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Adeel Arshad

Authored on 24 January 2024 by Adeel Arshad,

Reviewed 24 January 2024 by Dr Ruch Karunadasa.


Oral medication

Mirvaso is a gel containing Brimonidine tartrate for the treatment of rosacea. It reduces facial flushing & redness by reducing blood flow to the area.

Medication effect duration

How long you need to take Mirvaso depends on how quickly your condition improves. Mirvaso works on a daily basis, starting with the first day of treatment, applying to the affected areas of the face ONCE A DAY.

Skin treatment

Mirvaso is recommended to be applied to the face once a day only. During the first week, start the treatment with a small amount of gel (a pea-sized amount) as explained by your doctor or nurse.

How does Mirvaso work?

Mirvaso contains the active ingredient Brimonidine, a drug belonging to a group of medicines known as alpha agonists. Brimonidine decreases blood flow to the skin, which in turn reduces the redness associated with rosacea.

How much does Mirvaso cost?

What should I do if I apply/take too much or miss a dose?

If you forget to apply your Mirvaso gel then this should be applied as soon as you remember. If this is close to when the next dose would be due, do not apply a double dose. Instead continue as normal from when the next dose would be due.

There is no data available for overdosage through topical administration of Brimonidine. Reported overdosage, through oral administration, of other alpha agonists in patients has resulted in symptoms such as hypotension, asthenia, vomiting, lethargy, sedation, bradycardia, arrhythmias, miosis, apnoea, hypotonia, hypothermia, respiratory depression and seizure.

Overdosage through topical administration is highly unlikely, however, if suspected medical advise should be sought.

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How long does it take Mirvaso to work?

Mirvaso Gel works quite quickly and patients have reported seeing effects of the treatment within 30 minutes of applying the gel (it can take longer in some patients). It is important to remember that Mirvaso Gel is not a cure and the redness associated with rosacea will return once the effects of the gel wear off. The effects of the gel can last for up to 12 hours.

Is it safe to buy Mirvaso online?

Mirvaso is a prescription only medicine. This means that the medication can only be issued following the presentation of a valid NHS or Private prescription. At PrivateDoc we have a team of GMC and GPhC registered doctors and pharmacists, all with many years of experience in prescribing for skincare issues. Once a consultation is completed, this is reviewed by one of our prescribers. If deemed appropriate, a prescription is issued and sent securely to our GPhC registered pharmacy, where the treatment will be dispensed and shipped securely.

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How do I use Mirvaso?

Mirvaso is recommended to be applied to the face once a day only. During the first week, start the treatment with a small amount of gel (a pea-sized amount) as explained by your doctor or nurse.

If your symptoms remain the same or improve only slightly, you may then gradually increase the amount of gel. Spread it smoothly and evenly as a very thin layer as directed by your doctor or nurse. It is important not to exceed the maximum daily dose of 1 gram (5 pea sized amounts applied to the whole face).

Special considerations when taking Mirvaso

Consult your GP if you fall into any of the categories below before using Mirvaso -
  • Patients taking monoamine oxidase (MAO) inhibitor therapy and patients on tricyclic or tetracycline antidepressants.
  • You have problems with your heart or circulation.
  • Decreased blood flow to the hands, feet or skin,
  • Sjögren’s syndrome (a chronic disease in which the body’s natural defence - the immune system -attacks the moisture-producing glands).
  • You have kidney or liver problems or have had them in the past.
  • If you are pregnant or breastfeeding.

Mirvaso should not be used by patients under the age of 18. Do not use if you are allergic to the active ingredient or to any of the excipients. Discontinue treatment if you suffer from a severe reaction or contact allergy to the product.

Do not use more than the maximum recommended daily dosage.

For a more comprehensive list please read the patient information leaflet

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What are the side effects associated with Mirvaso?

Like all medicines, Mirvaso can cause side effects, although not everyone gets them.

Common side effects:
  • Flushing
  • Whitening (pallor) where the gel is applied
  • Skin redness
  • Burning feeling of the skin or itching
Uncommon side effects

Acne, dry mouth, feeling cold in hands and feet, feeling hot, headache, nasal congestion, skin rash, skin pain or discomfort, skin irritation or inflammation, dry skin, warm skin sensation, tingling or sensation of pins and needles, swelling of the eyelid, swelling of the face, urticaria, worsening of rosacea, dizziness.

Rare side effects

Angioedema (a serious allergic reaction usually with swelling of the face, mouth or tongue). Stop treatment if this occurs, hypotension (blood pressure decreased), decreased heart rate (slow heart rate, known as bradycardia).

A full list of potential side effects can be found in the product literature and patient information leaflet. We highly recommend all patients read this efore initiating any treatment.

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