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A safety update on brimonidine gel (Mirvaso) has been issued by the Medicines and Healthcare products Regulatory Agency (MHRA).1 Brimonidine, an alpha2 adrenergic receptor agonist, is available as a topical gel indicated for the symptomatic treatment of facial erythema of rosacea in adults.2 The MHRA statement warns against using the product on damaged or irritated skin, including after laser therapy. This follows reports of systemic cardiovascular effects …