Difference in vasoconstrictors: oxymetazoline vs. brimonidine

Abstract

Objective: Topical oxymetazoline and brimonidine are the only medications approved for treating persistent facial erythema of rosacea. This review aims to investigate the efficacy, safety, pharmacodynamics, and pharmacokinetic properties of oxymetazoline and brimonidine.

Methods and materials: Phase II and phase III clinical studies evaluating oxymetazoline and brimonidine were assessed to compare their efficacy and safety.

Results: In their respective phase III trials, both oxymetazoline and brimonidine met the primary efficacy outcome of having at least a 2-grade decrease from baseline on both the Clinician Erythema Assessment (CEA) and the Subject Self-Assessment (SSA) Scales compared to the vehicle control. Treatment related adverse events of oxymetazoline and brimonidine are most often mild and localized.

Conclusions: Topical oxymetazoline and brimonidine are effective for the management of persistent facial erythema associated with rosacea with a few mild and localized adverse effects. Further long-term research is imperative to further understand their long-term effects.

Keywords: Adrenergic; brimonidine; erythema; oxymetazoline; rosacea.