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Is brimonidine ophthalmic a safe therapy for infants?

G P Daubert1

  • 1Department of Emergency Medicine & Pediatrics, Children's Hospital of Michigan Regional Poison Control Center, Wayne State University School of Medicine, Detroit, MI, USA. gpat-md@sbglobal.net

Journal of Clinical Pharmacy and Therapeutics
|June 23, 2006
PubMed

Insights

Brimonidine ophthalmic solution can cause serious side effects like bradycardia and hypotension in infants. Caution is advised when using this glaucoma medication in children under two years old.

Area of Science:

  • Ophthalmology
  • Pediatric Pharmacology
  • Toxicology

Background:

  • Brimonidine is a topical alpha-2 agonist frequently prescribed for glaucoma treatment.
  • Its toxic effects are comparable to clonidine overdose, involving imidazoline and alpha-2 adrenergic receptor mechanisms.

Observation:

  • A 6-week-old infant with congenital glaucoma experienced bradycardia and hypotension after receiving brimonidine 0.15% ophthalmic solution.
  • This case highlights potential systemic toxicity in infants from topical brimonidine.

Findings:

  • Systemic toxicity from brimonidine in the pediatric population, especially in children under two years, is not fully understood.
  • Brimonidine is not weight-dosed, increasing the risk of adverse events in pediatric patients.

Implications:

  • The safety profile of brimonidine in children under two years requires careful consideration due to potential systemic toxicity.
  • Healthcare providers should be aware of brimonidine's side effect profile, particularly given its use in pediatric patients.

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