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RESPIRATORY SYSTEM › NASAL PREPARATIONS › DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE › Sympathomimetics, plain
xylometazoline
R01AA07
Forms & Strengths
- Nasal spray, 0.05%
- Nasal spray, 0.1%
- Nasal drops, 0.05%
- Nasal drops, 0.1%
Adult Dosing
- Nasal spray/drops (0.1%): 1-2 sprays or drops into each nostril every 8-10 hours as needed
- Maximum duration of use: 3-5 consecutive days to prevent rhinitis medicamentosa
Pediatric Dosing
- Children 2 to 11 years (0.05% formulation): 1-2 drops or sprays in each nostril every 8-10 hours as needed
- Children under 2 years: Contraindicated or not recommended
- Maximum duration of use: 3-5 consecutive days
Indications
- Nasal congestion associated with acute rhinitis, sinusitis, or common cold
- Facilitation of rhinoscopy or nasal surgery
Mechanism of Action
- Directly stimulates alpha-adrenergic receptors on blood vessels in the nasal mucosa
- Causes vasoconstriction, reducing blood flow and decreasing nasal congestion and mucosal edema
Contraindications
- Hypersensitivity to xylometazoline or any component of the formulation
- Patients taking monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping them
- History of transsphenoidal hypophysectomy or surgery exposing the dura mater
- Atrophic rhinitis or rhinitis sicca
- Children under 2 years of age
Adverse Reactions
- Transient burning, stinging, or dryness of the nasal mucosa
- Sneezing
- Rebound nasal congestion (rhinitis medicamentosa) with prolonged use (>3-5 days)
- Systemic effects (rare): headache, dizziness, nervousness, insomnia, palpitations, hypertension
Drug Interactions
- Monoamine oxidase inhibitors (MAOIs): May precipitate severe hypertensive crisis
- Tricyclic antidepressants: May potentiate the pressor effects of sympathomimetic amines
- Vasopressor agents: Concomitant use increases the risk of cardiovascular side effects and hypertension
Curated Content: Needs Vetting Before Put to Clinical Use