt in affected eye(s) tid
• Child < 2 years: Safety and effectiveness in pediatric patients < 2 yrs have not been established

• Reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension

• Hypersensitivity to any of the ingredients of the product
• Neonates and infants (< 2 years)

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined. Not recommended in patients with severe renal impairment

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• The drug contains brinzolamide, a sulfonamide, which is absorbed systemically. Topical use of sulfonamides has been associated with severe reactions such as Stevens-Johnson syndrome, toxic epidermal, necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias. If signs of serious reactions or hypersensitivity occur, discontinue therapy. Use cautiously in patients wuth history of hypersensitivity to sulfonamides
• Therapy may increase the potential for developing corneal edema in patients with low endothelial cell counts.
• The drug has not been specifically studied in patients with severe renal and hepatic impairment. Since brinzolamide and brimonidine are excreted predominantly by the kidney, use is not recommended in such patients
• Has not been studied in patients with acute angle-closure glaucoma
• Contact lenses should be removed during instillation and may be reinserted 15 minutes after instillation
• Use cautiously in patients with severe cardiovascular disease, brimonidine had a less than 5% mean decrease in blood pressure 2 hours after dosing in clinical studies
• Brimonidine may potentiate syndromes associated with vascular insufficiency. Use with caution in patients with depression, cerebral or coronary insufficiency, Raynaud’s phenomenon, orthostatic hypotension, or thromboangitis obliterans
• There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products

Pregnancy Category:C

Breastfeeding: It is not known whether brinzolamide and brimonidine are excreted in human milk following topical ocular administration. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

• EENT: Blurred vision, eye irritation, eye allergy, dry eye, ocular discharge, ocular discomfort, ocular keratitis, ocular pain, ocular pruritus and rhinitis, burning and stinging, conjunctival follicles, ocular allergic reactions, corneal staining/erosion, photophobia, eyelid erythema, ocular ache/pain, ocular dryness, tearing, eyelid edema, conjunctival edema, abnormal vision, ocular irritation, foreign body sensation, blepharitis, ocular hyperemia, conjunctival blanching
• GI: Dysgeusia dry mouth, abnormal taste, oral dryness, gastrointestinal symptoms
• DERM: Dermatitis
• CNS: Headache, fatigue/drowsiness, dizziness, asthenia
• RESP: Upper respiratory symptoms
• MUSC: Muscular pain

• Carbonic anhydrase inhibitor; inhibits carbonic anhydrase in the ciliary processes of the eye to decrease aqueous humor secretion, presumably by slowing the formation of bicarbonate ions with subsequent reduction in sodium and fluid transport
• Metabolism: Metabolised in liver to N-desethyl brinzolamide, N­desmethoxypropyl and O-desmethyl metabolites
• Excretion: Excreted predominantly in the urine as unchanged drug
• Half-life: 111 days
• Alpha2 adrenergic receptor agonist; decreases aqueous humor secretion and increases uveoscleral outflow
• Metabolized in liver
• Excretion: Urine: 87%
• Half-life: 3 hours

US Trade Name(s)

• Simbrinza

US Availability

Simbrinza (brinzolamide/brimonidine)

• OPTH SOLN: 1%/0.2%

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Psychiatric

Anxiolytics/Sedatives/Hypnotics

Miscellaneous Agents

Neurologic

Anxiolytics/Sedatives/Hypnotics

Miscellaneous Agents