Xylometazoline (Xynosine, Otrivin) nasal spray

Xylometazoline is a medication commonly used as a nasal decongestant. It works by constricting blood vessels in the nasal passages, which reduces swelling and congestion. This effect can help relieve symptoms of nasal congestion caused by conditions like the common cold, hay fever, or sinusitis. Xylometazoline is often available over-the-counter in nasal spray or nasal drop form. It's important to follow the instructions provided with the medication and not to use it for more than a few days at a time to avoid rebound congestion or other potential side effects.

An alpha-adrenergic agonist called xylometazoline constricts the arterioles in the conjunctiva and nasal mucosa.

  • It is used to provide individuals with allergic rhinitis with short-term relief from nasal and nasopharyngeal mucosal congestion.

Xylometazoline Dose in Adults

In order to treat nasal congestion, you should: Intranasal:

  • For drops (0.1% strength), put 2 to 3 drops in each nostril every 8 to 10 hours.
  • For metered dose spray (also 0.1% strength), use 1 spray in each nostril every 8 to 10 hours.
  • For spray (either 0.05% or 0.1% strength), you can use 1 or 2 sprays in each nostril every 8 to 10 hours.

Xylometazoline Dose in Children:

  • Infants younger than six months
  • Under medical supervision, administer 1 drop of a 0.05% solution into each nostril every six hours as necessary.
  • Infants and kids from six months to twelve years old:
    • Every 8-10 hrs, apply 2/3 drops of a 0.05% solution to the nasal mucosa.
    • A dosage shouldn't be administered more than three times in a 24-hr period.

Pregnancy Risk Factor: C

  • According to the maker, it's not advised to use xylometazoline during pregnancy.

Xylometazoline use during breastfeeding:

  • It's uncertain whether xylometazoline passes into breast milk.
  • The manufacturer suggests being cautious when giving xylometazoline to breastfeeding mothers.

Xylometazoline dose in Kidney Disease:

  • No dosage modification is required.

Xylometazoline Dose in Hepatic Disease:

  • No dosage modification is required.

Less Common Side Effects of Xylometazoline Include:

  • Gastrointestinal:
    • Nausea
  • Central nervous system:
    • Headache
  • Respiratory:
    • Dry nose
    • Nasal discomfort
  • Local:
    • Application site burning

Contraindication to Xylometazoline Include:

  • Xylometazoline shouldn't be used if you're allergic to it or any part of the product, had surgery involving the dura mater, or have narrow-angle glaucoma, rhinitis sicca, or atrophic rhinitis.

Warnings and precautions

Rebound your nasal congestion

  • Using xylometazoline frequently or for a long time can make nasal congestion come back or get worse.

Cardiovascular disease

  • Be careful using xylometazoline if you have high blood pressure or heart disease.

Diabetes mellitus:

  • Be cautious when using xylometazoline if you have diabetes mellitus.

Thyroid disease:

  • Use xylometazoline with caution if you have thyroid disease.

Prostatic hyperplasia/Urinary Obstruction:

  • Be cautious when using xylometazoline if you have prostate enlargement or urinary obstruction.

Xylometazoline (United States: Not available): Drug Interaction

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

May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol.

Doxofylline

Sympathomimetics may enhance the adverse/toxic effect of Doxofylline.

FentaNYL

FentaNYL's serum levels may drop if alpha1-agonists are present. In particular, blood concentrations of fentanyl nasal spray may drop and the start of action may be postponed.

Guanethidine

might make sympathomimetics more arrhythmogenic. Guanethidine could make sympathomimetic drugs more hypertensive.

Solriamfetol

Sympathomimetics may intensify Solriamfetol's hypertensive effects.

Sympathomimetics

might intensify the hazardous or harmful effects of other sympathomimetics.

Tricyclic Antidepressants

Alpha1-Agonists' potential therapeutic effects could be improved. The therapeutic benefit of Alpha1-Agonists may be diminished by Tricyclic Antidepressants.

Risk Factor D (Consider therapy modification)

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.

Cocaine (Topical)

May make sympathomimetics' hypertensive effects stronger. Management: Whenever feasible, look at alternatives to using this combo. Watch for markedly increased heart rate or blood pressure when being utilized concurrently, as well as any symptoms of myocardial ischemia.

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

May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline.

Iobenguane Radiopharmaceutical Products

Iobenguane radiopharmaceutical products' therapeutic effects may be reduced by alpha1-agonists. Treatment: Before administering iobenguane, stop taking any medications that might impede or interfere with catecholamine transport or absorption 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 could be amplified. Although this is the predicted mode of action for linezolid, treatment guidelines are different from those for other monoamine oxidase inhibitors. Details can be found in linezolid-specific monographs. Exceptions: Tedizolid; linezolid.

Tedizolid

might make sympathomimetics' hypertensive effects stronger. The tachycardic impact of sympathomimetics may be increased by tedizolid.

Monitoring Parameters:

No monitoring parameters were mentioned. 

How to administer Xylometazoline?

Instructions for Use: Xylometazoline Nasal Solution

  • For Nasal Use Only: Only use xylometazoline in your nose.
  • Clear Nostrils: Before using, blow your nose to clear it.
  • Position Your Head: Tilt your head slightly forward if you're using a spray, or backward if you're using drops.
  • Apply Solution: Spray or drop the solution into each nostril as directed.
  • Inhale Deeply: After applying, breathe in deeply.
  • Clean Tip: Wipe the tip of the container after each use to keep it clean.
  • Priming (if needed): Some products may need priming before the first use; check the package instructions for details.

Mechanism of action of Xylometazoline:

  • Xylometazoline works by stimulating alpha-adrenergic receptors in the blood vessels of the conjunctiva (the thin tissue covering the white part of the eye) and the nasal passages.
  • This stimulation leads to vasoconstriction, which means the blood vessels narrow.
  • As a result, there is reduced blood flow in these areas, helping to relieve congestion in the nose and alleviate symptoms like a runny or stuffy nose.

The nasal spray begins to work:

  • When used intranasally, xylometazoline starts working quickly, causing local vasoconstriction (narrowing of blood vessels) within about 2 minutes.

Duration of action:

  • This effect can help relieve nasal congestion promptly.
  • The duration of action of xylometazoline is up to 12 hours, providing relief from congestion for an extended period.

International Brands of Xylometazoline:

  • Af-Care
  • Amidrin
  • Antazol
  • Balkis
  • Cirovin
  • Colirio Azul
  • Decon
  • Decozal
  • Ezybreth
  • Fastorik N
  • FLO Rapid Relief
  • Galazolin
  • Gelonasal
  • Hidropid
  • Huma-Metazol
  • Hysan
  • Nasan
  • NasenGel ratiopharm
  • NasenSpray ratiopharm
  • NasenTropfen ratiopharm
  • Nasoferm
  • Nasolin
  • Nasostop
  • Nazol N
  • Neusdruppels
  • Novin
  • Novorin
  • Olynth
  • Osco Xuzulex Nasal Spray
  • Otrinase
  • Otriven
  • Otrivin
  • Otrivina
  • Otrivine
  • Pen Ke Tong
  • Rhinidine
  • Rhinozol
  • Senziola
  • Sinuvin
  • Snup Stada
  • Tezoline
  • Tyzine
  • Xoline
  • Xylo-POS
  • Xylolin
  • Xylomaris
  • Xylomet
  • Xylovit
  • Xymelin
  • Balminil Decongest
  • Otrivin
  • Alpha-Adrenergic Agonist
  • Decongestant
  • Imidazoline Derivative

Xylometazoline Nasal Spray in Pakistan:

  • Lyzo - Alina
  • Nasavin - Cibex
  • Rhezole - Epla
  • Xlomet - Karachi chemical
  • Xolisan - Sante
  • Xylomed - Mediate
  • Xylonas - Geofman
  • Xynosine - Zafa

Xylometazoline (HCl) [Nasal Drops 5 ml]

Xlomet

Karachi Chemical Industries

 

Xylometazoline (HCl) [Nasal Drops 0.05 %w/v]

Xlomet

Karachi Chemical Industries

Xynosine C.F

Zafa Pharmaceutical Laboratories (Pvt) Ltd.