Drug General Information (ID: DDIJ2M7ZCD)
Drug Name			Brimonidine (ophthalmic)		Drug Info		Zonisamide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Ophthalmic Glaucoma Agents				Analgesics
Structure

Mechanism of Brimonidine (ophthalmic)-Zonisamide Interaction (Severity Level: Moderate)
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Brimonidine (ophthalmic)				Zonisamide
Mechanism		CNS depression effects				CNS depression effects
Key Mechanism Factor 1
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Brimonidine (ophthalmic) and Zonisamide

Recommended Action
Management		Patients receiving topical alpha-2 adrenergic receptor agonists in combination with agents that can cause CNS depression should be made aware of the potential for increased adverse effects such as drowsiness, dizziness, lightheadedness and confusion, and counseled to avoid activities requiring mental alertness. Patients should also avoid rising abruptly from a sitting or recumbent position and notify their physician if they experience orthostasis or tachycardia.

References
1	Product Information. Alphagan (brimonidine ophthalmic). Allergan Inc, Irvine, CA.
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Product Information. Mirvaso (brimonidine topical). Galderma Laboratories Inc, Cranbury, NJ.