Mirvaso (brimonidine topical) dosing, indications, interactions, adverse effects, and more

Sections

Sections brimonidine topical
Dosing & Uses
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

topical gel

0.33%

Rosacea

Indicated for persistent facial erythema of rosacea

Apply topically to face qDay

<18 years: Safety and efficacy not established

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

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

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.

Mechanism of Action

Alpha-2 adrenergic agonist

Absorption

Onset: Rapid onset

Duration: Up to 12 hr

Images

No images available for this drug.

Patient Handout

A Patient Handout is not currently available for this monograph.

Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

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.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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