Открытоугольная глаукома. Повышенное глазное давление (как монотерапия, так и в комбинации с другими препаратами, которые снижают ВГД).
Противопоказания
Повышенная чувствительность к бримонидина тартрату и другим компонентам Альфаган Р. Одновременная терапия ингибиторами МАО. Период беременности и кормления грудью. Детский возраст до 2 лет, низкая масса тела (до 20 кг), поскольку безопасность и эффективность препарата у данных групп пациентов не изучалась.
Бримонидин — селективный α2-адреномиметик, оказывающий стимулирующее действие на α2-адренорецепторы. При применении в форме глазных капель 1,5 мг/мл максимальный эффект снижения внутриглазного давления (ВГД) достигается через 2 ч. Гипотензивное действие бримонидина обеспечивается за счет снижения образования и повышения оттока внутриглазной жидкости по увеосклеральному тракту.
Показания к применению
Открытоугольная глаукома. Повышенное глазное давление (как монотерапия, так и в комбинации с другими препаратами, которые снижают ВГД).
Противопоказания
Повышенная чувствительность к бримонидина тартрату и другим компонентам Альфаган Р. Одновременная терапия ингибиторами МАО. Период беременности и кормления грудью. Детский возраст до 2 лет, низкая масса тела (до 20 кг), поскольку безопасность и эффективность препарата у данных групп пациентов не изучалась.
Применение при беременности и в период грудного вскармливания
Противопоказано.
Способ применения и дозы
Применяют местно. Закапывают в конъюнктивальный мешок пораженного глаза по 1 капле 3 раза в сутки с интервалом между введениями 8 ч. Альфаган Р можно применять с другими офтальмологическими препаратами с целью снижения ВГД. Если пациент одновременно применяет другие глазные капли, следует придерживаться интервала как минимум 5 мин между закапываниями.
Побочное действие
Частоту побочных эффектов, выявленных в ходе исследований, оценивали таким образом: очень часто (больше 10%); часто (больше 1% и меньше 10%); нечасто (больше 0,1% и меньше 1%); редко (больше 0,01% и меньше 0,1%). В клинических исследованиях препарата Альфаган П выявленны следующие побочные эффекты: Со стороны органов зрения: очень часто — аллергический конъюнктивит, гиперемия конъюнктивы глаз, зуд слизистой оболочки глаз и кожи век; часто — ощущение жжения, фолликулез конъюнктивы глаз и фолликулярный конъюнктивит, местные аллергические реакции слизистой оболочки глаз (в том числе кератоконъюнктивит), блефарит, блефароконъюнктивит, нарушение четкости зрительного восприятия, катаракта, отек конъюнктивы, кровоизлияние в конъюнктиву, конъюнктивит, ретенционное слезотечение, слизистые выделения из глаз, сухость и раздражение слизистой оболочки глаз, боль, отек век, покраснение век, ощущение инородного тела в глазах, кератит, поражение век, фоточувствительность, поверхностная пятнистая кератопатия, слезотечение, выпадание поля зрения, функциональное поражение стекловидного тела, кровоизлияние в стекловидное тело, плавающие помутнения в стекловидном теле и снижение остроты зрения; нечасто — эрозия роговицы, ячмень. Со стороны ЦНС: часто — головная боль, сонливость, бессонница, головокружение. Со стороны сердечно-сосудистой системы: часто — повышение АД; нечасто — снижение АД. Со стороны органов дыхания: часто — бронхит, кашель, одышка; нечасто — сухость слизистой оболочки носа, апноэ. Со стороны ЖКТ: часто — желудочно-кишечные расстройства, диспепсия, сухость слизистой оболочки полости рта. Со стороны кожи и подкожно-жировой клетчатки: часто — высыпания, инфекционное заболевание (озноб и респираторная инфекция), ринит, синусит, в том числе инфекционный. Лабораторные показатели: часто — гиперхолестеринемия. Другие: часто — общие аллергические реакции, астения, утомляемость; нечасто — изменение вкусовых ощущений. У детей отмечено: апноэ, брадикардия, снижение АД, гипотермия, мышечная гипотония. Дополнительно получены данные о следующих эффектах: Со стороны органов зрения: частота неизвестна — ирит, кератоконъюнктивит, миоз. Со стороны ЦНС: депрессия. Со стороны сердечно-сосудистой системы: брадикардия, тахикардия. Со стороны ЖКТ: тошнота. Со стороны кожи и подкожно-жировой клетчатки: местные кожные реакции (эритема, зуд, отек лица, сыпь и вазодилатация сосудов кожи век).
Передозировка
Сообщений о случаях передозировки препарата нет. При случайном приеме препарата внутрь возможны следующие симптомы: угнетение ЦНС, сонливость, потеря сознания, снижение АД, брадикардия, снижение температуры тела, цианоз кожных покровов, апноэ. При выявлении симптомов передозировки необходимо проведение симптоматической терапии, контроль проходимости дыхательных путей.
Особые указания
Несмотря на данные, свидетельствующие о незначительном влиянии бримонидина тартрата на общее АД, необходимо с осторожностью применять его у больных со следующими заболеваниями: ортостатическая гипотензия, тяжелые сердечно-сосудистые заболевания, которые сопровождаются сердечной недостаточностью, цереброваскулярные заболевания, приводящие к церебральной недостаточности, почечная недостаточность (клиренс креатинина меньше 40 мл/мин), печеночная недостаточность, депрессия, синдром Рейно, облитерирующий тромбангиит. Необходимо сторого контролировать состояние больных при вышеперечисленных состояниях, при ухудшении состояния больного необходимо отменить прием препарата. Пациентам, которые носят мягкие контактные линзы, перед инстилляцией препарата необходимо их снять. Контактные линзы можно снова одеть через 15 мин.
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