Alphagan P

1 What is Alphagan P?

Brand: Alphagan P, Azopt Betagan, Betimol, Betoptic S, Combigan, Cosopt, Eserine, Iopidine, Isopto Carbachol, Isopto Carpine, Istalol, Latisse, Ocusert Pilo, Optipranolol, Phosphline Iodide, Propine, Rescula, Simbrinza, Timoptic Ocudose, Timoptic-XE Ocumeter Plus, Travatan, Trusopt Ocumeter, Xalatan, Zioptan

Generic: Brimonidine tartrate ophthalmic

Alphagan P is used alone or together with other medications to treat increased pressure in the eye that is caused by open-angle glaucoma or conditions called hypertension of the eye (ocular hypertension).

This medication is an alpha-adrenergic agonist. This medication is only available with your doctor’s prescription.

This product is available in the following forms:

  • Solution
  • Powder for suspension
  • Ointment
  • Gel forming solution
  • Suspension
  • Device
  • Gel/Jelly

2 What To Know Before Using

As with all medicines, the risks of using Alphagan P must be compared to how much a medication will help you. This is a decision that you and your doctor will make together.

For this medication, there are many things that need to be considered:

  • Allergies: Inform your doctor if you have ever had an allergic reaction to Doxorubicin or to any other medications. It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.
  • Pediatric: Demecarium, Echothiophate and Isoflurophate can cause serious side effects in patients. When these medications are used for extended amounts of time, eye cysts may occur, which is more common for children than adults. It is very important that you discuss with risks and benefits of this medication with the doctor.
  • Geriatric: No appropriate studies have been performed on the relationship of age to the effects of these medications in the elderly. Safety and efficacy have not been established.
  • Pregnancy: Because of the toxicity of these medications, Demecarium, Echothiophate and Isoflurophate are not recommended during pregnancy.
  • Breastfeeding: These medications are not recommended during breastfeeding as Demecarium, Echothiophate and Isoflurophate may be absorbed into the body and cause unwanted effects on nursing babies. It may be necessary for you to use another medication or to stop breastfeeding during treatment.
  • Drug Interactions: Certain medications should not be used together. However, in certain cases, two medications may be used together, even if an interaction might occur. In these cases, your doctor may want to change your dose or take other precautions.When taking this medication, it is important that you inform your doctor if you are taking any of the medications listed below. The following interactions were selected on the basis of potential significance and are not all-inclusive.Using this medication with any of the following is not recommended.Your doctor may decide not to treat you with this medication, or change some of the other medications you take:
    • Amiodarone
    • Clonidine
    • Diltiazem
    • Epinephrine
    • Fingolimod
    • Verapamil
  • Other Interactions: Certain medications should not be used while eating, or while eating certain foods in the case of negative interactions. Using alcohol or tobacco with certain medications may also cause negative interactions. Talk with your doctor about the use of your medication with food, alcohol or tobacco.
  • Other Medical Problems: Pre-existing medical problems may affect the use of this medication.Be sure to tell your doctor if you have any other medical problems, especially:
    • Asthma
    • Epilepsy
    • Heart Disease
    • High or low blood pressure (hypertension, hypotension)
    • Myasthenia gravis
    • Overactive thyroid
    • Parkinsonism
    • Stomach ulcer or other stomach problems
    • Urinary tract blockage - If these medications are absorbed into the body, it may make the condition worse.
    • Down’s Syndrome - This medication may cause these patients to become hyperactive.
    • Eye disease or problems - May increase absorption of these medications into the body or these medications may make these conditions worse.

3 Proper Usage

Only take Alphagan P as directed by your doctor. Do not take more, less or for a longer or shorter period of time than your doctor tells you.

If the applicator tip touches any surface, it may become contaminated with bacteria, which may increase the risk of developing an eye infection. If you think the applicator has become infected, notify your doctor immediately.

To use the solution (eye drops) form:

  • Wash your hands. Tilt your head back and press your lower finger gently just beneath the lower eyelid.
  • Pull the lower eyelid away from the eye to make a space. Drop the medication into this space.
  • Let go of the eyelid and close your eyes. Do not blink.
  • Keep the eyes closed and apply pressure to the inner corner of the eye for 1-2 minutes to allow your eye to absorb the medication.
  • Remove any excess solution around the eye with a clean tissue.
  • Immediately after using the eye drops, wash your hands to remove any medication that may be on them.

To keep the medication as germ-free as possible, do not touch the applicator tip to any surface. Keep the container tightly shut.

The preservative in the eye drops (demecarium) may be absorbed by soft contact lenses. If you wear soft contact lenses, and your doctor has told you that you can wear them while taking this medication, you should wait at least 15 minutes after applying the eye drops before inserting your lenses.

To use the ointment form:

  • Wash your hands. Tilt your head back and press your lower finger gently just beneath the lower eyelid.
  • Pull the lower eyelid away from the eye to make a space. Squeeze a thin strip of ointment into this space. A 1/4-in amount is enough, unless your doctor tells you to use a different amount.
  • Let go of the eyelid and close your eyes. Do not blink.
  • Keep the eyes closed and apply pressure to the inner corner of the eye for 1-2 minutes to allow your eye to absorb the medication.
  • Immediately after using the ointment, wash your hands to remove any medication that may be on them.

Because isoflurophate loses effectiveness when exposed to moisture, do not wash the tip of the ointment tube or allow it to touch any moist surfaces.

To keep the medication as germ-free as possible, do not touch the applicator tip to any surface. Keep the container tightly shut.

Eye ointment normally causes blurred vision for a short time after use and eye drops containing these medications may affect your vision for several hours after use. Ask your doctor if the dose can be used at bedtime.

Dosing

Different patients will be given a different dose of this medication based on the strength of the medication.

The number of doses you take each day, the time between doses and the length of time you take this medication depends on the reason you are taking this medication.

The following information only includes the average dose of this medication. If your dose is different, do not change it without first speaking to your doctor.

Demecarium (Solution):

  • For Glaucoma:
    • Adults and older children - Use one drop in the eye 1-2 times a day.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For treatment of Accommodative Esotropia:
    • Adults and older children - Use one drop in the eye once a day for 2-3 weeks, then one drop in the eye once ever 2 days for 3-4 weeks, then use as determined by your doctor.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For diagnosis of Accommodative Esotropia:
    • Adults and older children - Use one drop in the eye once a day for 2 weeks, then one drop in the eye once every 2 days for 2-3 weeks.
    • Infants and young children - Use and dose must be determined by your doctor.

Echothiophate (Solution):

  • For Glaucoma:
    • Adults and older children - Use one drop in the eye 1-2 times a day.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For treatment of Accommodative Esotropia:
    • Adults and older children - Use one drop in the eye once a day or one drop in the eye once every two days.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For diagnosis of Accommodative Esotropia:
    • Adults and older children - Use one drop in the eye once a day at bedtime for 2-3 weeks.
    • Infants and young children - Use and dose must be determined by your doctor.

Isoflurophate (ointment):

  • For Glaucoma:
    • Adults and older children - Use the ointment once every 3 days or as often as 3 times a day as directed by your doctor.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For Accommodative Esotropia:
    • Adults and older children - Use the ointment once a day at bedtime for 2 weeks, then once a week or as often as once every 2 days as directed by your doctor.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For diagnosis of Accommodative Esotropia:
    • Adults and older children - Use the ointment once a day at bedtime for 2 weeks.
    • Infants and young children - Use and dose must be determined by your doctor.
Missed Dose

Call your doctor or pharmacist for instructions.

If you miss a dose of the medication and your dosing schedule is:

  • One dose every other day - Use the missed dose as soon as possible if you remember it on the day it should be used. However, if you do not remember the missed dose until the next day, use it at that time. Then skip a day and start your dosing schedule again. Do not double dose.
  • One dose a day - Use the missed dose as soon as possible. However, if you do not remember the missed dose until the next day, skip the missed dose and go back to your regular dosing schedule. Do not double dose.
  • More than one dose a day - Use the missed dose as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double dose.
Storage

Store this medication in a closed container at room temperature. Keep it away from heat, moisture, and direct light. Do not freeze.

Keep out of the reach of children. Do not keep expired medication or medication you no longer need. Ask your doctor how to dispose of any medication you do not use.

4 Precautions To Take

If you are using Alphagan P for glaucoma, your doctor should check your eye pressure regularly to make sure the medication is working.

If you are using this medication for an extended period of time, your doctor should examine your eyes regularly to make sure these medications do not cause unwanted side effects.

Before you have any form of surgery, dental treatment or emergency treatment, tell the medical professional in charge and the anaesthesiologist that you use these medications or have used it within the past month.

These medications should not be used if an eye infection is present or if the eye is injured or wounded. If redness, pain or discharge develops, or if a foreign object becomes lodged in one or both eyes, or if you suffer a blow to the eye or eye area, inform your doctor immediately.

Avoid breathing in carbamate- or organophosphate-type insecticides or pesticides. They may add to the side effects of these medications.

Farmers, gardeners, residents of communities undergoing insecticide or pesticide spraying or dusting, workers in plants manufacturing such products or other persons exposed to such poisons should protect themselves by wearing a mask over the nose and mouth, changing clothes frequently and washing hands often.

Make sure your vision is clear before you drive, use machines or do anything else that may be dangerous if you cannot see well.

After you apply this medication:

  • Your pupils may become unusually small. This may impair your vision at night or in dim light.
  • Your vision may be blurred or there may be a change in your near or distance vision.
  • (If using ointment) Your vision may become blurred for a short time after using.

5 Potential Side Effects

Alphagan P may produce unwanted effects along with the intended effects. Although not all of these side-effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if you experience any of the following side-effects:

Rare
  • Burning, redness, stinging or other eye irritation
  • Eye pain
  • Veil or curtain appearing across part of vision
Symptoms of too much medication being absorbed into the body

Some side effects that may occur do not normally need medical attention. These may leave as your body becomes accustomed to treatment. Ask your doctor about ways to prevent or reduce some of these side effects.

Some patients may experience other side effects that are not listed. Check with your doctor if you notice any other side effects.

Ask your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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