Cardiovascular warning for rosacea gel

Patients using the topical rosacea treatment brimonidine (Mirvaso) should be warned to avoid applying the gel to irritated or damaged skin, as this may increase the risk of cardiovascular reactions.

Brimonidine reduces erythema by causing cutaneous vasoconstriction. | iSTOCK
Brimonidine reduces erythema by causing cutaneous vasoconstriction. | iSTOCK

Bradycardia, hypotension and dizziness have been reported after application of brimonidine gel (Mirvaso) in patients with rosacea, in some cases requiring hospitalisation.

Brimonidine, used for the symptomatic treatment of facial erythema of rosacea in adults, is an α2 adrenergic agonist. The reports of cardiovascular reactions, identified in a routine European review, were consistent with systemic α2 adrenergic effects.

In approximately 30% of the cases most strongly suggestive of a cardiovascular effect, the reactions occurred when brimonidine gel was applied after laser therapy to the skin, which may have caused increased absorption of the gel.

Prescribers should warn patients not to apply brimonidine gel to irritated or damaged skin, including after laser therapy.

Dizziness is known to be an uncommon adverse effect of brimonidine gel, and hypotension and bradycardia are known to occur rarely.

Want news like this straight to your inbox?
Sign up for our bulletins

Read these next

The management of rosacea

The management of rosacea

Diagnosing rosacea, understanding the various presentations,...

Start brimonidine gel at low dose in rosacea, cautions MHRA

Start brimonidine gel at low dose in rosacea, cautions MHRA

Treatment with the topical rosacea treatment brimonidine...

Ivermectin in rosacea

NICE has issued advice on the use of ivermectin cream...


Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register
Already registered?
Sign in

MIMS Product Slides

Product overviews prepared by the MIMS team, in a handy slide format.

Click here

Slides are initiated, funded & reviewed by the companies specified.

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

MIMS Adviser

Especially created for prescribing influencers.

Request free copy

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases