Brimonidine tartrate ophthalmic solution 0.025% for redness relief: an overview of safety and efficacy

ABSTRACT

Introduction

Ocular redness, or conjunctival hyperemia, is a common ophthalmic sign associated with reduced quality of life. For redness without apparent underlying pathology, topical ophthalmic decongestants have been widely used.

Areas covered

Brimonidine tartrate was approved in 2017 as a topical vasoconstrictor at a 0.025% concentration for relief of ocular redness. Since then, investigators have reported on efficacy and safety findings from studies evaluating low-dose brimonidine for reducing ocular redness.

Expert opinion

Brimonidine is highly selective for α₂-adrenergic receptors. Clinical trials have so far shown that the drug in low doses significantly reduces ocular redness in comparison to vehicle for up to 8 hours. Brimonidine-treated eyes did not present side effects of other vasoconstrictors, such as hypotension, cardiac arrhythmia, or drowsiness. Ocular adverse events, such as allergic reactions and redness rebound, were also minimal. In this review, we examine in detail published literature on the mechanism of brimonidine tartrate and its efficacy and safety in relieving conjunctival hyperemia.

KEYWORDS:

• Brimonidine tartrate
• efficacy
• hyperemia
• redness
• safety

Disclosure statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Article highlights

• Brimonidine tartrate is a selective α₂-adrenergic receptor agonist, and has a potent vasoconstrictor activity at concentrations as low as 0.025%.

• Previous clinical trials have examined its vasoconstrictor effect and demonstrated that brimonidine tartrate 0.025% effectively reduced ocular redness for up to 8 hours.

• Brimonidine tartrate 0.025% showed minimal adverse events. Ocular adverse events included mild stinging sensation and irritation. No significant rebound redness or allergic reaction was noted. Serious systemic adverse events, such as hypotension and drowsiness, were not associated with 0.025% brimonidine.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose. Bausch + Lomb provided a scientific accuracy review at the request of the journal editor.

Additional information

Funding

This paper was funded by the Basic Science Research Program through the National Research Foundation of Korea (No. NRF-2019 R1A2C1091089). The funding organization had no role in the design or conducting of this research.