Side effects seen with pediatric brimonidine use

The use of brimonidine to lower IOP in pediatric patients is effective but not without frequent side effects, according to a study. The authors suggested that alternatives should be considered, especially in children weighing under 20 kg or younger than 6 years of age.

Sami Al-Shahwan, MD, and colleagues at the King Khaled Eye Specialist Hospital in Saudi Arabia studied 83 children with primary infantile and secondary glaucoma to determine the side effects and IOP-lowering efficacy of brimonidine in this population. The average age of the children was 7.84 years. The patients’ parents completed a detailed questionnaire-type interview, and the children were examined to assess weight, major systemic effects and efficacy of adjunctive brimonidine therapy.

Parents reported side effects in 70 of 83 children (84%). The most common side effects were excessive sleepiness and lethargy (76%), eye itching and rubbing (49%) and stinging/burning of the eyes (39%). Age and weight correlated statistically to the lethargy and sleepiness levels. In symptomatic patients, symptom frequency increased with low weight and in those under 6 years old. The mean IOP reduction, mainly using brimonidine as an adjunctive therapy, was 5 mm Hg.

The study is published in the December issue of Ophthalmology.