Rhofade (Oxymetazoline) - Topical

What Is Rhofade?

Rhofade (oxymetazoline) is a prescription topical cream used in adults 18 and older with a skin condition called rosacea.

This medication is used to reduce facial redness caused by rosacea. Rhofade contains the active ingredient oxymetazoline, which is classified as an adrenergic agonist agent. It works by constricting blood vessels near the surface of your skin, which helps relieve redness.

Discontinued in generic form as a rosacea medication, the primary ingredient found in Rhofade, oxymetazoline hydrochloride, is also present in other brand-name products (e.g., Visine L.R., Upneeq).

However, for the explicit treatment of rosacea, Rhofade is the only currently available brand-name medication administered as a topical cream in the United States (U.S.).

Rhofade cream comes in a tube or a pump bottle. The product comes in two sizes: 30 grams and 60 grams.

Drug Facts

Generic Name: Oxymetazoline

Brand Name(s): Rhofade

Drug Availability: Prescription

Administration Route: Topical cream

Therapeutic Classification: Adrenergic agonist agent

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Oxymetazoline hydrochloride

Dosage Form(s): Tube, pump bottle

What Is Rhofade Used For?

The Food and Drug Administration (FDA) approves Rhofade to reduce persistent facial redness caused by rosacea. This prescription-only cream is approved for adults 18 and older.

Rosacea is a condition that causes chronic inflammation of the skin. People with rosacea often have reddening and acne-like bumps on their cheeks, nose, chin, or forehead.

How to Use Rhofade

Apply a pea-sized amount of cream once daily to your entire face, including your cheeks, nose, chin, and forehead. Try to apply at the same time each day. Make sure to avoid getting the cream in your eyes, mouth, or on your lips.

Also, avoid using the cream on open wounds or irritated skin. You'll want to wash your hands before and after each application.

Follow the directions on your prescription label carefully, and ask your healthcare provider to explain any part you do not understand. Use Rhofade exactly as directed. Do not use more or less of it or use it more often than prescribed by your healthcare provider.

Storage

Rhofade should be stored at room temperature in a dry place, away from heat and moisture (e.g., the bathroom).

Like all medications, Rhofade should be kept away from children and pets.

Off-Label Uses

Rhofade can also be used to treat epistaxis (bleeding from the nose).

How Long Does Rhofade Take to Work?

People using Rhofade cream typically see a noticeable decrease in facial redness after about a month. If you don't see an improvement, talk to your healthcare provider.

What Are the Side Effects of Rhofade?

This is not a complete list of side effects, and others may occur.

A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

In Rhofade's clinical trials, most participants did not report common side effects. But, some people reported the following skin discomforts at Rhofade application sites:

While these side effects may be mild or temporary, about 3% of people in Rhofade's clinical trials experienced worsening of their rosacea lesions. Talk to your healthcare provider if your skin redness seems to get worse instead of better while using Rhofade.

Severe Side Effects

Severe side effects haven't been reported with Rhofade use.

However, allergic reactions are a possible side effect of any medication. Call your healthcare provider or seek medical attention if you develop reactions such as hives, facial swelling, or trouble breathing.

Report Side Effects

Rhofade may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Rhofade Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (cream):
    • For treatment of facial redness caused by rosacea:
      • Adults—Apply a thin layer to the entire face once a day.
      • Children—Use and dose must be determined by your doctor.

Modifications

Due to the possible effects of this medication, there may be changes to how it is used. Therefore, Rhofade may require modifications for the following users:

Children: Rhofade is not approved for children as its safety and effectiveness have not been measured in people younger than 18. Ask your healthcare provider for alternative methods of treatment.

Pregnant or breastfeeding people: Due to limited studies, those who are pregnant, plan to become pregnant, or are breastfeeding should talk to their healthcare provider before taking Rhofade.

Older adults: The safety and efficacy of Rhofade are similar in younger and older adults. However, the prescribing information states that some older adults may have greater sensitivity to the drug. Speak with your healthcare provider to determine if your age may impact your ability to tolerate Rhofade.

Missed Dose

If you miss an application of Rhofade cream, apply it as soon as you remember. But if it’s almost time for your next application, skip the missed application. You shouldn't use more than a pea-sized amount of Rhofade cream once daily.

Overdose: What Happens If I Take Too Much Rhofade?

Rhofade is a cream you apply topically (directly to the skin). You should not swallow it. Applying too much Rhofade or ingesting it may be harmful because it could cause blood vessels in your body to constrict.

This restriction could lead to changes in blood pressure, heart rate, or other complications. You should contact the Poison Control Center or your healthcare provider immediately if ingestion occurs. They may advise you to seek medical attention.

What Happens If I Overdose on Rhofade

If you think you or someone else may have overdosed on Rhofade, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Rhofade, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to use it.

If your condition does not improve within a few days, or if it becomes worse, check with your doctor.

You will also need to have your blood pressure measured before starting this medicine and while you are using it. If you notice any change to your recommended blood pressure, call your doctor right away. If you have questions about this, talk to your doctor.

Check with your doctor immediately if blurred vision, eye pain, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Do not use this medicine for a skin problem that has not been checked by your doctor.

Do not use cosmetics or other skin care products on the treated skin areas.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Rhofade?

You shouldn’t use Rhofade if:

  • You are allergic to oxymetazoline or any component of Rhofade.
  • You are under the age of 18. It isn't known if this medication is safe or effective for use in children or adolescents.

What Other Medications May Interact With Rhofade?

Rhofade is a topical cream used to reduce facial redness in adults with rosacea. It works by tightening the blood vessels just beneath the skin.

This medication isn't expected to cause major medication interactions, but it is possible that Rhofade could interfere with the action of other drugs that affect blood vessels.

Because of this risk, your healthcare provider may monitor you more closely if you take the following medications while using Rhofade:

What Medications Are Similar?

Below is a list of topical medications that also treat rosacea:

While all the medications listed above can be used to reduce the symptoms of rosacea, Mirvaso is the only one that works similarly to Rhofade.

The other medications are topical antibiotics. Talk to your healthcare provider to determine which option is best for you.

Frequently Asked Questions

  • Is there any difference between the tube and pump bottle of Rhofade?

    Rhofade comes in either a tube or a pump bottle. Both products contain the same medication.

    Note that the pump requires you to "prime" it before the first use. You'll do this by holding the container upright and pumping it three times. Discard the cream that comes out. Now, the product is ready to use. (Only do this before the first use.)

  • Should I keep using Rhofade after the redness on my face gets better?

    Yes, you should continue using Rhofade once your redness goes away or as your healthcare provider instructs. Rhofade causes your blood vessels to shrink, which makes your skin look less red.

    However, stopping Rhofade may cause your facial redness to come back when your blood vessels enlarge due to rosacea.

  • Can I use moisturizer or makeup while using Rhofade?

    When applying skincare products, the American Academy of Dermatology Association recommends using the following order:

    1. Wash your face with a gentle cleanser and pat dry.
    2. Apply topical medication and allow to dry.
    3. Apply moisturizer and/or sunscreen and allow to dry.
    4. Apply makeup if desired.

    Consult your dermatologist if you have questions about the best skincare products for rosacea.

  • Is there a generic version of Rhofade?

    No. Currently, Rhofade is only available as a brand-name drug.

How Can I Stay Healthy While Using Rhofade?

There is no cure for rosacea, but the symptoms can be managed.

You can also take steps to prevent it from getting worse. Certain triggers can cause a rosacea flare-up. Try to avoid or limit common triggers, such as:

  • Sun exposure
  • Stress
  • Wind
  • Alcohol 
  • Spicy foods
  • Hot beverages
  • Extreme cold

Moreover, make sure you have a good daily skincare routine. Use a gentle, unscented cleanser when washing your face, and avoid hard scrubbing.

Don't forget to wear sunscreen before sun exposure, and see your healthcare provider regularly for personalized medical advice.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Food and Drug Administration. Drugs@FDA: FDA-approved drugs.

  3. van Zuuren EJ, Arents BWM, van der Linden MMD, Vermeulen S, Fedorowicz Z, Tan J. Rosacea: new concepts in classification and treatment. Am J Clin Dermatol. 2021;22(4):457-465. doi:10.1007/s40257-021-00595-7

  4. Prescribers' Digital Reference. Oxymetazoline hydrochloride - drug summary.

  5. Anderson MS, Nadkarni A, Cardwell LA, Alinia H, Feldman SR. Spotlight on brimonidine topical gel 0.33% for facial erythema of rosacea: safety, efficacy, and patient acceptabilityPatient Prefer Adherence. 2017;11:1143-1150. doi:10.2147/PPA.S115708

  6. American Academy of Dermatology. Should I apply my skin care products in a certain order?

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By Patricia Weiser, PharmD
Patricia Weiser, PharmD, is a licensed pharmacist and freelance medical writer. She has more than 14 years of professional experience.