brinzolamide 1% and brimonidine tartrate 0.2%
CONSUMER MEDICINE INFORMATION
What is in this leaflet
Please read this leaflet carefully
before you use Simbrinza Eye Drops.
This leaflet answers some common
questions about Simbrinza Eye
Drops. It does not contain all of the
available information. It does not
take the place of talking to your
doctor or pharmacist.
The information in this leaflet was
last updated on the date listed on the
final page. More recent information
on the medicine may be available.
You should ensure that you speak to
your pharmacist or doctor to obtain
the most up to date information on
You can also download the most up
to date leaflet from
The updates may contain important
information about the medicine and
its use of which you should be aware.
All medicines have risks and
benefits. Your doctor has weighed
the expected benefits of you using
Simbrinza Eye Drops against the
risks this medicine could have for
The information in this leaflet applies
to Simbrinza only. This information
does not apply to similar products,
even if they contain the same
If you have any concerns about
using this medicine, ask your
doctor or pharmacist.
Keep this leaflet with the medicine.
You may need to read it again.
What SIMBRINZA is
Simbrinza is used to lower pressure
in the eye and to treat open-angle
glaucoma or ocular hypertension.
Glaucoma is a condition in which the
pressure of fluid in the eye may be
high. However, some people with
glaucoma may have normal eye
Glaucoma is usually caused by a
build up of the fluid which flows
through the eye. This build up occurs
because the fluid drains out of your
eye more slowly than it is being
pumped in. Since new fluid continues
to enter the eye, joining the fluid
already there, the pressure continues
to rise. This raised pressure may
damage the back of the eye resulting
in gradual loss of sight. Damage can
progress so slowly that the person is
not aware of this gradual loss of
sight. Sometimes even normal eye
pressure is associated with damage to
the back of the eye.
There are usually no symptoms of
glaucoma. The only way of knowing
that you have glaucoma is to have
your eye pressure, optic nerve and
visual field checked by an eye
specialist. If glaucoma is not treated,
it can lead to serious problems,
including total blindness. In fact,
untreated glaucoma is one of the
most common causes of blindness.
Simbrinza is not suitable for use in
acute angle-closure glaucoma.
Simbrinza combines two ingredients,
brinzolamide and brimonidine
tartrate. Brinzolamide is a carbonic
anhydrase inhibitor and brimonidine
tartrate is an alpha-2 adrenergic
agonist. Both brinzolamide and
brimonidine tartrate work by
reducing the production of fluid
within the eye.
For more information about
glaucoma, contact Glaucoma
Australia (telephone 1800 500 880).
Your doctor may have prescribed
Simbrinza for another reason. Ask
your doctor if you have any questions
about why Simbrinza has been
prescribed for you.
This medicine is available only with
a doctor's prescription.
There is no evidence that Simbrinza
Use in Children
Simbrinza Eye Drops are not
recommended in children and young
adults aged between 2 to 17 years as
the safety and efficacy in children
has not been established.
Simbrinza Eye Drops should not be
used in children under 2 year of age.
Before you use
When you must not use it
Do not use Simbrinza if you have an
any other carbonic anhydrase
inhibitor or alpha-2 adrenergic
any of the ingredients listed at the
end of this leaflet.
If you are unsure if you are taking
or using any of these medicines ask
Some of the symptoms of an allergic
reaction may include:
shortness of breath
wheezing or difficulty breathing
swelling of the face, lips, tongue
or other parts of the body
rash, itching or hives on the skin.
Do not use Simbrinza if:
you have severe kidney problems
you have too much acidity in
your blood (a condition called
Do not use Simbrinza if:
you are taking any antidepressant
These include medicines called
monoamine oxidase (MAO)
inhibitors or other types of
Do not use this medicine after the
expiry date printed on the pack or
bottle, if the seal around the pack
is broken or shows signs of
If it has expired or is damaged, return
it to your pharmacist for disposal.
If you use this medicine after the
expiry date has passed, it may not
If you are not sure whether you
should start using Simbrinza, talk
to your doctor.
Before you start to use it
Tell your doctor if you have had an
allergy to any other medicines or
any other substances, such as
foods, preservatives or dyes.
Tell your doctor if you have an
allergy to sulphonamide medicines.
Brinzolamide, one of the active
ingredients in Simbrinza, is a sulfur-
containing medicine. If you are
allergic to sulfur medicines, such as
some antibiotics, you may be allergic
to Simbrinza Eye Drops. Check with
your doctor or pharmacist if you are
not sure whether you are allergic to
Tell your doctor if you have or
have had any medical conditions,
in particular the following:
These include coronary heart
disease (symptoms can include
chest pain or tightness,
breathlessness or choking), heart
failure, high or low blood
These include Raynaud's disease,
(Buerger disease) where there is
inflammation and clotting of the
small and medium arteries and
veins of the hands and feet and
poor circulation of blood in the
compromised cornea and/or
Tell your doctor if you are
pregnant or plan to become
Your doctor will discuss the possible
risks and benefits of using Simbrinza
Tell your doctor if you are
Your doctor will discuss the possible
risks and benefits of using Simbrinza
when you are breast-feeding.
If you have not told your doctor
about any of the above, tell
him/her before you use Simbrinza.
Taking or using other
Tell your doctor if you are taking or
using any other medicines, including
other eye drops or ointments, and any
other medicines that you buy without
a prescription from your pharmacy,
supermarket or health food shop.
Some medicines and Simbrinza may
interfere with each other or add to the
effects of Simbrinza. These include:
medicines to lower blood
digoxin, a medicine used to treat
other medicines or eye drops for
carbonic anhydrase inhibitors
such as acetazolamide,
antiviral or antibiotic medicines
salicylates such as aspirin
monoamine oxidates (MAO)
inhibitors, or other
clomipramine and mianserin.
CNS depressants such as alcohol,
barbiturates, opiates, sedatives or
These medicines may be affected by
Simbrinza, or may affect how well it
works. You may need different
amounts of your medicines, or you
may need to take different medicines.
Your doctor or pharmacist has more
information on medicines to be
careful with or avoid while using
How to use
Carefully follow all directions
given to you by your doctor and
They may differ from the
information contained in this leaflet.
If you are being changed from one
medicine to another, follow your
doctor's instructions carefully as to
when to stop the medicine and when
to start the new eye drops.
If you do not understand the
instructions on the carton, ask
your doctor or pharmacist for
How much to use
Use Simbrinza only when prescribed
by your doctor.
The usual dose of Simbrinza is one
drop in the affected eye(s) twice
daily. Usually, this means one drop
in the affected eye(s) first thing in the
morning, and one drop in the
Your doctor will tell you how many
drops you need to use each day.
These dosing instructions will be
printed on the label your pharmacist
How to use it
It is important to use Simbrinza
exactly as your doctor or pharmacist
has told you. If you use the drops less
often than prescribed, they may not
work as well and the eye problem
may not improve. Using the drops
more often than prescribed may not
improve the eye problem any faster
and may cause increased side effects.
If you are wearing soft contact
lenses, remove them before putting
the drops in your eye.
Follow these steps to use the eye
Wash your hands thoroughly with
soap and water.
Immediately before using a bottle
for the first time, break the safety
seal around the neck area and
throw the loose plastic ring away.
Shake the bottle.
Remove the cap from the bottle.
Hold the bottle upside down in
one hand between your thumb
and middle finger (see Diagram
While tilting your head back,
gently pull down the lower eyelid
of your eye to form a
Place the tip of the bottle close to
your eye. Do not let it touch your
Release one drop into the
pouch/pocket formed between
your eye and eyelid by gently
tapping or pressing the base of
the bottle with your forefinger
(see Diagrams 2 and 3).
Close your eye. Do not blink or
rub your eye.
10. While your eye is closed, place
your index finger against the
inside corner of your eye and
press against your nose for about
two minutes. This will help to
stop the medicine from draining
through the tear duct to the nose
and throat, from where it can be
absorbed into other parts of your
body. This will also reduce the
unpleasant taste sensation that
some people experience when
using these drops.
11. If necessary, repeat the above
steps for the other eye.
12. Your eyelids can only hold less
than one drop at a time, so it is
normal for a small amount of the
eye drop to spill onto your cheek.
You should wipe away any
spillage with a tissue.
13. Replace the cap on the bottle,
closing it tightly.
14. Wash your hands again with soap
and water to remove any residue.
You may feel a slight burning
sensation in the eye shortly after
using the eye drops. If this persists,
or is very uncomfortable, contact
your doctor or pharmacist.
Be careful not to touch the dropper
tip against your eye, eyelid or
This will help prevent the drops
becoming dirty or contaminated.
If you have trouble knowing whether
you have placed your drops correctly,
you may want to store them in the
fridge. Some people find it easier to
feel the drops in the eye if they are
After using Simbrinza, wait at least 5
minutes before putting any other eye
drops in your eye(s).
Wait 15 minutes before replacing
your contact lenses.
When to use it
Use Simbrinza every day, at about
the same times each day, unless your
doctor tells you otherwise. Using
your eye drops at the same times
each day will have the best effect on
your eye pressure. It will also help
you remember when to use the eye
How long to use it
Simbrinza helps control your
condition but does not cure it.
Simbrinza must be used every day.
Continue using SIMBRINZA for as
long as your doctor prescribes.
If you are unsure about when or how
to stop using Simbrinza, you should
talk to your doctor or pharmacist.
If you forget to use it
If it is almost time for your next
dose, skip the dose you missed and
use your next dose when you are
Otherwise, use the drops as soon as
you remember, and then go back
to using them as you would
Do not use double the amount to
make up for the dose that you
Using multiple doses may cause
unwanted side effects.
If you are not sure whether to skip
the dose, talk to your doctor or
If you have trouble remembering
to use your eye drops, ask your
pharmacist for some hints.
If you use too much
If you accidentally put several drops
in your eye(s), immediately rinse
your eye(s) with warm water.
If you think that you or anyone
else may have swallowed any or all
of the contents of a bottle of
Simbrinza, immediately telephone
your doctor or the Poisons
Information Centre on 13 1126 for
advice, or go to Accident and
Emergency at your nearest
hospital. Do this even if there are
no signs of discomfort or
While you are using
Things you must do
Have your eye pressure checked
when your eye specialist says, to
make sure Simbrinza is working.
If you are about to start taking or
using any new medicine, tell your
doctor and pharmacist that you
are using Simbrinza.
Tell all the doctors, dentists and
pharmacists who are treating you
that you are using Simbrinza.
Tell your doctor if, for any reason,
you have not used Simbrinza
exactly as prescribed. Otherwise
your doctor may think that the eye
drops were not effective and
change the treatment
If you become pregnant or decide
to breastfeed while using
Simbrinza, tell your doctor
Things you must not do
Do not use Simbrinza to treat other
complaints unless your doctor tells
Do not give Simbrinza to anyone
else, even if they have the same
condition as you.
Do not stop using Simbrinza
without first talking to your
doctor. If you stop using your eye
drops, your eye pressure may rise
again and damage to your eye may
Do not put the Simbrinza eye
drops into your eye(s) while you
are wearing soft contact lenses.
The preservative in Simbrinza
(benzalkonium chloride) may be
deposited in soft contact lenses. You
can put your soft contact lenses back
into your eyes 15 minutes after you
have used Simbrinza.
Things to be careful of
Be careful driving, operating
machinery or performing tasks
requiring mental alertness and/or
physical coordination until you
know how Simbrinza affects you
and your vision. As with any eye
medicine, temporary blurred
vision or other visual disturbances
may affect the ability to drive or
use machinery in some people. If
blurred vision occurs when you use
your drops, wait until your vision
is clear before driving or operating
Tell your doctor or pharmacist as
soon as possible if you do not feel
well while you are using Simbrinza.
Simbrinza helps most people with
high eye pressure and glaucoma, but
it may have unwanted side effects in
a few people.
All medicines can have side effects.
Sometimes they are serious, most of
the time they are not. You may need
medical treatment if you get some of
the side effects.
Do not be alarmed by the following
list of possible side effects. You
may not experience any of them.
Ask your doctor or pharmacist to
answer any questions you may
Tell your doctor if you notice any
of the following effects in the eye(s)
and the eye area, and they worry
eye surface inflammation
feeling of having something in
These are the more common side
effects of your medicine. They are
usually mild and short-lived.
Additional side effects that are
noticed less often include:
eye surface inflammation with
sensitivity to bright light
redness of the eyelids
inflammation of the eyelids
deposits on the eye surface
eye and eyelid swelling.
Occasionally some people notice
unwanted effects in the rest of their
body as a result of using Simbrinza.
These effects may include:
bad taste in the mouth
decreased blood pressure
abnormal sensation in mouth
skin inflammation, redness or
If any of the following happen, stop
using Simbrinza and tell your
doctor immediately or go to
Accident and Emergency at your
swelling of the face, hands or feet
wheezing, difficulty in breathing
shortness of breath (dyspnoea,
severe and sudden onset of
pinkish, itchy swellings on the
skin, also called hives or nettle
These hypersensitivity reactions can
be very serious side effects. You may
need urgent medical attention or
hospitalisation. These side effects are
Other side effects not listed above
may also occur in some people.
Store Simbrinza in a cool dry place
where the temperature stays below
25°C. It is not necessary to store
Simbrinza in the refrigerator, but it is
acceptable if you prefer to instil cold
Do not store Simbrinza or any
other medicine in the car, in the
bathroom or in other warm, damp
Heat and dampness can destroy some
Do not leave the top off the bottle
for any length of time, to avoid
contaminating the eye drops.
Keep it where children cannot
A locked cupboard at least one-and-
a-half metres above the ground is a
good place to store medicines.
Write the date on the bottle when
you open the eye drops and throw
out any remaining solution after
Eye drops contain a preservative
which helps prevent germs growing
in the solution for the first four
weeks after opening the bottle. After
this time there is a greater risk that
the drops may become contaminated
and cause an eye infection. A new
bottle should then be used.
If your doctor tells you to stop
using Simbrinza or they have
passed their expiry date, ask your
pharmacist what to do with any
What it looks like
Simbrinza is a liquid (white to off-
white uniform suspension) supplied
in a pack containing 5 mL in an 8 mL
dropper bottle (DROP-TAINER)
with screw cap.
Tamper evidence is provided with a
safety seal around the neck area of
Simbrinza contains the active
brinzolamide 10 mg/mL
brimonidine tartrate 2 mg/mL.
Simbrinz also contains the inactive
benzalkonium chloride (used as a
hydrochloric acid and/or sodium
hydroxide are added to adjust pH.
Simbrinza is supplied in Australia
Novartis Pharmaceuticals Australia
ABN 18 004 244 160
54 Waterloo Road
Macquarie Park NSW 2113
Telephone No. 1800 671 203
Date of preparation
This leaflet was prepared in August
Australian Register Number
AUST R 219839
© Novartis Pharmaceuticals
Australia Pty Limited 2017
® Registered Trademark
Internal document code:
(sib030717c) based on PI