Hypotension and bradycardia in infants after the use of topical brimonidine and beta-blockers

Brimonidine is a selective alpha-2 adrenergic agonist used to treat glaucoma. There have been several reports of central nervous system depression after its use in infants. (1-4) We observed rapid-onset bradycardia and decreased blood pressure in addition to central nervous system depression in 2 infants who received concomitant topical brimonidine and beta-blockers.