Brimonidine (Alphagan) is especially effective in which type of glaucoma?

Brimonidine, marketed as Alphagan, is primarily prescribed for the management of primary open-angle glaucoma (POAG). This medication belongs to a class of drugs known as alpha-2 adrenergic agonists, which work by decreasing aqueous humor production and increasing uveoscleral outflow. The reduction in intraocular pressure (IOP) that Brimonidine provides is particularly beneficial in POAG, which is characterized by an open anterior chamber angle and the need to manage chronic elevated IOP.

In the context of different types of glaucoma, while Brimonidine can have some effectiveness in managing secondary glaucoma or even normal-tension glaucoma, its primary indication and the greatest evidence supporting its efficacy is found in patients with primary open-angle glaucoma. This makes it a first-line treatment option for this specific condition, aligning with the most common form of glaucoma seen in the general population.

The option related to closed-angle glaucoma typically requires immediate surgical intervention or different classes of medications, as the angle closure leads to rapid increases in IOP that are not sufficiently addressed by medications like Brimonidine. Therefore, choosing primary open-angle glaucoma reflects an understanding of the specific pharmacological action and clinical applications of Brimonidine.