← Search & browse all drugs
RESPIRATORY SYSTEM › NASAL PREPARATIONS › DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE › Other nasal preparations
combinations
R01AX30
Forms & Strengths
- Nasal spray 0.05% oxymetazoline + 0.03% ipratropium bromide per actuation
- Nasal spray 0.025% phenylephrine + 0.2% diphenhydramine per actuation
- Nasal spray 0.05% naphazoline + 0.2% azelastine per actuation
Adult Dosing
- Oxymetazoline/ipratropium: 2 sprays each nostril q12h; max 4 sprays per nostril/24h
- Phenylephrine/diphenhydramine: 2 sprays each nostril q8h; max 6 sprays/24h
- Naphazoline/azelastine: 1 spray each nostril q12h; max 2 sprays/24h
Pediatric Dosing
- Oxymetazoline/ipratropium: children 6–12 yr: 1 spray each nostril q12h; max 2 sprays/24h
- Phenylephrine/diphenhydramine: children 6–12 yr: 1 spray each nostril q8h; max 3 sprays/24h
- Naphazoline/azelastine: not recommended <12 yr; consider adult dosing if benefits outweigh risks
Indications
- Temporary relief of nasal congestion due to common cold, sinusitis, allergic rhinitis
- Adjunctive treatment of allergic rhinitis with concurrent rhinorrhea
- Control of nasal obstruction in patients with mixed allergic and vasomotor symptoms
Mechanism of Action
- Oxymetazoline: selective α1‑adrenergic agonist → vasoconstriction of nasal mucosa
- Ipratropium: anticholinergic → reduces glandular secretions
- Phenylephrine: non‑selective α‑agonist → vasoconstriction
- Diphenhydramine: H1‑receptor antagonist → antihistamine effect
- Naphazoline: α‑adrenergic agonist → decongestion
- Azelastine: H1‑antagonist + mast cell stabilizer → anti‑inflammatory
Contraindications
- Known hypersensitivity to any component
- Severe hypertension or uncontrolled cardiovascular disease
- Narrow-angle glaucoma
- Pregnancy (first trimester) and lactation – use only if clearly indicated
- Pediatric use <6 yr for oxymetazoline‑containing combos
Adverse Reactions
- Local irritation, burning, or stinging sensation
- Rebound congestion with prolonged use (>5‑7 days)
- Dry nose, epistaxis
- Systemic sympathomimetic effects: tachycardia, hypertension
- Anticholinergic effects: dry mouth, urinary retention (ipratropium)
- Sedation, anticholinergic dryness (diphenhydramine)
Drug Interactions
- Concomitant MAO inhibitors or sympathomimetics → exaggerated pressor response
- Beta‑blockers may blunt decongestant effect
- Antihypertensive agents – monitor BP
- Other nasal decongestants – risk of additive systemic adrenergic load
- CNS depressants – may increase sedation with diphenhydramine
Curated Content: Needs Vetting Before Put to Clinical Use