Presbyopia occurs when your eyes slowly lose the ability to focus on objects that are close to you. Despite the long name, it is not a disease. Presbyopia happens as a natural part of getting older, and there is no way to stop or reverse this gradual change in the eyes. Although the aging process itself cannot be avoided, there are many safe and effective options to help you see clearly and stay comfortable as your vision changes. It can be managed with eyeglasses, contact lenses, medicine, or surgery. Without treatment, you may experience headaches and eye strain.
Yuvezzi (carbachol/brimonidine) is an eye drop that is used to treat adults with presbyopia.
How Does Yuvezzi Work?
Yuvezzi is an eye treatment that combines two medicines, brimonidine and carbachol. These medicines work together to make the pupil (the center of the colored part of your eye) smaller, which creates a pinhole effect that helps you see things up close more clearly. Carbachol helps tighten the muscles in the eye that make the pupil smaller. Brimonidine helps by reducing the activity of the muscles that would normally make the pupil larger. When used together, they help improve vision by increasing depth of focus.
How Do I Use Yuvezzi?
Yuvezzi is a clear, greenish-yellow eye drop that comes in small single‑use vials. It contains two medicines, brimonidine and carbachol, which work together to help you see up close more clearly.
The recommended dose of Yuvezzi is one drop in each eye once a day. If you wear contacts, take out your contact lenses before using the drops. After you put the drops in, wait 10 minutes before putting your contacts back in. If you use other eye medicines, use them at least five minutes apart from Yuvezzi. Each small single-use vial has enough medicine for both eyes. To avoid injury or contamination, try not to let the single‑dose vial touch your eye, eyelids, or anything else. Throw the vial away right after you use it, even if there is some medicine left.
How Can I Prevent and Manage Common Side Effects of Yuvezzi?
If you think Yuvezzi is causing a side effect, contact your health care provider right away. They may suggest adjusting how you use the drops or, if needed, stopping the medicine to keep you safe.
Vision changes. Some people using Yuvezzi may notice dim or dark vision or have trouble switching focus between near and far objects. These effects are usually temporary. To stay safe, avoid driving at night and use extra caution in low‑light situations. Do not drive or use machinery if your vision is not clear.
Retinal detachment is a rare risk of this medicine. Seek medical attention right away if you notice sudden symptoms of seeing flashes of light, new floaters, or experience any loss of vision.
Eye discomfort or irritation. Eye pain or irritation can occur right after putting in the drops. These side effects are generally mild and short‑lasting. If discomfort becomes severe or does not go away, tell your health care provider.
Headache. Headaches are one of the more common side effects reported with Yuvezzi. If your headaches are severe or continue over time, let your health care provider know. They may suggest ways to help manage them.
Contact lens problems. Always remove your contact lenses before using Yuvezzi. Once you’ve used the drops, wait 10 minutes before putting your lenses back in. This prevents the drops from being absorbed into the lenses.
Preventing eye injury or infection. To avoid injury or contamination, do not let the tip of the single‑dose vial touch your eye, eyelids, or any surface. Each vial is for one‑time use only. Throw it away right after using it, even if there is medicine left.
Using other eye medicines. If you use more than one type of eye medicine, space them at least five minutes apart. This helps each medicine work properly and lowers the chance of irritation.
What Kinds of Drug Interactions May Happen?
Yuvezzi contains an ingredient that can lower blood pressure. Because of this, it may interact with certain medicines used to treat high blood pressure or heart conditions. If you take medicines such as antihypertensives or cardiac glycosides, your health care provider may need to monitor you more closely to help prevent your blood pressure from dropping too low.
Yuvezzi may also interact with medicines that slow down the central nervous system. These include alcohol, sleep aids, opioid pain medicines, anxiety medicines, sedatives, and some anesthetics. Using these together may increase drowsiness or other nervous system side effects, so your health care provider may give you guidance on how to use them safely.
Some older antidepressants, called tricyclic antidepressants, can affect how your body responds to Yuvezzi. These medicines may change how the body processes certain chemicals, which could impact how well the eye drops work. If you take a tricyclic antidepressant, your health care provider may monitor you for changes in your eye response.
Monoamine oxidase inhibitors (MAOIs) may also interfere with how the body breaks down one of the ingredients in Yuvezzi. This could increase the risk of low blood pressure. If you are taking an MAOI or recently stopped using one, make sure your health care provider knows.
Tell your health care provider about all prescription and over‑the‑counter medicines, vitamins, herbal products, or supplements you use or have recently used. This helps ensure Yuvezzi is safe and effective for you.
How Was Yuvezzi Studied for the Management of Presbyopia?
Yuvezzi was tested in two phase 3 studies (BRIO I and BRIO II) to see how well it could help adults with presbyopia. Together, these studies included more than 600 adults between the ages of 45 and 80. Some participants had prior eye surgeries, including refractive surgery or lens implants, and they were still included in the trials.
In BRIO I study, 182 people received one dose of Yuvezzi, carbachol alone, and brimonidine alone, at different visits, with at least three days between each treatment. This allowed researchers to compare how well Yuvezzi worked compared with each ingredient on its own.
In BRIO II, 436 people were randomly assigned to receive either one dose of Yuvezzi or a placebo eye drop (inactive medicine). Participants then used either Yuvezzi or the placebo drop once a day for six months, followed by another six months where everyone used Yuvezzi.
What Were the Benefits of Yuvezzi Based on Studies?
Study researchers looked at how many people could read at least three lines better on a near‑vision eye chart without losing any distance vision. Both studies were done in low‑light conditions, similar to reading in a dim room.
In the first study (BRIO I), Yuvezzi worked better than either of its ingredients used alone, which is an important requirement for FDA approval of a combination medicine. In the second study (BRIO II), which compared Yuvezzi with a placebo, the drops met all major goals for improving near vision. Many people using Yuvezzi were able to see three lines or more better on a near‑vision chart for up to eight hours after using the drops, without losing distance vision.
Yuvezzi was generally well‑tolerated in the clinical studies. In BRIO II, which followed participants for 12 months, no serious side effects related to the medicine were reported. The most common side effects seen with Yuvezzi were headache, temporary changes in vision, and brief eye pain or irritation after putting in the eye drops.
Overall, these studies showed that:
- Yuvezzi can temporarily improve near vision in adults with presbyopia.
- Improvement starts within about 30 minutes after using Yuvezzi.
- The strongest improvement occurs around one to two hours.
- Some improvement can still be seen up to eight hours.
- Yuvezzi works better than its individual ingredients alone and better than placebo.
Your results may differ from those seen in clinical studies.
