Simbrinza Ophthalmic Drops contain a combination of brimonidine and brinzolamide. Brimonidine and brinzolamide reduce the amount of fluid in the eye, which decreases pressure inside the eye.

Simbrinza is used to treat open-angle glaucoma or ocular hypertension (high pressure inside the eye).

Simbrinza may also be used for purposes not listed in this medication guide.

Simbrinza should not be given to a child younger than 2 years old.

Simbrinza may cause drowsiness in some patients. Use caution when driving, operating machinery, or performing other hazardous activities.

Stop using Simbrinza and call your doctor at once if you have blurred or tunnel vision, eye pain, see halos around lights, eye redness, or severe discomfort.

Take special care that the tip of the dropper bottle does not touch your eye, the skin around your eye or your fingers. Germs can spread into the medicine bottle if you touch the tip of the bottle.

Use Simbrinza exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Do not use this medication while wearing contact lenses. Simbrinza may contain a preservative that can discolor soft contact lenses. Wait at least 15 minutes after using this medicine before putting in your contact lenses.

Wash your hands before using the eye drops.

Shake the eye drops well just before each use.

To apply the Simbrinza eye drops:

• Tilt your head back slightly and pull down your lower eyelid to create a small pocket. Hold the dropper above the eye with the tip down. Look up and away from the dropper and squeeze out a drop.

• Close your eyes for 2 or 3 minutes with your head tipped down, without blinking or squinting. Gently press your finger to the inside corner of the eye for about 1 minute, to keep the liquid from draining into your tear duct.

• Use only the number of drops your doctor has prescribed. If you use more than one drop, wait about 5 minutes between drops.

• Wait at least 5 minutes before using any other eye drops your doctor has prescribed.

Do not touch the tip of the eye dropper or place it directly on your eye. A contaminated dropper can infect your eye, which could lead to serious vision problems.

Do not use Simbrinza eye drops if the liquid has changed colors or has particles in it. Call your pharmacist for new medicine.

Tell your doctor right away if you have any eye injury or infection, or if you need to have any type of surgery, especially eye surgery.

Store Simbrinza at room temperature away from moisture and heat. Do not freeze. Keep the bottle tightly closed when not in use.

You should not use Simbrinza if you are allergic to brimonidine or brinzolamide.

Simbrinza should not be given to a child younger than 2 years old.

To make sure Simbrinza is safe for you, tell your doctor if you have:

• kidney disease;

• liver disease;

• congestive heart failure, coronary artery disease, history of stroke or blood clot;

• high or low blood pressure;

• circulation problems, such as Raynaud's syndrome (numbness or cold feeling in your fingers or toes);

• depression;

• an allergy to sulfa drugs; or

• narrow-angle glaucoma.

FDA pregnancy category C. It is not known whether Simbrinza will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether brimonidine and brinzolamide passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

An overdose of Simbrinza is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Get emergency medical help if you have any of these signs of an allergic reaction ro Simbrinza: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

You may have other signs of allergic reaction that develop more slowly while using this medicine. Call your doctor if you have:

• sudden liver failure--nausea, vomiting, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes), confusion, rapid weight gain, (especially in your midsection);

• bone marrow suppression--sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, red or swollen gums, trouble swallowing, pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

• severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Stop using this medicine and call your doctor at once if you have:

• blurred vision, tunnel vision, eye pain, or seeing halos around lights; or

• eye swelling, redness, severe discomfort, crusting or drainage (may be signs of infection).

Common Simbrinza side effects may include:

• blurred vision;

• mild itching, redness, or irritation of your eyes; or

• dry mouth, unpleasant taste.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other drugs may interact with Simbrinza, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.