Brimonidine and Brinzolamide (Ophthalmic)

Brimonidine and brinzolamide eye drops are used to treat open-angle glaucoma and ocular hypertension.


Brimonidine and brinzolamide eye drops are used to treat conditions that are related to increased pressure within the eye, including open-angle glaucoma and ocular hypertension.

Brimonidine and brinzolamide eye drops are sold in the US under the brand name, Simbrinza and come in the form of eye drops.

Open-angle glaucoma and ocular hypertension can cause pain from the pressure within the eye, which can eventually damage your eyesight. Brimonidine and brinzolamide works by helping to reduce the pressure within the eye and preventing pain.

Brimonidine and brinzolamide eye drops are only available on prescription from your doctor or ophthalmologist.

Conditions treated

  • open-angle glaucoma
  • ocular hypertension

Type of medicine

  • suspension
  • eye drops

Side effects

Along with the many benefits that brimonidine and brinzolamide eye drops can provide, some people may suffer some unwanted side effects. You may not notice any unusual or unpleasant side effects while using this medication, but if you do, you should check with your doctor or specialist in case further medical attention is required.

The side effects listed below can sometimes occur in people taking brimonidine and brinzolamide and should be reported to your treating physician without delay.

  • unusual tiredness
  • trouble breathing or swallowing
  • tightness in the chest
  • throbbing pain
  • tearing
  • swelling of the eyelids, face, lips, hands, or feet
  • slow or irregular heartbeat
  • skin rash
  • shortness of breath
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • redness of the skin
  • red, sore eyes
  • joint pain, stiffness, or swelling
  • itching
  • irritation
  • hoarseness
  • hives or welts
  • fever
  • feeling lightheaded, dizzy, or faint
  • fast, pounding, or irregular heartbeat or pulse
  • eyes sensitive to light
  • eye pain
  • eye irritation or redness
  • discoloration of the white part of the eye
  • discharge or excessive tearing
  • constricted, pinpoint, or small pupils
  • chest pain or discomfort
  • burning, dry, or itching eyes
  • blurred, decreased, or disturbed vision

There are some effects that may affect people who are taking brimonidine and brinzolamide, which do not usually require medical intervention. These effects often resolve themselves as your body becomes acclimatized to the medication. Your specialist or doctor may be able to provide you with advice on ways in which you can manage or reduce many of these unpleasant side effects if they are persistent or particularly troublesome. These effects include:

  • voice changes
  • insomnia
  • tightness in the chest
  • tender, swollen glands in the neck
  • stuffy nose
  • stomach discomfort, upset, or pain
  • stinging or burning sensation in the eyes
  • sneezing
  • runny nose
  • redness and tiny bumps on the lining of the eyelid
  • poor night vision
  • paleness of the eye or inner lining of the eyelid
  • nausea
  • muscle tension or tightness
  • muscle stiffness
  • muscle pain
  • loss of taste
  • lack or loss of strength
  • indigestion
  • increased sensitivity of the eyes to sunlight
  • increase in blood flow to the whites of the eyes
  • hoarseness
  • heartburn
  • headaches
  • hair loss or thinning of the hair
  • feeling of having something in the eye
  • excessive muscle tone
  • dryness or soreness of the throat
  • dry mouth
  • dry eyes
  • drowsiness
  • double vision
  • diarrhea
  • crusting in the corner of the eye
  • cough
  • congestion
  • changes in taste
  • changes in color vision
  • body aches or pain
  • belching
  • acid or sour stomach

This list of side effects is not necessarily all-inclusive. If you experience any other unusual effects, you should consult your specialist promptly.


When you receive your prescription of brimonidine and brinzolamide eye drops, you will be issued a Medication Guide. Take the time to read the guide thoroughly and make sure that you understand how to use the medication. If you have any questions, just ask your doctor or pharmacist.

You must only use this medication exactly as directed by your treating physician. Do not use more of the medication than you have been prescribed. Do not use the medication more frequently that you have been directed to by your doctor. Do not continue using the eye drops for longer than you have been directed to by your doctor. Do not omit any doses of the treatment. Missing out treatments could increase the likelihood of you suffering side effects and it could also reduce the effectiveness of the medication.

The dose of brimonidine and brinzolamide that patients are recommended to use may vary. You must follow your doctor's instructions or observe the directions given on the prescription label that comes with your medication. The dose outlined below is based on the average dosage. If the dose you are told to take is different, do not alter it, unless you are instructed otherwise by your doctor. The length of your course of treatment may change, depending on what you are being treated for and how effective the drops are.

If you miss a dose of your medicine, try to administer the missed dose as soon as possible. If your next dosage time is almost due, leave out the one you have missed and pick up your usual dosage schedule where you left off. Do NOT use double the dose to try to catch up.

If you usually wear soft contact lenses, you should take them out before using brimonidine and brinzolamide eye drops. Allow at least 15 minutes to elapse before replacing your contact lenses.

Follow the instructions given below when administering your eye drops:

  • Wash your hands thoroughly with soap and water.
  • Shake the medication bottle before each use.
  • Tilt your head back and use your index finger to pull down your lower eyelid so that it creates a pocket.
  • Holding the eye-dropper close to the eye with your other hand, apply the prescribed number of drops into the pocket you have created.
  • Close your eyes. Put your finger over the innermost corner of your eye and gently hold it closed for one minute.
  • If you missed your eye with the drop, repeat the process.
  • Do not allow the dropper to touch anything, including your eye. Do not wash or wipe the dropper. This is important to prevent bacteria from entering the bottle and causing an eye infection.
  • Replace the cap on the bottle of medication immediately.
  • Be sure to wash your hands thoroughly after using the medication.
  • If the solution becomes cloudy or changes color, discard it and ask your doctor for a fresh prescription.
  • If you have been prescribed two different eye drops for use together, allow five minutes between each application. This will prevent the second lot of drops from washing away the first ones.

For the treatment of glaucoma or hypertension of the eye

  • Adults: apply one drop in each affected eye three times daily.
  • Children 2 years of age and older: use and dosage as instructed by your treating physician.

Brimonidine and brinzolamide is not recommended for use in children under two years of age.

Major drug interactions

Some types of drugs should never be used together. To do so could increase the risk of serious side effects and may also affect how your medicines work. However, in some cases, it may be appropriate and safe to use two or more different medicines concurrently, even though an interaction between them may occur. In this case, your doctor may change the dose of one of your medicines. Alternatively, ways in which you can negate the effect of any interactions may be suggested to you.

Before starting to use brimonidine and brinzolamide eye drops, make a list of all the other medications that you are currently using. This list should include prescription and non-prescription drugs, herbal preparations, and vitamin products. Pass this list to your treating physician before you begin using your new medication. Do not change the dose or frequency of any of your medications without first asking your doctor.

Although using brimonidine and brinzolamide eye drops with the following medications is not recommended, it may be necessary for some patients. Your will be advised by your doctor if you need to change the dose or frequency of use of any medication.

  • memantine
  • idelalisib
  • ceritinib

This medication must NOT be used together with the following drugs as serious side effects may occur:

  • acetazolamide
  • dorzolamide
  • methazolamide

It should be noted that this list is not necessarily all-inclusive. Always make sure your doctor is aware if you are already taking any other form of medication before you start your course of brimonidine and brinzolamide.


While you are taking this medication, you will need to see your doctor for regular check-ups. These allow the doctor to make sure that the medication is working correctly. You will also have the opportunity to discuss any side effects that you may be suffering and to ask any questions that you may have about your new medicine. During your check-ups, your doctor may wish to send you for blood tests to check for any unwanted effects.

You must tell your doctor if you are known to be allergic to food colourings, certain food stuffs, preservatives, or animal derivatives.

This medication is available on prescription only. Do not share your brimonidine and brinzolamide eye drops with anyone else.

If your eyes begin to feel worse after you start using this medication, or if you do not think that your condition has shown any signs of improvement, speak to your doctor or specialist without delay.

In the event that you accidentally use too much of this medication, you may experience some or all of the following symptoms:

  • weakness and heaviness of the legs
  • trembling
  • sweating
  • seizures
  • numbness, tingling, pain, or weakness in the hands or feet
  • muscle cramps or pain
  • dizziness, faintness, or feeling lightheaded when getting up suddenly from a prone or seated position
  • confusion

Call 911 immediately, or seek your treating physician's advice if you do think that you might have overdosed.

Use brimonidine and brinzolamide with caution if you are known to be allergic to sulfa drugs. This medication can increase the risk of serious side effects.

Some other medical conditions can affect the use of brimonidine and brinzolamide eye drops. Always tell your doctor if you suffer from or have a history of any of the following health problems:

  • recent eye surgery
  • Raynaud's phenomenon
  • orthostatic hypotension
  • liver disease
  • heart or blood vessel disease
  • eye infections
  • depression
  • cornea problems
  • cerebral or coronary insufficiency
  • bacterial eye infection
  • kidney disease

Use this medication with caution, as it may make these conditions worse.

If your eye becomes swollen, red, or itchy, you may be allergic to the medication, and you should consult your doctor for advice. More serious allergic reactions include blistering, peeling or loosening of the skin, tarry or black stools, muscle or joint pain, dark urine, chills, a rash, red skin lesions with raised, purplish centers, ulceration, sores, or white spotting inside your mouth or on your lips.

In the event that you develop an eye infection or require eye surgery, consult your doctor immediately.

Do not stop using brimonidine and brinzolamide eye drops unless you are told to do so by your doctor or specialist. It is important that you complete the course of treatment in order for the medication to work properly.

Some patients may develop blurred vision for a short time after using these eye drops. If you are affected in this way, refrain from driving, operating machinery, or undertaking any other potentially dangerous activity until your vision has cleared completely.

As far as can be established from research, this medication has no adverse effects on unborn babies. However, if you are pregnant or are considering getting pregnant during the course of your treatment with this drug, you should discuss the pros and cons of using it with your doctor. It is not known if this drug can pass into breast milk. To be on the safe side you might want to stop breastfeeding while you are using the medication. Your doctor or midwife will be able to give you more advice on feeding your infant in the meantime.


Keep your bottle of brimonidine and brinzolamide eye drops with the cap tightly fastened. This medicine must be kept at room temperature or in a refrigerator. Do not freeze the medication. Keep the medication out of direct sunlight, and do not leave it near to sources of extreme heat.

Always keep your medication where it cannot be reached by children or pets. If a pet does consume brimonidine and brinzolamide, you should seek immediate veterinary advice.

Do not keep any unwanted brimonidine and brinzolamide eye drops, or use a prescription that has passed its use-by date. Do not flush any unwanted medication down the toilet or pour it into the drains. Do not throw out unused medication with your garbage where it could be found by children.

Always seek the advice of your pharmacist or doctor if you are in doubt and you need to dispose of any unwanted or unused medicines.


Brimonidine and brinzolamide eye drops are used to treat open-angle glaucoma and ocular hypertension, and certain other conditions related to increased pressure within the eye. The medication works by helping to reduce the pressure within the eye, preventing pain and potentially saving your vision from permanent damage.

This medication is sold in the US under the brand name, Simbrinza and comes in the form of eye drops.

There are a few prescription-only and over-the-counter drugs that can interact adversely with this medication. In addition, some people are allergic to the constituents in the medication and could potentially suffer a few nasty side effects, including eye inflammation and blurred vision.

Brimonidine and brinzolamide eye drops are known to be highly effective in treating high pressure within the eye. In order to get the best from your treatment with this medication, you should see your doctor or ophthalmologist for regular progress checks and eye tests, and to discuss any side effects that you may be experiencing.

Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
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