Evaluation of the Use of Brinzolamide-Brimonidine Fixed Combination in Maximum Medical Therapy

Turk J Ophthalmol. 2022 Aug 25;52(4):262-269. doi: 10.4274/tjo.galenos.2021.25488.


Objectives: To investigate the intraocular pressure (IOP)-lowering efficacy, safety, and treatment tolerability of brinzolamide/brimonidine fixed combination (BBFC) in maximum medical therapy.

Materials and methods: The medical records of 92 patients with glaucoma or ocular hypertension who had previously been treated with a different antiglaucomatous regimen and were switched to a treatment regimen that included BBFC were retrospectively analyzed. Patients were divided into 4 groups including 22, 20, 27, and 23 patients based on previous glaucoma treatment. All patients received maximum medical treatment regimen by adding a combination of beta blocker-prostaglandin analogue therapy along with BBFC. IOP values at baseline and month 1, month 3 and month 6 after starting BBFC and ocular adverse effects at follow-up visits were evaluated.

Results: The mean age of all patients was 62.7±16.6 years (range: 18-90). Fifty-two patients (56.5%) were women and 40 (43.5%) were men. Forty-eight (52.2%) patients had primary open-angle glaucoma, 35 (38.0%) had pseudoexfoliation glaucoma, and 9 (9.8%) had ocular hypertension. The IOP of the all eyes was 21.1±4.8 mmHg (range: 17-25) before and 17.6±3.7 mmHg, 17.3±3.4, and 17.0±3.5 mmHg at month 1, 3, and 6 after the introduction of BBFC, respectively (p<0.001 for all time points compared to baseline). In all 4 groups, a significant decrease in IOP was observed at month 1, 3, and 6 follow-ups compared to baseline after the introduction of BBFC. The mean number of antiglaucoma drops was significantly reduced from 2.5±0.6 at baseline to 2 after BBFC (p<0.001). The most frequent ocular adverse event was ocular allergic reactions reported in 8 patients (8.7%), conjunctival hyperemia in 5 patients (5.4%), and ocular discomfort in 2 patients (2.5%).

Conclusion: Maximum medical therapy with BBFC provides significant IOP reduction and antiglaucoma therapy simplification with a favorable safety profile in patients with glaucoma.

Keywords: Brimonidine; brinzolamide; fixed combination; glaucoma; intraocular pressure.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Brimonidine Tartrate / adverse effects
  • Brimonidine Tartrate / therapeutic use
  • Drug Combinations
  • Female
  • Glaucoma* / drug therapy
  • Glaucoma, Open-Angle* / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Ocular Hypertension* / chemically induced
  • Ocular Hypertension* / drug therapy
  • Retrospective Studies
  • Sulfonamides
  • Thiazines
  • Young Adult


  • Antihypertensive Agents
  • Drug Combinations
  • Sulfonamides
  • Thiazines
  • Brimonidine Tartrate
  • brinzolamide