There has been a new step in science leading towards evolution. Alphagan P has been recognized as the next leading pharmaceutical product in the treatment of glaucoma. It is gentle on the ocular surface, unlike other medications which can damage it. Alphagan P provides an IOP reduction comparable to a beta blocker, but without the side effects caused by most other medications. It is an alpha-2 agonist, which is a class of drugs that bind to and stimulate alpha-2 adrenergic receptors, causing responses comparable to those of adrenaline and norepinephrine. Alphagan was first introduced in 1996. The latest generation of "adrenergic agonist" is three times more selective for alpha 2 receptors than apraclonidine. Due to its selectivity, it does not include alpha 1 side effects that affect the heart and blood pressure. The most important side effects are drowsiness, dry mouth and fatigue. There is also superficial irritation, with approximately “7 to 15% of patients suffering from allergic conjunctivitis.” Alphagan has remained popular since its release despite its side effects. What should you know about Alphagan P before using it? Be sure not to use brimonidine ophthalmic (Alphagan P) if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam ) or tranylcypromine (Parnate) in the past. 2 weeks. Tell your doctor if you have kidney or liver disease, heart disease, circulation problems such as Raynaud's or Buerger's disease, high blood pressure, a history of fainting, or low blood pressure . Be sure not to use this medication if you use contact lenses, as the medication contains a preservative that may be absorbed by soft contact lenses. If... middle of paper......continue their studies. Studies are currently underway to study this event in more detail. Although Alphagan P has a list of reported side effects, it remains the most widely used medication to treat glaucoma patients. Numerous clinical studies have been done on the drug since its release in 1996, and further improvements have been made since then. Works Cited Osborne, S., Montgomery, D., Morris, D. and McKay, I. (2005). Alphagan allergy may increase the propensity for multiple eye drop allergy. Eye, 19(2), 129-137. doi:10.1038/sj.eye.6701441Bowman, RC, Cope, JJ, & Nischal, KK (2004). Ocular and systemic side effects of brimonidine eye drops 0.2% (Alphagan®) in children. Eye, 18(1), 24-26. doi:10.1038/sj.eye.6700520ALPHAGAN P: THE NEXT STEP IN THE EVOLUTION OF GLAUCOMA THERAPY. (2003). Ophthalmology examination, 10(9), 8.