A Comparison of the Short-Term Hypotensive Effects and Side Effects of Unilateral Brimonidine and Apraclonidine in Patients with Elevated Intraocular Pressure

Abstract

Purpose: To compare the short-term ocular hypotensive efficacy and side effects of 0.2% brimonidine and 0.5% apraclonidine in patients with elevated intraocular pressure (IOP). Methods: We performed a double-masked, placebo-controlled study to compare the efficacy of the application of 0.2% brimonidine and 0.5% apraclonidine for the effect of IOP, systemic blood pressure and heart rate in 20 newly diagnosed ocular hypertensive patients. Effects on the untreated fellow eye and ocular side effects were also determined. All measurements were performed 1, 2, 4, 6 and 8 h after the instillation of one drop. Results: Brimonidine and apraclonidine significantly reduced IOP from baseline at all observation times. No significant difference was observed between the treatment groups. IOP decreased significantly in the untreated fellow eye in the brimonidine group at 4-, 6- and 8-hour checks and at 6-hour checks in the apraclonidine group when compared with placebo. Blood pressure and heart rate decreased significantly in the brimonidine group compared with placebo. Apraclonidine did not affect blood pressure or heart rate any differently than placebo. The pupil diameter and the interpalpebral fissure width significantly increased in the apraclonidine group, but not in the brimonidine group. There were no significant differences in the overall incidence of foreign body sensation, burning and stinging and dry mouth in the treatment groups. Conclusions: In the short-term, brimonidine was effective in reducing IOP in patients with elevated IOP and was equivalent in efficacy to apraclonidine. On the other hand, a significant change in blood pressure and heart rate was observed with brimonidine; there was no change at all in the apraclonidine group.

Recent advances in pharmacotherapy of glaucoma

“…Its efficacy was equivalent to that of apraclonidine. [22] Due to high selective action on a-2 adrenoceptor agonist activity, the IOP-lowering ability of brimonidine may be comparable with that of timolol and dorzolamide and superior to betaxolol. [23–25] Brimonidine is available as 0.2 and 0.5%, to be applied twice daily.…”

Influência do colágeno tipo I na propriedade físico-química, morfológica e biológica de blendas poliméricas de PLGA para aplicação oftálmica

“…Diversas estratégias de obtenção de novos sistemas de liberação de drogas associados a biotecnologia e desenvolvimento de biomateriais, tem sido alvo de constantes de pesquisas devido as grandes vantagens que oferecem à terapêutica, tais como aumento da biodisponibilidade, liberação prolongada e controlada de drogas, redução de efeitos colaterais, redução dos riscos de infecção, redução ou anulação da frequência de administração proporcionando maior conforto, menor custo e portanto, maior adesão ao tratamento [21,22]. Nesse sentido, as propriedades desejáveis dos polímeros de PLGA e colágeno encontradas em sistema de liberação de drogas impulsiona a descoberta de novos produtos versáteis e aplicáveis na área médica.…”

Contralateral intraocular pressure lowering effect of prostaglandin analogues

“…[3456] Topical alpha-adrenergic agonists have also been reported to have a contralateral effect. [789] Similar studies evaluating the contralateral effects of prostaglandin analogues (PGA) are sparse,[510] despite PGA showing a marked increase in their use for reduction of IOP over the past decade. [11] The purpose of this study was to evaluate if PGA treatment in one eye has an effect on the IOP of the untreated fellow eye.…”