Brimonidine gel launched for reduction of erythema associated with rosacea

Brimonidine gel received a licence from the European Medicines Agency in February 2014 after it was shown to be effective for patients with moderate to severe facial redness caused by rosacea. The medicine will be marketed as Mirvaso by Galderma.

The drug is already on the market in the form of eye drops, marketed as Alphaga, used to reduce elevated intraocular pressure in patients with open angle glaucoma or ocular hypertension. Brimonidine works by activating the alpha2-adrenergic receptors in the blood vessels, causing vasoconstriction.

In two clinical trials (n=553), brimonidine applied topically reduced facial redness; after 29 days 31.5 per cent of patients in the first trial and 25.9 per cent in the second trial  had reduced facial redness, compared with 10 per cent and 9.2 per cent of patients, respectively, who received a placebo. However, brimonidine can begin to reduce redness from three hours after application, with the results lasting up to 12 hours.

Patients who experienced side effects most commonly reported redness of the skin, itching, flushing and skin burning (1.2–3.3 per cent occurrence). The summary of product characteristics reports that this did not usually require discontinuation of treatment. The medicine is contraindicated for patients taking monoamine-oxidase inhibitors, or tricyclic or tetracyclic antidepressants.