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Talking to Your Doctor

Glaucoma is a chronic medical condition. You should work with your eye care professional and his or her staff to get the information you need for successful treatment. Don’t hesitate to ask questions. As a patient, the decisions you make and the actions you take to treat your condition make you an integral part of your eye care therapy.

Questions to Ask Your Eye Care Professional
This checklist of questions may help you gather the information you need about glaucoma and its treatment. Print it, check off the questions that you have right now, and bring the list with you to your next appointment so you’ll remember what you want to talk about. You may want to ask other questions on the list at a future appointment. Over time, you can find the answers to the questions you have about your condition and treatment.

My Eyes
  • What is my diagnosis?
  • What caused my condition?
  • What is the difference between my visual acuity and my visual field?
  • Has my visual field or my optic nerve been affected by high
    eye pressure?
  • Should I watch for any particular symptoms and notify you if they occur?
  • Should I make any lifestyle changes?
My Treatment
  • What is the best long-term treatment for my condition?
  • What are the benefits of this treatment?
  • What are the risks and side effects associated with this treatment?
My Tests
  • What kinds of tests will I have?
  • What can I expect to find out from these tests?
  • When will I know the results?
  • How do you monitor if damage to my optic nerve is getting worse
    over time?
  • Can I get copies of my test results for my records?
Other Suggestions
  • Don't be embarrassed to say "I don't understand"
  • Make sure you are comfortable with your doctor's answers before you leave the office
  • Bring a friend or family member to your appointments—to take notes, to remind you of your questions, or just for support
  • Ask for written instructions, printed materials, or references to
    relevant websites
  • Talk to the medical staff and support personnel in your doctor's office. They can help with information, follow-up questions, and referrals to other services
  • Take an active role in your eye care

INDICATIONS AND USAGE
ALPHAGAN® P (brimonidine tartrate ophthalmic solution) 0.1% or 0.15% is an alpha-adrenergic receptor agonist indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS
Neonates and Infants (under the age of 2 years): ALPHAGAN® P is contraindicated in neonates and infants (under the age of 2 years).
Hypersensitivity Reactions: ALPHAGAN® P is contraindicated in patients who have exhibited a hypersensitivity reaction to any component of this medication in the past.
See more below.

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INDICATIONS AND USAGE
ALPHAGAN® P (brimonidine tartrate ophthalmic solution) 0.1% or 0.15% is an alpha-adrenergic receptor agonist indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS
Neonates and Infants (under the age of 2 years): ALPHAGAN® P is contraindicated in neonates and infants (under the age of 2 years).
Hypersensitivity Reactions: ALPHAGAN® P is contraindicated in patients who have exhibited a hypersensitivity reaction to any component of this medication in the past.

WARNINGS AND PRECAUTIONS
Potentiation of Vascular Insufficiency: ALPHAGAN® P may potentiate syndromes associated with vascular insufficiency. ALPHAGAN® P should be used with caution in patients with depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension, or thromboangiitis obliterans.
Severe Cardiovascular Disease: Although brimonidine tartrate ophthalmic solution had minimal effect on the blood pressure of patients in clinical studies, caution should be exercised in treating patients with severe cardiovascular disease.
Contamination of Topical Ophthalmic Products After Use: There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products. These containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of the ocular epithelial surface.

DRUG INTERACTIONS
Antihypertensives/Cardiac Glycosides: Because ALPHAGAN® P may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with ALPHAGAN® P is advised.
CNS Depressants: Although specific drug interaction studies have not been conducted with ALPHAGAN® P, the possibility of an additive or potentiating effect with CNS depressants (alcohol, barbiturates, opiates, sedatives, or anesthetics) should be considered.
Tricyclic Antidepressants: Tricyclic antidepressants have been reported to blunt the hypotensive effect of systemic clonidine. It is not known whether the concurrent use of these agents with ALPHAGAN® P in humans can lead to resulting interference with the IOP-lowering effect. Caution is advised in patients taking tricyclic antidepressants, which can affect the metabolism and uptake of circulating amines.
Monoamine Oxidase Inhibitors: Monoamine oxidase (MAO) inhibitors may theoretically interfere with the metabolism of brimonidine and potentially result in an increased systemic side effect such as hypotension. Caution is advised in patients taking MAO inhibitors, which can affect the metabolism and uptake of circulating amines.

ADVERSE REACTIONS
Adverse reactions occurring in approximately 10% to 20% of the subjects receiving brimonidine ophthalmic solution (0.1% to 0.2%) included: allergic conjunctivitis, conjunctival hyperemia, and eye pruritus. Adverse reactions occurring in approximately 5% to 9% included: burning sensation, conjunctival folliculosis, hypertension, ocular allergic reaction, oral dryness, and visual disturbance.

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Visit www.fda.gov/medwatch or call 1 (800)-FDA-1088.