Brimistar-S

Brimonidine (0.1% w/v) + Stabilized Oxychloro (0.005% w/v)
Price: ₹175 - ₹215 (MRP for 5ml)
Mfr: Micro Labs Limited | Form: Ophthalmic Solution

📋 Clinical Overview

A fixed-dose combination ophthalmic solution primarily indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. Brimonidine is a selective alpha-2 adrenergic agonist that reduces aqueous humor production and increases uveoscleral outflow. Stabilized Oxychloro (Sodium Chlorite, stabilized) is a broad-spectrum antimicrobial and anti-inflammatory agent that helps manage blepharitis and ocular surface inflammation often associated with glaucoma therapy, improving tolerability and compliance.

💊 Dosage & Administration

Adult: One drop in the affected eye(s) twice daily, approximately 12 hours apart.

Note: Wash hands before use. Tilt head back, pull lower eyelid down to form a pouch. Instill one drop. Close eyes gently for 1-2 minutes, applying light pressure with finger at the inner corner of the eye (nasolacrimal occlusion) to minimize systemic absorption. Wait at least 5 minutes before instilling any other ophthalmic medication. Do not touch dropper tip to any surface to avoid contamination.

⚠️ Contraindications

  • Hypersensitivity to brimonidine tartrate, stabilized oxychloro, or any component of the formulation
  • Patients on monoamine oxidase (MAO) inhibitor therapy
  • Infants and neonates (risk of severe CNS depression, apnea, bradycardia)

🔬 Mechanism of Action

Brimonidine tartrate is a relatively selective alpha-2 adrenergic receptor agonist. Its primary mechanism for lowering IOP is dual: reduction of aqueous humor production by the ciliary body and increased uveoscleral outflow. Stabilized Oxychloro (Sodium Chlorite 0.005%) is an oxidative agent that, in solution, generates chlorine dioxide (ClO2). It exhibits broad-spectrum antimicrobial activity against bacteria, viruses, fungi, and Demodex mites. It also has anti-inflammatory properties, reducing pro-inflammatory cytokines and reactive oxygen species on the ocular surface and lid margin.

🤕 Side Effects

  • Ocular hyperemia (redness)
  • Ocular burning or stinging upon instillation
  • Foreign body sensation
  • Pruritus (itching) of the eye
  • Blurred vision (transient)
  • Oral dryness (bitter taste due to nasolacrimal drainage)

🤰 Special Populations

Pregnancy: Category B. Animal studies have shown no risk, but no adequate and well-controlled studies in pregnant women. Use only if clearly needed and potential benefit justifies potential risk to the fetus.

Driving: May cause blurred vision, dizziness, fatigue, or drowsiness. Patients should not drive or use machinery until they know how the medication affects them.

🔄 Drug Interactions

Antihypertensives (Beta-blockers, ACE inhibitors, Diuretics)Additive hypotensive effect, risk of severe hypotension/bradycardia.Major
Cardiac Glycosides (Digoxin)Increased risk of bradycardia.Moderate
Tricyclic Antidepressants (Amitriptyline, Imipramine)May antagonize the IOP-lowering effect of brimonidine.Moderate
Monoamine Oxidase Inhibitors (Phenelzine, Tranylcypromine)Potentiation of systemic alpha effects (hypertensive crisis); CONTRAINDICATED.Major
CNS Depressants (Alcohol, Barbiturates, Opioids, Benzodiazepines)Additive sedative effects.Moderate
Other Topical Ophthalmic Agents (Beta-blockers, Prostaglandins, CAIs)Additive IOP-lowering effect. Administer at least 5 minutes apart.Minor

🔁 Alternatives to Brimistar-S

Same composition (Brimonidine (0.1% w/v) + Stabilized Oxychloro (0.005% w/v)), different brands:

Brimate-S Briox-S Brimotim-S