brimonidine topical (Rx)Brand and Other Names:Mirvaso

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

topical gel

  • 0.33%
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Rosacea

Indicated for persistent facial erythema of rosacea

Apply topically to face qDay

<18 years: Safety and efficacy not established

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Adverse Effects

1-10%

Flushing (10%)

Erythema (8%)

Nasopharyngitis (5%)

Skin-burning sensation (4%)

Increased intraocular pressure (4%)

Headache (4%)

Postmarketing Reports

Cardiovascular disorders: Bradycardia, hypotension (including orthostatic hypotension)

Immune system disorders: Angioedema, hypersensitivity, lip swelling, swollen tongue, throat tightness, urticaria

Nervous system disorders: Dizziness

Skin and subcutaneous disorders: Pallor

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Warnings

Contraindications

Hypersensitivity

Cautions

Caution with depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension, thromboangiitis obliterans, scleroderma, or Sjögren’s syndrome

Alpha-2 adrenergic agents can lower blood pressure; caution with severe or unstable/uncontrolled cardiovascular disease

Serious adverse reactions may occur following accidental ingestion of alpha-2 agonists by children; keep out of reach of children

Not for oral, ophthalmic, or intravaginal use

Erythema involving areas of face previously not affected by erythema and areas (e.g., neck and chest) outside of treatment sites reported

Treatment effect of topical gel may begin to diminish hours after application

Increased frequency of flushing and/or erythema with flushing following gel application reported

Pallor or excessive whitening at or outside application site, following treatment with topical gel.reported

Allergic contact dermatitis reported

Hypersensitivity reactions following gel application include angioedema, throat tightening, tongue swelling, and urticaria; Institute appropriate therapy and discontinue therapy, if clinically significant hypersensitivity reaction occurs

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Pregnancy & Lactation

Pregnancy Category: C

Lactation: Unknown if distributed in human breast milk

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Mechanism of Action

Alpha-2 adrenergic agonist

Absorption

Onset: Rapid onset

Duration: Up to 12 hr

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Images

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Formulary

FormularyPatient Discounts

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Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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