BRIMONIDINE - A NEW ALPHA(2)-ADRENOCEPTOR AGONIST FOR GLAUCOMA TREATMENT

Purpose: Brimonidine is a highly selective alpha2-adrenoceptor agonist . It has intraocular pressure (IOP)-lowering characteristics similar t o other alpha2-agonists and acts by reducing aqueous humor production and increasing uveoscleral outflow. It is oxidatively stable, which ma y account for its loa er reported rate of ocular allergy compared with other alpha2-agonists. The focus of this report is to review the rece ptor pharmacology and clinical experience with brimonidine tartrate, t he newest of the alpha2-adrenergic agonists. Methods: Clinical studies have been performed for acute indications using the 0.5% concentratio n and chronic indications using the 0.2% of concentration. Results: Br imonidine 0.5% given as one drop before, after, or both before and aft er 360 degrees argon laser trabeculoplasty significantly lowers the in cidence of postlaser IOP spikes. Brimonidine 0.2% installed twice dail y offers long-term IOP control comparable with that achieved with timo lol 0.5% and better than betatolol 0.25% suspension. Conclusions: In l ight of these data, brimonidine 0.5% may be considered for prophylaxis against laser-induced IOP spikes and brimonidine 0.2% for chronic use in patients with ocular hypertension and glaucoma.