Brimonidine (Alphagan, Mirvaso) and Ketamine Therapy | Tovani Health
Alphagan P (Brimonidine ophthalmic) (also: Mirvaso (topical for rosacea), Combigan (combo)) — α2-adrenergic agonist eye drop (glaucoma); also topical rosacea
Verdict at Tovani Health
Fully compatible with KAP — local action with punctal-occlusion technique.
Topical brimonidine and ketamine have no clinically significant interaction. Used for glaucoma (Alphagan), often combined with timolol (Combigan), and as topical rosacea treatment (Mirvaso). Some systemic absorption can occur, with rare systemic α2 effects (hypotension, fatigue) in sensitive patients — punctal occlusion minimizes this. Not related to ketamine.
If you take Alphagan P regularly and are considering at-home ketamine therapy, the combination is generally safe at therapeutic doses. This page covers the brief pharmacologic context and what we do at intake.
How Alphagan P interacts with ketamine
Selective α2 adrenergic agonist reducing aqueous humor production and increasing uveoscleral outflow. Topical/ophthalmic application with minimal systemic absorption. No CYP interaction with ketamine.
What we do at intake
Continue as prescribed. Use punctal-occlusion technique after each drop.
Bottom line
Topical brimonidine and ketamine have no clinically significant interaction. Used for glaucoma (Alphagan), often combined with timolol (Combigan), and as topical rosacea treatment (Mirvaso). Some systemic absorption can occur, with rare systemic α2 effects (hypotension, fatigue) in sensitive patients — punctal occlusion minimizes this. Not related to ketamine.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Alphagan P (Brimonidine ophthalmic) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 23, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.