Brimonidine (Topical)

By helping to narrow the blood vessels in the face, brimonidine gel is used to reduce the redness associated with the condition rosacea.


Brimonidine is a topical gel which is designed for use on the face. It is used as a treatment for the skin condition rosacea, which causes excessive facial redness. Taking brimonidine narrows the blood vessels inside your face, which in turn cuts down on the amount of redness displayed on your cheeks.

Brimonidine can only be acquired with a prescription from a physician, and comes as either a gel or a jelly. Its brand name in the USA is Mirvaso, which means you may see it labelled in this way in stores, pharmacies and more.

Condition(s) treated

  • Rosacea

Type of medicine

Alpha agonist

Side effects

As with almost all drugs, there are possible side effects involved when taking this drug. While topical brimonidine helps many patients recover from the symptoms of rosacea, it is also possible that unpleasant side effects may occur as well.

The side effects of taking topical brimonidine can broadly be split into two categories. The first category includes those side effects which are more serious, and which require you to check in with your physician immediately in order to confirm that there are no problems.

The more common side effects in this category include changes to the skin, such as an unusually high skin temperature or unusual redness or flushing. The less common side effects found in this category include a wide range of skin problems, such as dryness and flakiness, the appearance of blemishes or pimples, a sensation of blistering or burning, and more.

The second category of side effects which may arise as a result of taking topical brimonidine includes those which are less serious, and which can usually be left to go away on their own. They tend to be natural consequences of taking this medication, and will subside as your body gets used to the effects the drug is having.

Ordinarily, you would only need to consult a doctor over problems like these if the symptoms persist or if they are causing you excessive problems.

The side effects in this category are not common. If they do occur, they can include aching muscles, fevers, headaches, a sore throat, a runny nose, pronounced fatigue and tiredness, and more. They also include a wide range of skin-related problems, including pins and needles as well as sensations of crawling, numbness or tingling.

Remember, these are not exhaustive lists of side effects and there is no guarantee that you will or will not experience a certain symptom as each patient can respond differently to the medication.

If you are worried about any of the potential side effects of taking topical brimonidine, you should consult your healthcare professional. They will be able to put your mind at ease, and might also have some handy tips and tricks for managing any side effects you do experience.


The exact dosage you will need will be determined by your physician, and it's important to always follow their instructions as this dosage will have been designed around your needs.

In addition, you should also follow other dose-related instructions from your physician, including the frequency of doses, the number of doses you need to take each day, the length of the intervals to be left in between doses, and more.

Standard dosages for topical brimonidine do exist. For adults using this gel to address the problem of facial redness, you are usually told to apply the gel to the five appointed areas of your face once per day. For children, the specific dosage tends to be determined by a physician.

Applying topical brimonidine is a simple process. Firstly, you should ensure your hands are clean by washing them with soap and water before beginning. You should then put a pea-sized amount of the gel on to the five key areas of your face. These are your chin, nose, central forehead and each one of your cheeks. Following this, you should gently rub the gel in. You should then wash your hands again.

In the event that you miss your dose of topical brimonidine, you should decide what to do based on the current time and on how long is left until your next dose is due. In the event that your next dose is still a long time away, you should go ahead and take your missed dose even if it is late. However, if the time for your next dose is about to occur, you should skip the dose you missed, take the next dose as planned and then ensure you return to your ordinary dosing schedule.


As with many drugs, topical brimonidine can interact strongly with a wide range of other drugs once inside the human body.

For this reason, it's very important that you maintain an up to date list of all your current medications and provide your physician and healthcare team with this list. They may decide to alter the configuration of drugs you are currently taking in order to cut down on the risk of problems further down the line resulting from interactions, so you should be honest and accurate.

There are hundreds of other drugs which are known to interact with topical brimonidine, and they all run the risk of causing moderate-level interactions. These drugs include advair diskus (composed of fluticasone and salmeterol), cardizem (diltiazem), durezol (difluprednate ophthalmic), klaron (sulfacetamide sodium topical) and tylenol (acetaminophen).

Other medications which can interact with topical brimonidine include Azuphen MB (composed of hyoscyamine, methenamine, methylene blue, phenyl salicylate and sodium biphosphate), bromaline (brompheniramine and pseudoephedrine) and Balminil Cough and Flu Sugar Free (made up of acetaminophen, dextromethorphan, guaifenesin and pseudoephedrine).

In addition, alcohol can also interact with this medication. For that reason, you should avoid drinking alcohol or cut down on your consumption of it while taking this medication. If you don't, there is likely to be a higher risk that you will experience problems such as dizziness. Furthermore, you should not drive or operate heavy machinery while taking this medication until you are aware of how it is affecting you.

These are not exhaustive lists of the medications which interact with brimonidine, so once again, it's vital to make sure that your medical records are up to date for your physician to see.


Your topical brimonidine is likely to come with a booklet that details the potential side effects of taking this medication along with a range of other helpful pieces of information. You should read this booklet carefully and only discard it well after you have finished taking the medication, as you may need to refer back to it further down the line. If you have any questions about the content of this booklet, you should speak to your physician.

This medication is only designed for use on the face, and use elsewhere could cause health problems. It should not be used on your eyes or mouth, or on areas like the vagina. It should also not be used on parts of the skin which have scrapes, burns or cuts, and as a result you should be careful not to get a cut if shaving your face while following a course of the medication. In the event that your topical brimonidine gets on those areas, you should rinse it away there and then with water.


When it comes to storing your topical brimonidine gel, it's vital to make sure you follow some basic storage guidelines both for the safety of yourself and others around you and to avoid the medication becoming damaged or unusable.

Firstly, you should make sure - as you should with any medication in your household - that you keep your topical brimonidine out of the reach of children at all times. This is to help cut down on the risk of accidental consumption. Even if you do not have children living with you in your home, you should still do this just in case children enter your home on another occasion.

Secondly, you should optimise your topical brimonidine for use by ensuring it is stored in suitable environmental conditions. For example, you should ensure it is stored in a sealed container, and prevent it from experiencing direct light, excessive heat or nearby sources of moisture. You should also never freeze your topical brimonidine, as this can damage the medication.

Finally, you should always dispose of any medication - including topical brimonidine - carefully. While you should be careful to not stop taking the medication unless advised to do so by a physician, in the event that you have any gel left over you should throw it away in an appropriate manner and place. If you do not know how and where to do this, talk to your healthcare team.


Topical brimonidine is a gel which is designed to be used on the face to treat the facial redness associated with the condition rosacea. It works by narrowing the blood vessels inside the face, which in turn causes less redness to appear. It can only be acquired with a prescription from a physician, and is available as a gel or a jelly.

Some side effects can arise as a result of taking this medication. Some are more serious, and require speaking to your physician right away. These include dry or flaky skin or the appearance of pimples. Less serious side effects include aching muscles and fever, and these can generally be left to go away by themselves unless they cause you extra problems.

You should avoid or cut down on alcohol while taking this medication, and ensure that your physician has an up to date list of other medications you are currently taking. Always follow the dosage prescribed by your physician.

Always follow the warnings provided in the information booklet given to you alongside your medication, and always ensure that the medication is stored out of the reach of children and away from heat, moisture and sources of excessive light. Take steps to dispose of any leftover medication appropriately, and if you are unsure how to go about this then speak to your healthcare team.

Last Reviewed:
December 23, 2017
Last Updated:
April 02, 2018