SIMBRINZA (BRINZOLAMIDE/BRIMONIDINE)

Simbrinza is a brand name, prescription ophthalmic suspension, a generic combination drug containing Brinzolamide and Brimonidine Tartrate. Its manufacturer is Alcon Laboratories. It got FDA approval in 2013 for the lowering of increased intraocular pressure (IOP) caused by excess fluid accumulation in the eyes of patients suffering from open-angle glaucoma or having ocular hypertension.

Simbrinza eye drop contains a combination of Brinzolamide and Brimonidine Tartrate as its active ingredient and the following inactive ingredients: mannitol, sodium chloride, propylene glycol, carbomer 974P, tyloxapol, boric acid, and purified water. It even contains preservative benzalkonium chloride and pH adjuster hydrochloric acid and/or sodium hydroxide.

Brinzolamide is a water-insoluble, white powder chemically designated as (R)-(+)-4-Ethylamino-2-(3-methoxypropyl)-3,4-dihydro-2Hthieno [3,2-e]-1,2-thiazine-6-sulfonamide-1,1- dioxide. Brimonidine tartrate is a white to yellow, water-soluble powder chemically designated as 5-bromo-6-(2-imidazolidinyl ideneamino) quinoxaline L-tartrate.

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Simbrinza comes under the pharmacological class: Antiglaucoma Combos or Ophthalmic Glaucoma Agents. It is a fixed combination of an alpha-2 adrenergic receptor agonist and carbonic anhydrase inhibitor.

Antiglaucoma combos are the drug class that can work in different ways to reduce intraocular pressure. These include a reduction in the aqueous humor production or improved drainage of aqueous humor. Each of these medications acts on different enzymes or protein molecules.

Simbrinza is available in a 10mL bottle that has a combination medication of only 8mL. Each mL of Simbrinza eye drops contains 2mg (0.2%) of brimonidine tartrate and 1 mg (1%) of brinzolamide. This is the only strength available.

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Simbrinza is given by doctors to reduce intraocular pressure in patients suffering from:

• Open-angle Glaucoma: It is the most common form of glaucoma- an eye condition characterized by progressive atrophy of the optic nerve in the existence of an open angle. It obstructs the exiting of the flow of clear eye fluid (aqueous humor) which leads to a significant increase in fluid pressure within the eyes.
• Ocular Hypertension: It refers to the increased pressure of aqueous humor (a fluid) inside the eye. It can happen due to different reasons including excess production of aqueous humor or problems with drainage of aqueous humor. In some cases, this condition causes the patient to feel pain or discomfort while moving eyes or touching them.

The recommended dose of Simbrinza ophthalmic suspension is one drop in the affected eye(s) three times every day until prescribed by the doctor. It is also important to follow the recommended dosage and consult the doctor for any adjustments or concerns.

Simbrinza is an ophthalmic suspension, so it is meant for only topical use to the eyes. To apply Simbrinza Eye drops: Slightly tilt your head back and bring down the lower eyelid to create a tiny pocket for the installation of eye drops. Hold the DROP-TAINER dispenser above the affected eye and squeeze it a little to let a drop fall into the created pocket. Close your eyes for 1-2 minutes.

Common side effects include:

• Dry mouth or unpleasant taste.
• Watery eyes.
• Mild itchy or irritated eyes.
• Blurred vision.
• Drowsiness
• Red eyes.
• Allergic reaction.

Possible serious side effects that call for immediate medical attention are:

• Vision problems including tunnel vision, blurred vision, or seeing halos around lights.
• Swelling of the eyes, eye redness, crusting or drainage of the eyes, or severe eye discomfort.
• Signs of severe allergic reaction.

Simbrinza is known to interact with the ingredients of some medications including:

• Tricyclic antidepressants.
• Monoamine oxidase inhibitors.
• CNS depressants.
• Medications to treat hypertension.
• Furosemide
• Gabapentin
• Levothyroxine
• Lisinopril
• Rosuvastatin
• Tramadol
• Travatan Z (Travoprost Ophthalmic).

Simbrinza eye drops are not approved or safe for use by:

• Pregnant or Breastfeeding women.
• Anyone having an eye infection.
• People who are allergic to brinzolamide, brimonidine tartrate, any other components of the eye drop, or sulfa-drugs.
• Neonates and Infants aged below 2 years
• Anyone suffering from kidney disease, liver disease, hypertension, hypotension, depression, coronary artery disease, congestive heart failure, history of blood clot or stroke, circulation problems such as Raynaud’s syndrome, or narrow-angle glaucoma.

When using Simbrinza eye drops, it is important to watch for the following:

• Before starting using Simbrinza eye drops, inform the doctor of any existing allergies or medical conditions, current intake of medications/supplements, whether pregnant or breastfeeding, if planning pregnancy, and other significant health-related facts.
• Avoid contamination of dropper tip and solution by not letting the tip come in contact with eyelids or surrounding areas. When an eye drop is not in use, keep the bottle tightly closed.
• If wearing soft contact lenses, take them off before instilling Simbrinza eye drops and wear them back only when eyes are not red, after at least 5 minutes.
• Wash hands and shake the bottle well just before using the medication.
• Do not use eye drops if their contents appear cloudy or of a different color.
• If experiencing temporary blurred vision due to the use of Simbrinza eye drops, avoid driving or doing any activity that requires an alert mind, let vision become clear first.
• Do not consume alcohol while on the course of this medication as the components can interact with alcohol.

• Keep Simbrinza eye drops tightly closed at 2-25℃ when not in use.
• Store it away from heat and moisture and out of reach of small children.
• After opening the bottle, use it only till its date of expiration.
• If the weather is too hot, store it in a refrigerator but do not freeze it.
• Store Hiprex away from direct sunlight or bright light.

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