Overview
Oxymetazoline is a topical sympathomimetic agent used primarily as a nasal decongestant and ophthalmic vasoconstrictor. It produces local vasoconstriction of blood vessels, leading to reduced nasal congestion or ocular redness. It is intended for short-term use due to the risk of rebound congestion with prolonged administration.
Mechanism of Action
Oxymetazoline is a direct-acting sympathomimetic amine that stimulates alpha-adrenergic receptors (primarily α1 and partial α2 agonist activity) in the arterioles of the nasal mucosa and conjunctiva. Activation of these receptors causes vasoconstriction, which decreases blood flow, reduces mucosal edema, and relieves congestion.
Indications
- Temporary relief of nasal congestion due to: Common cold Allergic rhinitis Sinusitis
- Temporary relief of redness of the eye (ophthalmic formulation)
Dosage
Nasal Spray (0.05%) – Adults and Children ≥ 6 years: 2 to 3 sprays in each nostril every 10–12 hours Do not exceed 2 doses in 24 hours Do not use for more than 3 consecutive days Ophthalmic Solution (0.025%–0.05% depending on product): 1–2 drops in the affected eye(s) every 6 hours as needed
Contraindications
- Hypersensitivity to oxymetazoline or any component of the formulation
- Narrow-angle glaucoma (ophthalmic use)
- Concomitant use with monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping MAOIs
Side Effects
- Nasal:Transient burning, stinging, dryness
- Nasal:Sneezing
- Nasal:Rebound congestion with prolonged use
- Systemic (rare but possible):Increased blood pressure
- Systemic (rare but possible):Palpitations
- Systemic (rare but possible):Nervousness
- Systemic (rare but possible):Insomnia
- Ophthalmic:Temporary irritation
- Ophthalmic:Blurred vision
Interactions
- Monoamine oxidase inhibitors (risk of hypertensive crisis)
- Tricyclic antidepressants
- Other sympathomimetic agents
- Beta-blockers (may alter cardiovascular response)
Counseling Points
- Max 3 days use to avoid rebound. OTC.