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Brimonidine is a highly selective alpha-2 adrenergic receptor agonist and 2-imidazoline derivative used primarily to lower intraocular pressure in patients with open-angle glaucoma or ocular hypertension. It is also approved for the topical treatment of persistent facial erythema associated with rosacea. Brimonidine acts by reducing aqueous humor production and increasing uveoscleral outflow in the eye. Its selectivity for alpha-2 over alpha-1 adrenergic receptors minimizes systemic side effects and unwanted ocular effects compared to less selective agents. For rosacea, its vasoconstrictive action on peripheral blood vessels reduces facial redness[3][4][5][6][8].
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