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  • Here is a patent which describes hyperemia/rebound vasodilation.

    Am I correct in understanding that if we dilute the drug, it might not have that effect?



    Laura, who is the only rosacean having long term success with brimonidine is diluting hers.
    I haven't, because the gel I normally use with no problem has recently been reformulated and I can't tolerate it. But I do have a sample of the old stuff left, so I should try mixing the brimonidine in that. Or, perhaps even in water. Does water work?

    Laura, exactly how much do you use? Just one or two of the tiny drops which come out of the container when squeezed? Is that for the entire face?
    Previous Numerous IPL.
    Supplements: High dose Niacinamide, Vit K2, low dose Vit A. Moderate Dose Vit C, Iodine, Taurine, Magnesium. Mod- dose B's. Low dose zinc. Testing Quercetin.

    Skin Care: No Cleanser, ZZ cream mixed with Niacinamide gel 4% and LMW HA 2%, ethyl ascorbate 2%.

    Treating for gut dysbiosis.(This is helping).
    Previous GAPS diet. Have now introduced lots of fibre.
    Fermented Foods. Intermittent fasting -16-18 hours.
    Oral Colostrum. Helps reduce food reactions.

    Comment


    • Well, It is 2am and I have been battlling the most AWFUL flush since 12:30am. I went to bed at 10:15pm, with some tingling in my face.
      It is only now, that I can take the ice pack off for a few minutes to type this.

      I am very glad that this is working for Laura and others, but I wish I had never started it.
      This is the worse I have been in a year.

      I wonder how long it will take to recover?
      Weeks by that patent.
      Previous Numerous IPL.
      Supplements: High dose Niacinamide, Vit K2, low dose Vit A. Moderate Dose Vit C, Iodine, Taurine, Magnesium. Mod- dose B's. Low dose zinc. Testing Quercetin.

      Skin Care: No Cleanser, ZZ cream mixed with Niacinamide gel 4% and LMW HA 2%, ethyl ascorbate 2%.

      Treating for gut dysbiosis.(This is helping).
      Previous GAPS diet. Have now introduced lots of fibre.
      Fermented Foods. Intermittent fasting -16-18 hours.
      Oral Colostrum. Helps reduce food reactions.

      Comment


      • Originally posted by Mistica View Post
        Well, It is 2am and I have been battlling the most AWFUL flush since 12:30am. I went to bed at 10:15pm, with some tingling in my face.
        It is only now, that I can take the ice pack off for a few minutes to type this.

        I am very glad that this is working for Laura and others, but I wish I had never started it.
        This is the worse I have been in a year.

        I wonder how long it will take to recover?
        Weeks by that patent.
        Perhaps there is some weird interaction going on with the eye drops and the drugs you are taking for some of the issues you are going through. I mean, your body right now is not in 100% healthy stage so that has got to be playing a big part in it.

        Just a thought...

        Comment


        • Originally posted by Mistica View Post
          Does anyone here have glaucoma and uses brimonidine? Or does anyone know anyone else with glaucoma?
          I do. My brother in law is blind in one eye and has glaucoma in his other. He use a solution with Brimonidine and another ingredient but I cannot remember what it is right now. Did you have a question, more specifically about the side effects? I can ask him next time I visit with him if you'd like.

          Comment


          • Originally posted by brasileirao View Post
            Perhaps there is some weird interaction going on with the eye drops and the drugs you are taking for some of the issues you are going through. I mean, your body right now is not in 100% healthy stage so that has got to be playing a big part in it.

            Just a thought...
            Hi,

            I have considered all of that and it is possible that my gut has taken this opportunity for further evil ( due to amoxcillin),but honestly, based on all I have read now, technical and anecdotal, I really feel my horrendous night flushing ( when trying to sleep) is due to the brimonidine.

            My rosacea was severe, completely engorged face, including eyelids for over two years (incessant flushing),before high dose vitamin D started to deflate and heal it. But D3 only does so much for me.
            I was housebound for two and a half years with ice packs attached to my face nearly all day, plus I had to suck on 13 trays of ice cubes per day. I wanted to die.

            So, in retrospect, seeing I am such a bad case, I probably shouldn't have dived into this latest experiment so fully.
            Previous Numerous IPL.
            Supplements: High dose Niacinamide, Vit K2, low dose Vit A. Moderate Dose Vit C, Iodine, Taurine, Magnesium. Mod- dose B's. Low dose zinc. Testing Quercetin.

            Skin Care: No Cleanser, ZZ cream mixed with Niacinamide gel 4% and LMW HA 2%, ethyl ascorbate 2%.

            Treating for gut dysbiosis.(This is helping).
            Previous GAPS diet. Have now introduced lots of fibre.
            Fermented Foods. Intermittent fasting -16-18 hours.
            Oral Colostrum. Helps reduce food reactions.

            Comment


            • Mistica,

              since last thursday I have been using 3 drops in to my palm then take my right finger let it run a under the tab water just enough to get the finger tip wet then mix that finger w/water in to the palm with the 3 drops of the brimonidine then i apply it to my nose. i do this in the am and then in the pm after i clean and take off my makeup. When i tried it only in the am i got rebound flushing in the pm. but doing it the am and pm keeps it from flushing and swelling up. I also tried it on my ears again over the weekend when i was in key west and my ears did fine but then yesterday it didnt work much on my ears. last night i had a horrible flush after i had cleaned my face the flush was on my right ear i had to apply ice pak gel for about half an hour or so until i felt it go back to normal. so on my ears it doesnt work well. on my cheeks i tried the drops a couple of weeks ago but i also got rebound flushing. so far its working on my nose just need to apply in the morning and in the evening. it really helps my nose since it doesnt flush then i also dont get the swelling. it has flushed like this morning i woke up with my nose normal color but after washing my face a couple of minutes later i notice a bit of flushing not on the front but the sides fo the nose but i was able to bring it down quickly with the ice pak gel who is my best friend.

              If its the drops that made you flush more then it will only take a couple of days for you to go back to your normal flushing if you stop the drops. But it could be the others meds you are taking cause of your teeth. Oh I so feel for you I pray you get better soon, this rosacea sucks so much. About 3 wks ago i came down with a head cold and it was so much worse for me cuase it caused me to flush so much more. Yet my hubby got the cold and he was fine in a couple of days but for me it lasted so much more it was awful being feeling so cold yet my face so hot and flushed. On top of that having to blow my nose all the time making the flushing and rosacea on my nose even worse.

              Take care and I pray you get over this awful time quickly.

              Alba
              using elidel at night, taking atelenol, had 2 vbeam laser treatments, 46 year old female

              Comment


              • I do wonder why some folks are getting horrific rebound flushing. It certainly takes away from the wonder of this vasoconstrictor.

                Let me repeat that I am using very small amounts of the Brimonidine.

                I literally add NO MORE THAN two or three drops from the tiny bottle to a rather large dollop of finacea; I add a few drops of water to that, I stir it all around with my finger, and then I use that to paint my entire face.

                It does seem like a little Brimonidine goes a very long way.

                I've noticed that Finacea is fabulous for my rosacea, I wonder if that's making the difference? Some of the folks with rebound flushing are diluting the Brimonidine only with water and putting that directly on their face. That's not what I do.

                Hoping for better health for all of us.

                -WC
                • 58 yr old woman
                • Rosacea at 48, debilitating at 52
                • Clonidine 100mgc ev. 8 hrs;
                • Remeron 15mg nightly;
                • Zebeta=Bisoprolol=Beta blocker 5mg nightly;
                • Brimonidine worked well initially, then MASSIVE rebound flushing and damage;
                • Countless IPL with Lumenis One;
                • Now purpuric V Beam with Candela Perfecta; more clearance, less downtime than IPL;
                • Botox (with mesotherapy needles), good not great results;
                • Monthly Kenalog injection to blunt debilitating flushing.

                Comment


                • Well I didn't get any further sleep last night, despite laying in bed again. The cheeks and nose started up as soon as I began to doze and I had to get up. My cheeks and nose were extremely red and swollen. No amount of icing would bring them down, so not knowing what else to do, I diluted the brimonidine by four or more, ( hard to tell when dripping water drops into the palm of my hand) and applied it to my cheeks and nose only. After some time, they began to calm. But my nose has been flushing on and off, all day. It is now 2pm and I am exhausted. As soon as I sit to relax, the damn nose starts up again. I can feel pressure in my cheeks too. If I were to relax any longer, they too would explode in the fury of intense flushing.

                  This is a nightmare. I am back to severe rosacea.

                  When looking at a couple of paragraphs from that patent I posted avbove, I feel very depressed as I simply don't know how I can overcome this state.
                  I have to sleep sometime, but past experience has taught me, if I sleep through a flush, or leave a daytime flush unattended, ie, no ice pack to beat it back, my face will engorge permanently.

                  ***************************************

                  [0005]The clinically available compounds belong to the general category of a adrenergic receptor agonists. It is a known property of all a adrenergic receptor agonists, including brimonidine, to cause vasoconstriction. However, known formulations of brimonidine and other known a-2 adrenergic receptor agonists are associated with a high incidence of rebound hyperemia, or other side effects, in clinical use. For example, after as few as three doses of applying known formulations of a adrenergic receptor agonists, patients may develop secondary rebound hyperemia or secondary vasodilation. Brimonidine (5-bromo-6-(2-imidazolidinylideneamino) quinoxaline L-tartrate), a known selective alpha 2 agonist is associated with significant rebound hyperemia (primary or delayed onset vasodilation) in its current concentration range for treating glaucoma of about 0.1% to 0.2%.

                  Read more: http://www.faqs.org/patents/app/2010...#ixzz0zjHlP3Y5
                  [0007]To the best of the inventor's knowledge, there are currently no means to induce effective vasoconstriction without concomitant ischemia caused by an excessive reduction in blood flow and a cascade of inflammatory mediators, resulting in undesirable clinical sequelae of rebound hyperemia, and or medicamentosa, a potentially prolonged inflammatory state that can last for several weeks or months of rebound mucosal congestion.

                  Read more: http://www.faqs.org/patents/app/2010...#ixzz0zjHtbyTF
                  Previous Numerous IPL.
                  Supplements: High dose Niacinamide, Vit K2, low dose Vit A. Moderate Dose Vit C, Iodine, Taurine, Magnesium. Mod- dose B's. Low dose zinc. Testing Quercetin.

                  Skin Care: No Cleanser, ZZ cream mixed with Niacinamide gel 4% and LMW HA 2%, ethyl ascorbate 2%.

                  Treating for gut dysbiosis.(This is helping).
                  Previous GAPS diet. Have now introduced lots of fibre.
                  Fermented Foods. Intermittent fasting -16-18 hours.
                  Oral Colostrum. Helps reduce food reactions.

                  Comment


                  • I am still flushing HORRENDOUSLY. Mostly during the night when trying to sleep, so I simply don't sleep until I am at the point of exhaustion, after some days, when I have to grab a couple of hours. Lack of sleep also fuels flushing, but as soon as I reach the point of dozing the flushing starts. My face swells terribly, so I have to get up, wander about in the middle of the night and apply icepacks.

                    I can't eat anything even remotely warm. Nor can I shower without my nose just about exploding. So I only shower every second day. I don't even bother to dress.

                    I have SEVERE rosacea again.

                    IT IS HELL!!!!!!!!!!!!!!!!!!!

                    Honestly I would rather die than continue like this.

                    That Dr Webster, the derm is a rotten lying weasel. Brimonidine DOES could rebound flushing and scientific literature supports this. I should have done more research before believing him and now I have paid the price.
                    He is affiliated with the drug company and there is nothing like having one's finger in the pot.
                    He ought to be sued. But no chance of that of course. And at the end of the day it won't help me and other victims.

                    I know WC is having luck with this, but she is also taking a lot of other medication, which might, for all we know be warding off rebound at this stage. I am happy that WC is not suffering as she has been through such a lot, but I can't help but worry about her future.

                    I urge everyone, be very, very careful with brimonidine use.
                    Last edited by Mistica; 18 September 2010, 01:18 AM.
                    Previous Numerous IPL.
                    Supplements: High dose Niacinamide, Vit K2, low dose Vit A. Moderate Dose Vit C, Iodine, Taurine, Magnesium. Mod- dose B's. Low dose zinc. Testing Quercetin.

                    Skin Care: No Cleanser, ZZ cream mixed with Niacinamide gel 4% and LMW HA 2%, ethyl ascorbate 2%.

                    Treating for gut dysbiosis.(This is helping).
                    Previous GAPS diet. Have now introduced lots of fibre.
                    Fermented Foods. Intermittent fasting -16-18 hours.
                    Oral Colostrum. Helps reduce food reactions.

                    Comment


                    • I too urge caution. Clearly a lot of people have rebound flushing from Brimonidine. I don't know why I don't. Other meds I'm taking? Cause I'm using so little? Because I'm diluting it with Finacea?

                      I feel wretched for those who are suffering with this-- I've had rebound flushing from other things and it's awful; it's usually worse than the original flushing. I'm so sorry that Brimonidine is not the wonder I'd hoped it might be for us.

                      If you're using it, and you need to stop for some reason, please stop gradually. Dilute the Brimonidine heavily; dilute it a bit more each day, so you can wean off it if you need to and not stop cold turkey.

                      Please be careful icing your face, too; I've experienced horrible hyperemic flushing from doing that. Hyperemic flushing is when the blood comes rushing back in to an area and engorges it. It's awfully painful and feels like it will never settle.

                      Hoping for better health for all of us.
                      • 58 yr old woman
                      • Rosacea at 48, debilitating at 52
                      • Clonidine 100mgc ev. 8 hrs;
                      • Remeron 15mg nightly;
                      • Zebeta=Bisoprolol=Beta blocker 5mg nightly;
                      • Brimonidine worked well initially, then MASSIVE rebound flushing and damage;
                      • Countless IPL with Lumenis One;
                      • Now purpuric V Beam with Candela Perfecta; more clearance, less downtime than IPL;
                      • Botox (with mesotherapy needles), good not great results;
                      • Monthly Kenalog injection to blunt debilitating flushing.

                      Comment


                      • Alba,

                        If its the drops that made you flush more then it will only take a couple of days for you to go back to your normal flushing if you stop the drops
                        Alas, once an inflammatory cascade has started in me, it doesn't easily stop. And it would appear that this certainly isn't going to stop for me. Even as today has passed, I have developed additional permanent red areas, due to the intense and prolongued flushing episodes. My face is swelling inbetween flushing now as well.

                        I had hoped for advice from Prof Ayers, but it appears he has become bored with rosaceans.
                        My pleas for help have fallen on deaf ears.
                        Previous Numerous IPL.
                        Supplements: High dose Niacinamide, Vit K2, low dose Vit A. Moderate Dose Vit C, Iodine, Taurine, Magnesium. Mod- dose B's. Low dose zinc. Testing Quercetin.

                        Skin Care: No Cleanser, ZZ cream mixed with Niacinamide gel 4% and LMW HA 2%, ethyl ascorbate 2%.

                        Treating for gut dysbiosis.(This is helping).
                        Previous GAPS diet. Have now introduced lots of fibre.
                        Fermented Foods. Intermittent fasting -16-18 hours.
                        Oral Colostrum. Helps reduce food reactions.

                        Comment


                        • Originally posted by Mistica View Post
                          Alba,



                          Alas, once an inflammatory cascade has started in me, it doesn't easily stop. And it would appear that this certainly isn't going to stop for me. Even as today has passed, I have developed additional permanent red areas, due to the intense and prolongued flushing episodes. My face is swelling inbetween flushing now as well.

                          I had hoped for advice from Prof Ayers, but it appears he has become bored with rosaceans.
                          My pleas for help have fallen on deaf ears.
                          Reading things like "I would rather die then go through this" makes me sad. You shouldn't say things like that. I know that I do not exactly know how you feel nor have I gone through what you are going through but there is a plan. Something will come around, it will be sooner rather then later. If I had healing powers I would make all your problems go away, but in time someone will figure it out.

                          Hope you are having a better night.

                          Sincerely,
                          Tony

                          Comment


                          • Well, my worse fears have come true.
                            I went to bed last night and only woke for one flush, presumably the first one. I iced my face, but I didn't get up. A mistake, as I fell back asleep and when I awoke this morning, around 6:30am, my face was a BLOODY, ENGORGED SWOLLEN BLOB and even ice packs don't bring it down fully. My nose is the worse, surprise, surprise, it has always been my worse area.

                            I would like to kill F*** Webster!

                            I am completely crippled by this beast of a disease yet again.
                            Previous Numerous IPL.
                            Supplements: High dose Niacinamide, Vit K2, low dose Vit A. Moderate Dose Vit C, Iodine, Taurine, Magnesium. Mod- dose B's. Low dose zinc. Testing Quercetin.

                            Skin Care: No Cleanser, ZZ cream mixed with Niacinamide gel 4% and LMW HA 2%, ethyl ascorbate 2%.

                            Treating for gut dysbiosis.(This is helping).
                            Previous GAPS diet. Have now introduced lots of fibre.
                            Fermented Foods. Intermittent fasting -16-18 hours.
                            Oral Colostrum. Helps reduce food reactions.

                            Comment


                            • Originally posted by Mistica View Post
                              Here is a patent which describes hyperemia/rebound vasodilation.

                              Am I correct in understanding that if we dilute the drug, it might not have that effect?

                              http://www.faqs.org/patents/app/20100029660
                              There's a lot of information there, but trying to skip to the relevant bits, it does seem like diluting is the way forward to avoiding rebound flushing.

                              One aspect of the present invention refers to a surprising and unexpected finding that using highly selective a-2 agonists at low concentrations allows reducing, minimizing, and/or eliminating rebound hyperemia while optimally providing clinically equal or more effective vasoconstriction. Rebound hyperemia refers to induced vasodilation (instead of intended vasoconstriction) occurring, often with a lag time, after an application or, more typically, repeated applications of vasoconstrictors and characterized by engorgement of blood vessels (such as those in the conjunctiva or nasal mucosa), increased capillary permeability and leakage, and, in some cases, inflammatory sequelae (medicamentosa), frequently due to the use of an alpha 1 constricting drug and particularly, chronic use of a vasoconstricting drug.

                              Comment


                              • Hi Mistica,

                                I'm sorry you are doing bad at the moment. I too was very pale initially with the brimonidine but had the most herrendous flushing for about 2 days afterwards. About as bad as in my worst years. Normally flushes calm down within an hour for me when I cool with a coolpacka nd a fan, but these post brimonidine flushes where throbbing and ongoing and extremely severe. Couldn't sleep from them either. But they did calm down again for me and in a few days I was doing like I used to. I took 50 mg of diclofenac every 8 hours for 2 days for this and Xyzal antihsitamines for a few days. That calmed it down again (together with my normal meds, clonidine, propranolol and mirtazapine).
                                I am positive this is a severe reaction from the blood vessels/ central neurvous system, for some reason. I would not use any more of the solution for a week or more and see how you can calm things down again.

                                It is a bummer though, as I had hoped to have my ultimate 'pale night out' solution with the brimonidine. I agree with you here I most likely overdid it drastically with my applyance the last time, but I don't feel comfortable anymore to be pale for some time but feel like I am a walking road bom, ready to explode in time.
                                My rosacea related blog: http://scarletnat.blogspot.com/2012/...edication.html

                                Comment

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