GLAUCOMA DROPS: SIMBRINZA

written by Dr. William McSwain

Simbrinza is a combination drop containing two medications: brinzolamide 1% and brimonidine tartrate 0.2%.

Brinzolamide 1% (carbonic anhydrase inhibitor) – This medication lowers eye pressure by reducing the amount of fluid that is made inside the eye

SIDE EFFECTS INCLUDE BUT ARE NOT LIMITED TO:

The eye drop form of this medicine may cause some burning and stinging in the eye when this medicine is first taken. Additionally, the eye may become red and the eyelids swollen, very similar to an allergic type reaction. If this occurs, the eye drop should be discontinued and your doctor should be contacted. Although rare, patients who have had a previous “Sulfa” allergy could react to these preparations. Adverse reactions are unusual, even in patients who have previously been told they had “Sulfa” allergies. However, please inform your doctor if you have been told that you had an allergy to “Sulfa” in the past. Changes in the blood count (decreased white cells, red cells and platelets) may occur. This is reversible in some cases, but in extremely rare cases, may lead to death. Please have your primary care physician check your blood count every six months while taking this medicine. Tiredness, skin rash, weight loss, depression, decreased sexual drive, and an altered taste for food (especially carbonated drinks) all have been noted as possible side effects. Patients also taking diuretics for blood pressure control may develop a low potassium level.

Brimonidine tartrate 0.2% (alpha-2 agonist) – This medication lowers the eye pressure primarily by reducing the amount of fluid that is made in the eye. It also may lower the eye pressure by improving the ease with which the fluid drains out of the eye.

SIDE EFFECTS INCLUDE BUT ARE NOT LIMITED TO:

There may be some burning and stinging in the eye when this medicine is first taken. Additionally, a “dry mouth” is common if the drop is introduced into the tear duct and drained into the nose and throat. A “red eye” and crusting of the eyelids may also occur. Combigan should be used cautiously in those patients using a MAO (monoamine oxidase inhibitor), a medicine that is commonly used as an antidepressant. Consult your primary care physician if there are any questions regarding this.

MINIMIZING THE RISK OF SIDE EFFECTS:

After administering a drop, keep the eye closed for two minutes and gently compress (with a tissue, if desired) the area over the tear duct near the inner corner of the eyelids. This will make the medication less likely to get into the bloodstream and affect other parts of the body by preventing it from draining from your eye into your nose and the back of your throat.

DOSAGE: 1-3 x daily

ADDITIONAL READING: https://www.rxlist.com/simbrinza-drug.htm