Accidental poisoning with brimonidine eye drops in a 9-day-old infant

Brimonidine is a selective alpha-2-adrenergic agonist used to treat glaucoma. We report a case of a 9-day-old female who developed, 90 minutes after accidental ingestion of 3 eye drops of 0.2% brimonidine, coma, apnea, hyperglycemia and miosis requiring intubation and mechanical ventilation. Plasma concentration, 3 hours after intake, was 11.7 ng/mL. Normal consciousness was reached after 27 hours. Apnea recovered slowly, normal breath was reached 47 hours after accidental intake. This report adds to the existing evidence that brimonidine has serious systemic effects in newborns and can require fast and supportive management in intensive care unit.