Mirvaso Gel

Mirvaso is indicated for the symptomatic treatment of facial erythema of rosacea in adult patients. Mirvaso is a prescription only medicine which comes in a gel form and its active ingredient is brimonidine 3mg/g. Brimonidine belongs to a class of medicine called alpha-adrenergic agonist. When applied on the affected area it causes the narrowing of blood vessels and reduced surface blood flow. Mirvaso can reduce redness within 30 minutes reaching peak action at 3-6 hours. After its peak action you may notice redness returning and in small cases the redness may get worse. If the symptoms worsen then treatment should be stopped.

Mirvaso is licensed for 18-64 year olds. Mirvaso is a once daily application and can be used for as long as facial reddening is present. Treatment should be initiated with a smaller amount of gel (less than the maximum) for at least one week. The amount of gel can then be increased gradually based on tolerability and patient response. The maximum daily recommended dose is 1 g of gel in total weight, which corresponds to approximately five pea sized amounts.

Apply 1 pea sized amount to each of the affected areas of the face. Mirvaso should be applied smoothly and evenly as a thin layer across the entire face (forehead, chin, nose and both cheeks) avoiding the eyes, eyelids, lips, mouth and membrane of the inner nose. Mirvaso should be applied only to the face. Hands should be washed immediately after applying the medicinal product.

Mirvaso can be used in conjunction with other cutaneous medicinal products for the treatment of inflammatory lesions of rosacea and with cosmetics. These products should not be applied immediately before the daily application of Mirvaso; they may be used only after the applied Mirvaso has dried.

Mirvaso should not be applied on irritated skin (including following laser therapy) or open wounds. In case of severe irritation or contact allergy, the treatment with the medicinal product should be discontinued. Exacerbation of rosacea symptoms is very common in patients treated with Mirvaso. Across all clinical studies, 16% of patients receiving Mirvaso experienced an event of symptom exacerbation.

Systemic cardiovascular effects including bradycardia, hypotension, and dizziness have been reported after application of brimonidine gel. To minimise the possibility of systemic absorption, it is important to avoid application to irritated or damaged skin, including after laser therapy.

The exacerbation of rosacea symptoms can occur in patients and therefore it is important that treatment is initiated with a small mount of gel and dose increased gradually based on tolerability and response to treatment. Some patients have noticed redness and flushing to return with greater severity. This should resolve after discontinuing Mirvaso gel. It is recommended you perform a test application on a small area of the face at least one day before full facial application is resumed.

The most common side effects include redness, itching, flushing and skin burning sensation. They are mild to moderate in severity and usually do not require discontinuation of treatment.

Patients who are pregnant or breastfeeding, severe, unstable or uncontrolled cardiovascular disease, liver or kidney disease, depression, poor circulation to brain or heart, Reynaud’s phenomenon, low blood pressure and Sjogren’s syndrome.