Oxymetazoline Nasal Spray is a sympathomimetic drug that is used in the symptomatic treatment of patients with rhinitis and nasal congestion.
Oxymetazoline Nasal Spray Uses:
-
Nasal congestion:
- It is prescribed to temporarily relieve nose and sinus discomfort and congestion (due to a cold, hay fever, or other upper respiratory allergies).
-
Off Label Use of Oxymetazoline in Adults:
- It may be used topically for vasoconstriction in nasal procedures.
Oxymetazoline Nasal Spray Dose in Adults
Oxymetazoline Nasal Spray Dose in the treatment of Nasal congestion:
- Intranasal:
- Instill 2 to 3 sprays into each nostril two times a day for 3 days or less
- Maximum dose is 2 doses/24 hours.
Oxymetazoline Nasal Spray Dose in Children
Oxymetazoline Nasal Spray Dose in the treatment of Nasal congestion:
-
Children ≥6 years and Adolescents:
- 05%: Intranasal:
- Instill 2 to 3 sprays into each nostril two times a day.
- Limit the duration of treatment to three days or less.
- 05%: Intranasal:
Note:
- The intranasal spray is not recommended for use in children 6 years of age or younger (especially in infants) due to CNS depression.
Oxymetazoline Nasal Spray Pregnancy Category: C
- When the drug is taken for prolonged periods or at high doses, it can cause adverse effects in neonatal and fetal health.
- The drug is safe for single-use and does not affect the blood flow to the baby if used in the last trimester.
- Pregnant women should not use decongestants for rhinitis. Some patients may only need the nasal decongestant spray for a few days.
Oxymetazoline use during breastfeeding:
- During lactation, local nasal decongestants should be used.
Dose in Kidney Disease:
There are no dosage adjustments provided in manufacturer’s labeling.
Dose in Liver Disease:
There are no dosage adjustments provided in manufacturer’s labeling.
Side effects of Oxymetazoline Nasal Spray:
-
Respiratory:
- Dry nose
- Nasal congestion (rebound; chronic use)
- Nasal mucosa irritation (temporary)
- Sneezing
Contraindications to Oxymetazoline Nasal Spray:
OTC labeling
- Self-medication should not last more than three days.
- Cross-sensitivity may occur when patients are exposed to sympathomimetic drugs, such as those used for ophthalmic purposes.
Warnings and precautions
-
Local nasal effects:
- Some patients may feel a temporary sensation of discomfort such as burning, stinging or increased nasal discharge.
-
Rebound your nasal congestion
- The drug can worsen or cause recurrences of nasal congestion (rhinitis medicamentosa).
-
Cardiovascular disease
- Patients suffering from hypertension or heart disease need to be cautious when using alpha-adrenergic activating drugs.
-
Diabetes:
- Diabetes mellitus patients should be cautious when using it.
-
Thyroid disease:
- Patients suffering from thyroid disease should be cautious when using alpha-adrenergic activators.
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Prostatic hyperplasia, urinary obstruction
- Patients suffering from genitourinary or prostatic hyperplasia must be cautious when taking the drug.
Oxymetazoline (nasal): Drug Interaction
Note: Drug Interaction Categories:
- Risk Factor C: Monitor When Using Combination
- Risk Factor D: Consider Treatment Modification
- Risk Factor X: Avoid Concomitant Use
Risk Factor C (Monitor therapy) |
|
| Alpha1-Blockers | May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1Agonists may antagonize Alpha1-Blocker vasodilation. |
| AtoMOXetine | May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. |
| Cannabinoid-Containing Products | Renders sympathomimetics' tachycardic effect stronger. Cannabidiol is an exception. |
| Doxofylline | Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. |
| FentaNYL | Alpha1-Agonists may lower the level of FentaNYL in the blood. The serum concentrations of fentanyl nasal spray may fall, and the effects may take longer to manifest. |
| Guanethidine | May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. |
| Solriamfetol | Sympathomimetics may enhance the hypertensive effect of Solriamfetol. |
| Sympathomimetics | May enhance the adverse/toxic effect of other Sympathomimetics. |
| Tedizolid | May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. |
| Tricyclic Antidepressants | Alpha1-Agonists' potential therapeutic effects might be improved. The therapeutic benefit of Alpha1-Agonists may be diminished by Tricyclic Antidepressants. |
Risk Factor D (Consider therapy modification) |
|
| Cocaine (Topical) | May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. |
| Esketamine | Esketamine's therapeutic impact may be diminished by nasally administered decongestant drugs. Treatment: Patients who need a nasal decongestant on the day of their esketamine dose should give them at least an hour before the esketamine. |
| Linezolid | May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. |
Risk Factor X (Avoid combination) |
|
| Ergot Derivatives | Alpha1-Agonists' hypertensive effects might be amplified. Alpha1-Agonists may have a greater vasoconstrictive impact when combined with ergot derivatives. Exceptions: Mesylates of ergoloid; nicergoline |
| Iobenguane Radiopharmaceutical Products | Iobenguane radiopharmaceutical products' therapeutic effects may be reduced by alpha1-agonists. Treatment: Before administering iobenguane, stop taking any medications that could impede or interfere with catecholamine transport or uptake for at least five biological half-lives. After each dose of iobenguane, wait at least 7 days before administering these medications. |
| Monoamine Oxidase Inhibitors | Alpha1-Agonists' hypertensive effects might be amplified. Although this is the expected mode of action for linezolid, management guidelines are different from those for other monoamine oxidase inhibitors. Details can be found in linezolid-specific monographs. Linezolid and Tedizolid are exceptions. |
Monitoring Parameters:
Monitor the response to therapy.
How to administer Oxymetazoline Nasal Spray?
- It is intended for intranasal use only.
- When using it for the first time or using a brand new nasal spray, prime the pump several times by firmly depressing the rim several times.
- Insert the nozzle into the nostril while keeping the head upright. Press the rim firmly and inhale deeply.
Mechanism of action of Oxymetazoline Nasal Spray:
It increases the activity of the alpha-adrenergic receptors located in the nasal mucosa arterioles, resulting in vasoconstriction. It reduces nasal congestion and rhinorhea symptoms.
The onset of action:
- Within 10 minutes
Duration:
- Up to 12 hours.
International Brand Names of Oxymetazoline:
- 12 Hour Decongestant
- 12 Hour Nasal Decongestant
- 12 Hour Nasal Relief Spray
- 12 Hour Nasal Spray
- Afrin 12 Hour
- Afrin Menthol Spray
- Afrin Nasal Spray
- Afrin NoDrip Extra Moisture
- Afrin NoDrip Original
- Afrin NoDrip Sinus
- Afrin Sinus
- Dristan Spray
- Long Lasting Nasal Spray
- Mucinex Nasal Spray Full Force
- Mucinex Nasal Spray Moisture
- Mucinex Sinus-Max Clear & Cool
- Mucinex Sinus-Max Full Force
- Nasal Decongestant Spray
- Nasal Spray 12 Hour
- Nasal Spray Max Strength
- Neo-Synephrine 12 Hour Spray
- NRS Nasal Relief
- QlearQuil
- Sinus Nasal Spray
- Vicks Sinex 12 Hour Decongest
- Vicks Sinex Moisturizing
- Vicks Sinex Severe Decongest
- Vicks Sinex
- Afrin
- Alrin
- Aturgyl
- Confree
- Congesta
- Dan Zhong Di Be Ye
- Dimetapp 12 Hour Decongestant Spray
- Drixine
- Feenoze
- Friresp
- Iliadin
- Lidil
- Metzodin
- Mexalon
- Nafazol
- Nasal Relief Spray Wilson
- Nasal Spray
- Nasalong
- Nasalox
- Nasavin
- Nasex
- Nasin
- Nasivin
- Nasivion
- Nasivon
- Nasofree
- Nasopharm
- Nazol
- Nesivine
- Nezeril
- Numark
- Operil
- Oxamet
- Oxazoline
- Oxinasal
- Oxymet
- Respiben
- Respibien
- Respir
- Rhinoclir
- Rinerge
- Rinex
- Rynex
- Sinarest
- Sinazol
- Sindecon
- Sinex
- Vicks Sinex
Oxymetazoline Brands Names in Pakistan:
Oxymetazoline (HCl) Nasal Spray 0.5 mg/ml in Pakistan |
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| Rinerge | Epla Laboratories (Pvt) Ltd. |
