August 31, 2015


Mirvaso Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Mirvaso (brimonidine) Topical Gel is an alpha adrenergic agonist used to treat persistent (nontransient) skin redness (erythema) of rosacea in adults. Common side effects include redness, flushing, burning sensation of the skin, skin irritation. Skin redness and flushing may happen about 3 to 4 hours after you apply Mirvaso topical gel.

Apply a pea-size dose of Mirvaso once daily to each of the five areas of the face: central forehead, chin, nose, and each cheek. Mirvaso topical gel should be applied smoothly and evenly as a thin layer across the entire face avoiding the eyes and lips. Mirvaso may interact with beta-blockers, anti-hypertensives, cardiac glycosides, alcohol, barbiturates, opiates, sedatives, anesthetics, or monoamine oxidase (MAO) inhibitors. Tell your doctor all medications and supplements you use. During pregnancy, Mirvaso should be taken only if prescribed. It is unknown if Mirvaso passes into breast milk. Consult your doctor before breastfeeding.

Our Mirvaso (brimonidine) Topical Gel Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Mirvaso FDA Prescribing Information: Side Effects
(Adverse Reactions)


Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

During clinical trials, 1210 subjects were exposed to MIRVASO topical gel. A total of 833 subjects were treated for persistent (nontransient) erythema associated with rosacea, and 330 of those were treated once daily for 29 days in vehicle-controlled trials.

Adverse reactions that occurred in at least 1% of subjects treated with MIRVASO topical gel once daily for 29 days and for which the rate for MIRVASO topical gel exceeded the rate for vehicle are presented in Table 1.

Table 1 : Adverse Reactions Reported in Clinical Trials by at Least 1% of Subjects Treated for 29 Days

Preferred Term MIRVASO Topical Gel
n (%)
Vehicle Gel
n (%)
Subjects with at least one adverse reaction, Number (%) of Subjects 109 (33) 91 (28)
  Erythema 12 (4%) 3 (1%)
  Flushing 9 (3%) 0
  Skin burning sensation 5 (2%) 2 (1%)
  Dermatitis contact 3 (1%) 1 ( < 1%)
  Dermatitis 3 (1%) 1 ( < 1%)
  Skin warm 3 (1%) 0
  Paraesthesia 2 (1%) 1 ( < 1%)
  Acne 2 (1%) 1 ( < 1%)
  Pain of skin 2 (1%) 0
  Vision blurred 2 (1%) 0
  Nasal congestion 2 (1%) 0

Open-label, Long-term Study

An open-label study of MIRVASO topical gel when applied once daily for up to one year was conducted in subjects with persistent (nontransient) facial erythema of rosacea. Subjects were allowed to use other rosacea therapies. A total of 276 subjects applied MIRVASO topical gel for at least one year. The most common adverse events (. 4% of subjects) for the entire study were flushing (10%), erythema (8%), rosacea (5%), nasopharyngitis (5%), skin burning sensation (4%), increased intraocular pressure (4%), and headache (4%).

Allergic contact dermatitis

Allergic contact dermatitis to MIRVASO topical gel was reported in approximately 1% of subjects across the clinical development program. Two subjects underwent patch testing with individual product ingredients. One subject was found to be sensitive to brimonidine tartrate, and one subject was sensitive to phenoxyethanol (a preservative).

Read the entire FDA prescribing information for Mirvaso (Brimonidine Topical Gel)

Report Problems to the Food and Drug Administration


You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

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