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 …