Effect
Oxymetazoline constricts the vessels of the nasal mucosa (vasoconstrictor effect). All drugs from the group of sympathomimetics make use of this effect. They excite special binding sites of the sympathetic nervous system, so-called alpha-adrenoreceptors.
Together with its counterpart, the parasympathetic nervous system, the sympathetic nervous system forms the autonomic nervous system, which we cannot actively control.
Because oxymetazoline re-narrows the dilated vessels, the nasal mucosa swells. In addition, oxymetazoline also acts against viruses. In one study, the use of oxymetazoline shortened the duration of the common cold by up to two days.
Application
Oxymetazoline is used in the form of nasal drops or nasal sprays. There are separate preparations for babies, toddlers, schoolchildren and adults. They differ in the amount of active ingredient they contain.
Preservatives such as benzalkonium chloride are suspected of causing additional damage to the already stressed nasal mucosa. For this reason, many experts (including the German Federal Institute for Drugs and Medical Devices, BfArM) warn against prolonged use because the preservative can cause irritation or additional swelling of the nasal mucosa.
Preparations for babies (birth to 12 months)
Because you have to be very careful with the dosage at this age, decongestant medications with oxymetazoline are only available as dosing drops. With a nasal spray, too much spray can cause an overdose. This can lead to breathing disorders and comatose states.
If you gently tilt your baby’s head back, dripping is easier. It may take 20 minutes to clear the nose.
Preparations for infants (from 1 year to 6 years)
Preparations for toddlers have a higher dose of 0.25 milligrams of oxymetazoline per milliliter than for babies (0.025 percent oxymetazoline hydrochloride). There are nasal drops and nasal sprays.
Preparations for schoolchildren and adults (6 years and older)
For children 6 years and older and adults, drops and sprays containing oxymetazoline are available with 0.5 milligrams of oxymetazoline per milliliter (0.05 percent oxymetazoline hydrochloride).
Oxymetazoline may be used two to three times daily. One spray (nasal spray) or one to two drops (nasal drops) per nostril are possible according to the package insert (expert information).
Oxymetazoline: side effects
Most side effects of oxymetazoline are local, meaning directly at the site of application. These include dry nasal mucosa and burning and sneezing. Systemic side effects, which may be felt throughout the body, such as headache, sleep disturbance, or palpitations, are rare.
For more rare side effects, see the package leaflet that came with your oxymetazoline medicine. Contact your doctor or ask at your pharmacy if you suspect any undesirable side effects.
Indications for use
Oxymetazoline is used to treat nasal mucosal swelling in:
- Acute rhinitis
- @ Allergic rhinitis
- Runny nose
- Inflammation of the paranasal sinuses
- Tubal catarrh
Contraindications
Drug interactions
Certain medicines together with oxymetazoline increase blood pressure. If you are taking the following medicines, you should seek advice from your family doctor’s office or pharmacy:
- Tricyclic antidepressants (such as amitriptyline, imipramine, doxepin).
- Irreversible monoamine oxidase (MAO) inhibitors (such as tranylcypromine)
- Blood pressure-increasing drugs (such as midodrine and etilefrine).
Children
Pregnancy and lactation
Pregnant and breastfeeding women may use oxymetazoline. This is also the opinion of the experts at the Pharmacovigilance and Advisory Center for Embryonic Toxicology at Charité-Universitätsmedizin Berlin.
Alternative preparations without oxymetazoline are sprays and drops with a saline solution. For allergic rhinitis, pregnant and breastfeeding women may also use certain anti-allergic drugs, such as azelastine.
