Brimonidine gel for rosacea Mirvaso

Authored by Peer reviewed by Dr Krishna Vakharia
Originally published Meets Patient’s editorial guidelines

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The maximum recommended amount of gel to be used is five pea-sized amounts once each day. Start your treatment by using a smaller amount of gel, and then gradually increase the amount used.

Avoid contact with the eyes and eyelids, mouth and inside your nostrils.

Wash your hands immediately after using the gel.

Type of medicineAlpha2-adrenergic receptor agonist (vasoconstrictor)
Used forFacial redness in acne rosacea in adults over 18
Also calledMirvaso®
Available asGel

Brimonidine gel is used to treat a skin condition called rosacea (sometimes referred to as acne rosacea). Rosacea is a skin condition that affects parts of your face. Symptoms of rosacea include flushing, redness, and small lumpy red spots. Although it can look similar to 'teenage' acne, it is an unrelated condition.

Brimonidine gel is used to reduce redness of the skin in people with rosacea. It works by narrowing the blood vessels in the skin which in turn reduces blood flow in the skin and reduces the appearance of redness.

Brimonidine gel can be used alongside other topical treatments for rosacea, such as metronidazole gel and cream and azelaic acid gel.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using brimonidine gel it is important that your doctor knows:

  • If you are pregnant, trying for a baby, or breastfeeding.
  • If you have severe or unstable cardiovascular disease.
  • If you ever experience dizziness when standing (due to low blood pressure).
  • If you have problems with your blood circulation, such as in Raynaud's syndrome or Buerger's disease.
  • If you have an immune system disorder called scleroderma.
  • If you have Sjögren's syndrome.
  • If you have ever had an allergic reaction to a cream or gel.
  • If you have depression or are taking certain antidepressant medicines.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
  • Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The manufacturer’s leaflet will give you more information about brimonidine gel and a full list of side-effects which you may experience from using it.
  • Use brimonidine gel exactly as your doctor tells you to. It should be applied once each day.
  • Apply brimonidine gel thinly and evenly over the whole face including forehead, nose, chin and both cheeks.
  • The maximum recommended amount of gel to be used is five pea-sized amounts, but it is usual to start by using smaller amounts.
  • Do not apply more than the recommended amount or more often than once daily.
  • Take care to avoid contact with your eyes and eyelids, mouth and inside your nostrils.
  • Wash your hands immediately after using the gel.
  • Do not apply brimonidine gel to sore or irritated skin or to open wounds
  • Try to keep all your regular appointments with your doctor. This is so your doctor can check on your progress.
  • Some people who use brimonidine gel find that it makes their rosacea symptoms seem worse. Start your treatment by using a small amount of gel, to see how your skin reacts, then gradually increase the amount used, up to the maximum
  • If you feel your symptoms are getting worse, stop using the gel and speak to your doctor.
  • The effects of brimonidine gel should last for a few hours but as it begins to wear off, the facial redness will return and you may feel it is worse than before treatment. If this continues for more than two weeks, speak to your doctor about whether continuing with treatment is right for you.
  • Brimonidine gel can be used with other creams, ointments or gels for the treatment of rosacea. If you are using more than one skin product, apply brimonidine gel first and allow it to dry before applying anything else.
  • If you use cosmetics or make-up, apply brimonidine gel first and allow it to dry.
  • If you buy any medicines, check with your doctor or a pharmacist that they are suitable for you to take with brimonidine gel.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking brimonidine gel.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with brimonidine gel. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common brimonidine gel side-effectsWhat can I do if I experience this?
Either facial flushing or pale skin at the application siteUse smaller amounts of gel until you know how your skin reacts
Redness, itching or a burning sensation at the application siteReduce the amount of gel you are using and speak to your doctor for advice
Worsening of roacea symptomsStop using brimonidine gel and speak to your doctor

Important: there have been reports of brimonidine gel causing an allergic reaction (such as a blistering skin rash, hives and swelling around the face or mouth). Although this is uncommon, if you experience any of these symptoms, you should stop using brimonidine gel and contact your doctor straightaway.

Brimonidine gel can cause dizziness due to low blood pressure, usually when standing up quickly. This is called postural hypotension and the feeling should soon pass. If this happens to you it may be a sign you are using too much gel or that you are sensitive to its effects. Speak to your doctor if this becomes a problem. Do not drive and do not use tools or machines whilst affected.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

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