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Onreltea is a topical gel formulation of brimonidine tartrate (0.5%, equivalent to 0.33% brimonidine free base), a small molecule alpha-2 adrenergic receptor agonist. Developed by Galderma, it is primarily approved for the treatment of persistent facial erythema associated with rosacea in adults. The drug works by inducing direct vasoconstriction of small arteries and veins in the skin, thereby reducing redness. The Hospital for Sick Children is currently investigating Onreltea in a Phase 2 clinical trial (NCT02764411) as a potential treatment for facial capillary malformations (port-wine stains) in pediatric patients aged 12-17 years. This investigational use aims to evaluate the efficacy and safety of daily topical application in reducing lesion discoloration and preventing the progressive vessel ectasia and tissue thickening associated with these congenital vascular malformations.
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