Alphagan P (Brimonidine Tartrate) : Uses, Side-Effects, Dosage & Precautions

Alphagan P - Brimonidine Tartrate

Brimonidine tartrate is the generic name for what is commonly sold in the market as Alphagan P. The ophthalmic solution or eye drops is a clear greenish-yellow liquid.

This ophthalmic solution gained approval by the FDA in 1996 to treat the symptoms of open-angle glaucoma or ocular hypertension. It works by reducing the elevated intraocular pressure (IOP) in the eye to effectively help the patient.

This article discusses everything about brimonidine tartrate, including the uses, side-effects, dosage, interactions, and precautions. Read further to know more.

Uses of Alphagan P

As mentioned above, Alphagan P (brimonidine tartrate) is used to treat ocular hypertension and open-angle glaucoma. It is important to note here, that it does not cure these conditions, but only manages the symptoms.

It works by increasing the drained quantity of aqueous humor and decreasing the quantity that is made in the eye, thus reducing the overall pressure exerted. Remember, high pressure in the eye can lead to complete blindness or vision loss, and even serious nerve damage.

This solution in gel form is also used to topically treat facial erythema of rosacea. Rosacea, or acne rosacea, is a skin condition extremely common in middle-aged women with fair skin. This condition causes visible blood vessels in the face and red, pus-filled, swollen bumps.

Brimonidine is a selective alpha-2 adrenergic agonist. Thus, its topical application for persistent erythema of rosacea works by constriction of the dilated blood vessels in the face. This effectively reduces the redness caused due to rosacea. Brimonidine gel is the first topical treatment approved to treat erythema of rosacea.

Side-Effects of Alphagan P (Brimonidine Tartrate)

Brimonidine tartrate ophthalmic solution can have several side-effects varying in severity. They have been mentioned in the following list, divided into severe and less severe if experienced.


Common Side-Effects

  • Itching and redness in the eyes
  • Headaches
  • Conjunctival Hyperemia (dilation and swelling of conjunctival vessels)
  • Follicular Conjunctivitis

Less Common Side-Effects

  • Depression
  • Changed or blurred vision
  • Eroded cornea
  • High blood pressure
  • Digestive disturbances
  • Pink eye with pus
  • Swollen eyelids
  • Stuffed or runny nose
  • Chemosis (inflammation of the white portion of the eye)

Extremely Rare Side-Effects

  • Decreased heart rate

Less Severe

Common Side-Effects

  • Dryness in the mouth
  • Excessively watery eyes
  • Low energy and sleepiness
  • Allergic Conjunctivitis (swollen conjunctiva due to an allergic reaction)
  • Irritation in the eyes

Less Common Side-Effects

  • Anxiety
  • Sleeping issues
  • Impaired taste
  • Eyelid crusting
  • Sensitivity to light
  • Weakness in muscles

Extremely Rare Side-Effects

  • Swollen iris (colored portion of the eye)

This is not a complete list of the side-effects caused by brimonidine tartrate. However, in case you experience any of these, immediately contact a medical health professional. Therefore, do not stop or change the dose without proper consultation.

Dosage of Alphagan P (Brimonidine Tartrate)

For patients of ocular hypertension and glaucoma using the eye drops to manage their symptoms, it is suggested to use one drop, thrice a day. But keep a minimum time of 8 hours between the three doses.

To manage minor ocular pain or irritation, use a 0.025% ophthalmic solution. Instill one drop every 6 -8 hours as needed but do not exceed 4 drops a day.

The topical gel of brimonidine tartrate should be used in pea-size amounts once a day to treat persistent erythema of rosacea. Apply daily and focus on the five prime areas of the face – central forehead, nose, both cheeks, and chin.

Using the Ophthalmic Solution

Clean your hands thoroughly with soap and water before opening the bottle to maintain hygiene. Tilt your head backward and create a pocket by pulling the lower eyelid with your index finger.

Carefully place the tip of the dropper as close to your eye as possible without actually touching the surface. It is important that the dropper does not come in contact with the surface of the eye, hands, or any other surface as this can lead to contamination. Insert a drop and gently shut your eyes for 2 – 3 minutes. And do not rub, squeeze, or blink during this period.

To avoid the medicine from draining out of your eyes, place a finger on the inner corner of your eye, near the nose, and apply light pressure. Do not try and clean the dropper by any means but simply replace the dropper cap after each use.

Some important things to keep in mind while making use of these eye drops:

  • It is safe to use with other topical ophthalmic drugs that lower the pressure in the eye.
  • In case you need to use other products, wait for a minimum of 5 – 15 minutes before the next application.
  • Remember to remove contact lenses (if any) before applying this medicine. You can place them back after 15 minutes.
  • Keep using the medicine regularly for maximum efficacy.
  • If possible, it is best to use it at the same time every day.


It is very common for certain drugs to cause adverse effects when in interaction with other drugs. Remember to provide your doctor with a complete list of all your medications. Some of the drugs that brimonidine tartrate can interact with are:

Blood Pressure Medications

Patients who take antihypertensives or cardiac glycosides should not be taking brimonidine tartrate since it can lower the blood pressure of the patient.

CNS Depressants

Alcohol, opiates, sedatives, among others, are CNS depressants that might have a potentiating effect when combined with brimonidine tartrate.

Tricyclic Antidepressants

There is not an adequate amount of research present to determine if antidepressants hinder the pressure-lowering effects of Alphagan P. But they do affect the metabolism and uptake of circulating amines.

Monoamine Oxidase Inhibitors

Monoamine oxidase inhibitors might interfere and interact with brimonidine tartrate to effectively cause hypotension in the patient thus reducing the metabolism of brimonidine tartrate.


Brimonidine tartrate is not advised for children under the age of 2 years, mainly because the safety and efficacy have not yet been thoroughly tested.

Pregnancy and Lactation

Pregnant women should only take brimonidine tartrate if prescribed by the doctor and if completely necessary. There has been no evidence to conclude that brimonidine tartrate is excreted in breast milk in humans. However, the potential risks of breastfeeding infants with brimonidine tartrate can be extremely dangerous. Therefore, before you start feeding your child it is advised not to consume the drug or discontinue it completely .

Hepatic or Renal Impairment

The effects of Alphagan P (brimonidine tartrate) are not yet known on patients diagnosed with hepatic or renal impairment. Hence, they should be closely administered.

Cardiovascular Patients

The drug has minimal effects on blood pressure, but it should still be carefully consumed in patients with any kind of cardiovascular disease.

Driving and Heavy Machinery

As mentioned above, brimonidine tartrate is known to cause sleepiness and nausea. Therefore, patients are advised to avoid driving and operating heavy machinery at least until the symptoms have completely subsided.


Overdose of Alphagan P (brimonidine tartrate) usually only leads to hypotension in adults, which is followed by extreme hypertension. Also, keep in mind, one bottle should not be used by more than one patient.
Contact a doctor in case any of the symptoms persist for too long. Do not change, stop, or start taking the medication without consulting a doctor first.