Brimodin Plus Sterile Eye Drops: Each ml contains Brimonidine Tartrate INN 2 mg and Timolol Maleate USP equivalent to Timolol 5 mg.
Brimodin Plus is a combination preparation of selective alpha-2 adrenergic receptor agonist, brimonidine and a non-selective beta-adrenergic receptor inhibitor, timolol. Fluorophotometric studies in animals and humans suggest that brimonidine tartrate has a dual mechanism of action. Brimonidine lowers IOP by reducing aqueous humor production and increasing uveoscleral outflow. Timolol also lowers IOP by reducing aqueous humor production.
Brimodin Plus is indicated for the reduction of elevated intraocular pressure (IOP) in patients with glaucoma or ocular hypertension who require adjunctive or replacement therapy due to inadequately controlled IOP.
The recommended dose is one drop of this eye drops in the affected eye(s) twice daily approximately 12 hours apart.
If more than one topical ophthalmic product is to be used, other eye drops should be instilled at least 5 minutes apart.
Safety and effectiveness in children below the age of 2 years have not been established.
The most frequent reactions of this combination are allergic conjunctivitis, conjunctival folliculosis, conjunctival hyperemia, eye pruritus, ocular burning, blepharitis, corneal erosion, epiphora, eye dryness, eye pain, eyelid edema, eyelid pruritus, headache, hypertension, superficial punctate keratitis, and visual disturbance.
Like other topically applied ophthalmic agents, it may be absorbed systemically. Due to the presence of Timolol, the same types of cardiovascular and pulmonary adverse reactions as seen with systemic beta-blockers may occur. Cautions should be exercised in treating patients with severe or unstable and uncontrolled cardiovascular or pulmonary diseases.
Pregnancy: Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. It should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.
Lactation: Timolol has been detected in human milk following oral and ophthalmic drug administration. It is not known whether brimonidine passes into human breast milk. However, it has been shown to pass into the milk of nursing animals. Because of the potential for serious adverse reactions from this combination 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.