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Alpha Agonists for the Treatment of Glaucoma

While there is no cure for glaucoma, it can be controlled with proper management.

Elevated intraocular pressure (IOP) can damage the optic nerve, which may lead to vision loss. Treatment for glaucoma focuses on lowering the IOP to a level that is less likely to cause further optic nerve damage. This is known as the “target pressure.” The target pressure differs from individual to individual. Your target pressure may change during your course of treatment.

If you have glaucoma, your ophthalmologist (Eye M.D.) may prescribe medication to lower your eye pressure. There are many more choices for topical treatment with eyedrops today than there were only a few years ago. Your ophthalmologist has chosen an alpha agonist medication to treat your glaucoma.

How Do Alpha Agonists Work?
Alpha agonist medications are reliable for lowering the intraocular pressure. They work by decreasing the production of the fluid that the eye continually makes, called the aqueous humor.

What Are the Alpha Agonists?
There are three alpha agonist drugs:

  • apraclonidine (Iopidine);
  • brimonidine (Alphagan, Alphagan P); and
  • dipivefrin (Propine).

A generic version of Alphagan is available.

Possible Side Effects of Alpha Agonists
All medications, including eyedrops, can have side effects.Some people taking alpha agonist eyedrops may experience

  • dry mouth;
  • ocular allergy with a red eye or red eyelids;
  • tiredness or fatigue;
  • low or high blood pressure and possible slowing of heart rate (less than with beta blockers);
  • blurred vision;
  • sensitivity of the eyes to bright light; and
  • headache.

For glaucoma medications to work, you must take them regularly and as prescribed by your doctor.

Medication Tips
With each new medication that your ophthalmologist prescribes, make sure you understand the following:

  • the name of the medication;
  • how to take it;
  • how often to take it;
  • how to store it;
  • if you can take it with your other medications (make sure all of your doctors know about all the different medications you take, including nonprescription medications);
  • what the possible side effects may be;
  • what you should do if you experience side effects; and
  • what you should do if you miss a dose.