Uses

What is topical brimonidine used for?

Topical brimonidine is commonly applied to the skin to treat redness that can happen with rosacea. Rosacea is a long-term skin condition that can cause symptoms such as redness and small bumps.

Topical brimonidine may also be used for other conditions as determined by your healthcare provider.

How does topical brimonidine work (mechanism of action)?

Brimonidine belongs to a group of medicines called alpha-2 agonists. Topical brimonidine is believed to work by causing blood vessels to shrink, which reduces skin redness.

How is topical brimonidine supplied (dosage forms)?

Topical brimonidine is available as Mirvaso and generic topical brimonidine in a 0.33% gel that is applied to the skin. 

How should I store topical brimonidine?

Topical brimonidine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of topical brimonidine?

The most common side effects of topical brimonidine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Skin redness 
  • Flushing 
  • Burning sensation of the skin
  • Skin reactions

There may be other side effects of topical brimonidine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of topical brimonidine?

While less common, the most serious side effects of topical brimonidine are described below, along with what to do if they happen.

Severe Allergic Reactions. Topical brimonidine may cause allergic reactions, which can be serious. Stop using topical brimonidine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Low Blood Pressure (Hypotension). Topical brimonidine may cause low blood pressure, including a sudden drop in blood pressure when standing up from a seated or lying position. To help prevent this, be careful not to get up too quickly. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Blurred vision
  • Confusion
  • Feeling weak or tired

Warnings & Precautions

Who should not use topical brimonidine?

Allergies to Ingredients. People who are allergic to any of the following should not use topical brimonidine.

  • Brimonidine
  • Mirvaso
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific topical brimonidine products they stock.

What should I know about topical brimonidine before using it?

Do not use topical brimonidine unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

Do not share topical brimonidine with other people, even if they have the same condition as you. It may harm them.

Keep topical brimonidine out of the reach of children.

Topical brimonidine is for use on the skin only. It should not be used on other areas of the body such as your eyes, mouth, or vagina. 

Do not use topical brimonidine on irritated skin or open wounds. This can increase the risk of serious side effects.

Wash your hands after applying topical brimonidine.

Topical brimonidine can cause pale coloring or excessive whitening of skin, called hypopigmentation. This can occur at or outside the skin area where the product is applied. Tell your healthcare provider if you notice skin whitening that is concerning to you.

Do not swallow topical brimonidine. This can cause serious side effects that may require hospitalization. Seek emergency medical help right away if you or anyone else swallows topical brimonidine.

What should I tell my healthcare provider before using topical brimonidine?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, skin products, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if topical brimonidine is right for you.

In particular, make sure that you discuss any of the following.

Heart or Blood Vessel Problems. Topical brimonidine may worsen any heart or blood vessel problems you have. Tell your healthcare provider if you have any heart or blood vessel problems, such as any of the following.

  • Heart conditions
  • High or low blood pressure
  • History of stroke
  • Dizziness
  • Depression
  • Blood flow problems, such as Raynaud’s phenomenon
  • Sjögren’s syndrome, which is a condition that can cause dry eyes and mouth
  • Scleroderma, which is a condition that can cause thickening or tightening of your skin
  • Buerger’s disease (thromboangiitis obliterans), which is a condition that causes inflammation of blood vessels in your arms and legs

Recent or Scheduled Laser Procedures. Using topical brimonidine after laser procedures may increase the risk of serious side effects that may require hospitalization. Tell your healthcare provider if you have recently had or plan to have a laser procedure.

Other Medicines and Supplements. Topical brimonidine may interact with other medicines and supplements. Before using topical brimonidine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how topical brimonidine could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use topical brimonidine while you are pregnant or trying to get pregnant. 

Breastfeeding. It is not known if topical brimonidine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop topical brimonidine.

Interactions

Does topical brimonidine interact with foods or drinks?

There are no known interactions between topical brimonidine and foods or drinks.

It is unknown if drinking alcohol will affect topical brimonidine. The risk of drowsiness or sleepiness may be increased if you drink alcohol while using topical brimonidine.

Does topical brimonidine interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using topical brimonidine.

  • A medicine for high blood pressure
  • A beta-blocker, such as metoprolol (Lopressor, Toprol XL, and others), atenolol (Tenormin), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to reduce blood pressure
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • A barbiturate, such as phenobarbital, butalbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
  • An opioid, such as oxycodone, morphine, codeine, or fentanyl, which is a medicine used for certain types of pain
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
  • A monoamine oxidase inhibitor (MAOI), which is a medicine usually used for depression or Parkinson’s disease

This may not be a complete list of medicines that can interact with topical brimonidine. Always check with your healthcare provider.

Does Brimonidine topical (Mirvaso) interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much topical brimonidine?

If you or someone else has used too much topical brimonidine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of topical brimonidine?

If you miss your scheduled dose of topical brimonidine, apply it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and follow the original schedule. Do not apply topical brimonidine more often than prescribed.

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