Mirvaso Gel

What is Mirvaso Gel?

Mirvaso is a prescription-only gel used to reduce the persistent facial redness associated with rosacea in adults. Its active ingredient, brimonidine tartrate, temporarily narrows the blood vessels responsible for visible facial redness.

Mirvaso is applied directly to the face and is designed to provide rapid, cosmetically significant relief from erythema (redness), one of the most common and distressing features of rosacea. It is available as a 3 mg/g gel and is not suitable for children or adolescents under 18.

How Does Mirvaso Work for Rosacea?

Rosacea is a long-term skin condition that causes persistent redness, flushing and visible blood vessels. It most commonly affects the cheeks, nose, forehead and chin. This redness occurs because small blood vessels near the surface of the facial skin dilate (widen) abnormally, making more blood visible beneath the skin.

As a topical gel, Mirvaso works by stimulating the receptors that constrict (narrow) these blood vessels. This reduces the amount of blood visible beneath the skin surface, making the redness significantly less noticeable. The effect typically begins within 30 minutes of application and can last for up to 12 hours. Mirvaso targets the visible symptoms of rosacea rather than the underlying condition.

How Long Does Mirvaso Take to Work?

You will typically notice reduced redness within 30 minutes of applying Mirvaso gel, with effects lasting up to 12 hours. How quickly it works may also vary from individual to individual and may be influenced by the dose you use. During your first week of using Mirvaso, you will need to use a lower dose (a smaller amount of gel); as a result, it may not appear to work as well as when you use the full dose.

Is Mirvaso Gel Effective for Rosacea?

A journal article summarised Mirvaso's clinical effectiveness by reviewing two randomised, double-blind, vehicle-controlled trials (similar to a placebo, except the same gel is used without the active medication). The participants were adults with moderate-to-severe facial erythema of rosacea.

Both trials assessed erythema reduction using validated clinician and patient scoring tools measured at multiple time points across the treatment day (0.5, 3, 6, 9 and 12 hours post-application). This provided a comprehensive picture of onset, peak effect, and duration.

Key findings across both trials:

• Visible reduction in facial redness within 30 minutes of a single morning application when compared to vehicle gel
• Improvements in clinician-rated erythema scores compared to vehicle gel at all measured time points throughout the day
• Effects lasted up to 12 hours following a single application. More participants reported being satisfied or very satisfied with their appearance when using brimonidine (Mirvaso) gel
• Consistent results were replicated across both independent trials, strengthening confidence in the findings

These results support brimonidine as a clinically effective option for controlling rosacea-associated facial redness. Note that not all patients will achieve the same level of improvement, as individual responses can vary, and it should be part of a broader rosacea management plan.

How to Use Mirvaso Gel

Apply a thin layer of Mirvaso gel once daily to the entire face, especially covering the forehead, nose, chin and both cheeks. Avoid contact with the eyes, eyelids, lips and mouth. Wash your hands before and after application. Do not apply to broken, irritated or sunburned skin. Do not apply any other skin medicines or cosmetics immediately before using Mirvaso. Allow the product to dry before applying anything else to your face.

During the first week of treatment, you should use a small amount of Mirvaso (roughly a pea-sized amount). If your symptoms remain the same or improve slightly, you may then gradually increase the dose as guided by your prescriber.

The gel is typically applied in the morning so its effects last through the day, but this is not required. Do not use more than the recommended amount, as applying excess product does not improve effectiveness and only increases the risk of side effects. When opening the tube for the first time, be careful not to spill excess gel. If you do, discard the excess and wash your hands.

Mirvaso Dosage Information

The starting dose is a pea-sized amount of Mirvaso gel, applied as a thin layer once daily across the facial areas mentioned above. Using more than the recommended dose or applying it more often does not increase its effect and may instead cause rebound redness when the gel wears off. The maximum daily dose is 5 pea-sized portions (approximately 1g).

If You Forget to Use Mirvaso

Mirvaso gel starts working for rosacea from the first application. If you forget a daily dose, your redness will not be reduced for that day. Never try to use a double dose to make up for one you have missed. Instead, continue with your usual treatment schedule as prescribed.

If You Use Too Much Mirvaso

Using more than your maximum daily dose of 1 gram per 24 hours could cause skin irritation or other adverse reactions at the application site. Repeated doses may result in side effects such as drowsiness, sleepiness, or low blood pressure. Contact your clinician or doctor for more information.

If You Accidentally Swallow Mirvaso Gel

Contact your doctor or go to your nearest accident and emergency department immediately if you or anybody else accidentally swallows Mirvaso gel. This is especially the case if you experience symptoms such as vomiting, tiredness or drowsiness, decreased or irregular heartbeats, low blood pressure, or dizziness.

Take the medication pack with you so the medical team knows what you have taken. More information can be found in the Patient Information Leaflet that comes with the treatment.

If You Stop Using Mirvaso Prematurely

Stopping Mirvaso treatment before finishing the full course could cause your rosacea to return to its initial state. Consult a clinician or doctor before you stop using the medication, so they can suggest an alternative course of action. Your prescriber can answer any further questions you may have about this medication.

Mirvaso Side Effects and Cautions

Before using Mirvaso for the first time, take a moment to review the potential side effects and medication warnings. Like all medicines, it may not be suitable for everyone. Ask your prescriber for advice if you are unsure whether Mirvaso is right for you.

Potential Side Effects of Mirvaso Gel

Not everyone who takes Mirvaso will experience side effects. However, if you do, seek advice from your pharmacist or doctor. The following side effects have been reported:

More information about the possible side effects of Mirvaso gel can be found within the Patient Information Leaflet that comes with the medication. You can also report any adverse reactions via the MHRA's Yellow Card Scheme.

When to Stop Using Mirvaso

You may experience certain uncommon skin reactions when taking Mirvaso (less than 1 in 100 people will be affected). These include:

• Severe skin irritation or inflammation
• Skin rash
• Skin pain or discomfort
• Dry skin
• Warm skin sensation
• Tingling or pins and needles sensation
• Swelling of the face
• Worsening rosacea (affecting up to 1 in 10 people)

If you experience any of these skin reactions, stop using Mirvaso and speak to your doctor, since this medicine may not be suitable for you. In some cases, symptoms may extend beyond the treatment area.

If you develop contact allergy (rash) or rare angioedema (a serious allergic reaction with swelling of the face, mouth, or tongue), stop using Mirvaso and seek prompt medical advice.

Mirvaso Gel Prescription Criteria

Mirvaso is prescribed for adults aged 18 and over with moderate-to-severe persistent facial erythema (redness) associated with rosacea. It is not suitable for use in children or adolescents. Do not apply it near or in the eyes, on broken/irritated skin, or on other skin conditions. Before prescribing, your prescriber should review the nature and severity of your rosacea.

Do not use Mirvaso gel if you are:

• Allergic to brimonidine or any other ingredient listed in the medication
• Taking certain medications for depression or Parkinson's disease, including monoamine oxidase (MAO) inhibitors, tetracyclic antidepressants, or tricyclic antidepressants

Precautions Before Using Mirvaso

Speak to your prescriber before taking Mirvaso if any of the following apply to you:

• The skin on your face is irritated or has open wounds
• You have problems with your heart or blood circulation
• You have depression
• You have decreased blood flow to the brain, heart, hands, feet, or skin
• You have a fall in blood pressure on standing up
• You have Sjögren's syndrome
• You have or have had kidney or liver problems
• You have had or plan to have any laser procedure on the skin of your face

Up to 1 in 6 people who use Mirvaso will experience a return of facial redness worse than it was initially. This usually develops within the first 2 weeks of treatment. Generally, this resolves after a few days of stopping use of Mirvaso. If you wish to restart treatment, test it on a small area of your face. If your symptoms do not worsen, you can continue the usual treatment. If you do experience increased redness, discontinue the treatment and speak to your doctor.

Mirvaso Gel and Other Medicines

Tell your prescriber if you are taking or have recently taken any other prescribed medication, over-the-counter remedies, supplements, or herbal products.

Do not take Mirvaso if you are also taking selegiline, moclobemide, imipramine, mianserin, or maprotiline. These medicines can be used for depression or Parkinson's disease. Using them alongside Mirvaso could increase the risk of side effects, such as a fall in blood pressure.

Tell your prescriber before taking Mirvaso if you are taking any of the following:

• Medicines for the treatment of pain, sleep disorders, anxiety disorders
• Medicines used for the treatment of psychiatric disorders (chlorpromazine)
• Medicines used for hyperactivity (methylphenidate)
• Medicines used for the treatment of high blood pressure (reserpine)
• Alpha agonists (such as clonidine) or alpha antagonists (such as prazosin or isoprenaline)
• Cardiac glycosides (such as digoxin)
• Blood pressure lowering medications such as beta-blockers (e.g., propranolol) or calcium channel blockers (e.g., amlodipine)

Tell your prescriber if you consume alcohol regularly as this could affect your treatment with Mirvaso.

Pregnancy and Breastfeeding

Mirvaso is not recommended for use during pregnancy as the effects on a foetus are unknown. You should not use this medicine whilst breastfeeding as it is unknown whether it passes into breast milk. If you are pregnant, may become pregnant, or are breastfeeding, speak to your prescriber for advice.

Frequently Asked Questions About Mirvaso Gel