Cardiorespiratory depression and hyperglycemia after unintentional ingestion of brimonidine in a neonate

PURPOSE. Brimonidine is a third-generation selective alpha-2 adrenergic agonist that lowers intraocular pressure by decreasing aqueous humor production and increasing uveoscleral flow. Its safety profile for children <2 years of age remains unknown. METHODS. We describe a case of ingestion of a single drop of brimonidine 0.2% in a newborn, resulting in sedation, cardiorespiratory depression, and hyperglycemia within minutes. CONCLUSIONS. This report adds to the existing evidence that brimonidine can have serious adverse side effects and should therefore be used with extreme caution in infants <2 years of age. Additionally, safety procedures like double-checking should also include vitamins or oral supplements to improve medication safety in the neonatal intensive care unit. (Eur J Ophthalmol 2009; 19: 694-5)