Efficacy and safety of various brimonidine formulations in the treatment of glaucoma and ocular hypertension

Purpose. To present data on the mechanism of action, efficacy, and side effects of various brimonidine dosage forms in the treatment of glaucoma and ocular hypertension. Material and methods. To perform the review, literature sources were searched through the PubMed and Scopus databases up to and including 2021, using the keywords «brimonidine», «efficacy», «safety», «glaucoma medication». A total of 36 articles related to the topic of the review were selected. The beginning of publications on this topic dates back to 1995. Results. Brimonidine, an alpha2-adrenoceptor agonist, effectively reduces intraocular pressure and can be used as monotherapy, adjuvant and replacement therapy. The effectiveness of brimonidine is similar to that of timolol and prevails over betaxolol but inferior to prostaglandin analogues. The new drug formulation brimonidine-purite 0.15% has a more favorable safety and tolerability profile than the original brimonidine 0.2% while maintaining similar efficacy. However, most patients require two or more hypotensive medications to maintain target IOP. In this context, brimonidine is one of the most appropriate drugs because of its pr oven efficacy when combined with other classes of hypotensive drugs. Conclusion. Brimonidine can be used as monotherapy for glaucoma and ophthalmic hypertension. Experimental and clinical studies have shown a potential neuroprotective effect of brimonidine, which is associated with a direct effect on retinal cells, regardless of the effect of the drug on intraocular pressure. Key words: glaucoma, brimonidine, hypotensive drops, intraocular pressure.