Carbonic anhydrase inhibitor + alpha-2 agonist (combination eye drops)
Brinzolamide with brimonidine
Brand names: Simbrinza
Adult dose
Dose: 1 drop affected eye(s) BD
Route: Ophthalmic
Frequency: BD
Clinical pearls
- NICE NG81 glaucoma: combination drops to reduce drop burden when monotherapy inadequate
- RCOphth glaucoma pathway
- Punctal occlusion 1 minute reduces systemic absorption
Contraindications
- Severe renal impairment
- Concurrent MAOI / TCA
- Sulfonamide hypersensitivity
- Children <2 years
- Hypersensitivity
Side effects
- Ocular discomfort, taste disturbance, blurred vision
- Conjunctival hyperaemia
- Dry mouth
- Drowsiness
- Hypotension
- Allergic conjunctivitis
Interactions
- Oral CAIs
- CNS depressants
- MAOIs
Monitoring
- IOP
- Visual fields
- BP / HR
Reference: BNF; NICE NG81; RCOphth; SmPC; https://bnf.nice.org.uk/drugs/brinzolamide-with-brimonidine/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Acute Red Eye / Vision Loss Screen · RCOphth 2020; NICE CKS
- Idiopathic Intracranial Hypertension · ABN; consensus 2018
- Acute Red Eye Assessment · RCOphth / AAO
- Acute Angle Closure Glaucoma · RCOphth / EGS Guidelines
- Retinal Detachment · RCOphth Guidelines / EURETINA
- Diabetic Retinopathy — Screening and Management · NICE NG28 2016 / NHS DES Programme