Which ocular medication should be avoided in patients with a history of MAOI usage to prevent dangerous interactions?

Brimonidine should be avoided in patients with a history of monoamine oxidase inhibitor (MAOI) usage due to the potential for serious drug interactions. MAOIs can increase the levels of norepinephrine and other monoamines in the system, enhancing the sympathomimetic effects of drugs like brimonidine, which is an alpha-2 adrenergic agonist. This interaction could lead to hypertensive crises or other adrenergic overload symptoms, posing significant risks to the patient.

Brimonidine can cause decreases in intraocular pressure and is often used to manage glaucoma, but its action on the adrenergic receptors must be carefully considered in the context of MAOI therapy. Recognizing the interaction potential is crucial for patient safety, particularly for those with a medication history that includes MAOIs.