(oks i met AZ oh leen)
Adjunctive therapy for nasal congestion, associated with acute or chronic rhinitis, the common cold, sinusitis, hay fever, or other allergies
Hypersensitivity to oxymetazoline or any component of the formulation
Nasal congestion: Intranasal: Instill 2-3 sprays into each nostril twice daily for ≤3 days
Refer to adult dosing.
Nasal congestion: Intranasal: Children ≥6 years: Refer to adult dosing.
Store at room temperature.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Nasal, as hydrochloride:
12 Hour Nasal Relief Spray: 0.05% (15 mL, 30 mL)
12 Hour Nasal Spray: 0.05% (30 mL) [contains benzalkonium chloride]
12 Hour Nasal Spray: 0.05% (30 mL) [contains benzalkonium chloride, benzyl alcohol, edetate disodium, polyethylene glycol]
Afrin 12 Hour: 0.05% (30 mL) [contains benzalkonium chloride, disodium edta, polyethylene glycol, propylene glycol]
Afrin Extra Moisturizing: 0.05% (30 mL [DSC])
Afrin Menthol Spray: 0.05% (15 mL)
Afrin Nasal Spray: 0.05% (15 mL)
Afrin Nasal Spray: 0.05% (15 mL, 20 mL, 30 mL) [contains benzalkonium chloride, disodium edta]
Afrin NoDrip Extra Moisture: 0.05% (15 mL) [contains benzalkonium chloride]
Afrin NoDrip Original: 0.05% (15 mL) [contains benzalkonium chloride]
Afrin NoDrip Sinus: 0.05% (15 mL) [contains benzalkonium chloride, menthol]
Afrin Sinus: 0.05% (15 mL)
Dristan Spray: 0.05% (15 mL) [contains benzalkonium chloride, disodium edta]
Long Lasting Nasal Spray: 0.05% (30 mL) [contains benzalkonium chloride]
Mucinex Nasal Spray Full Force: 0.05% (22 mL) [contains benzalkonium chloride, disodium edta, menthol, polysorbate 80]
Mucinex Nasal Spray Moisture: 0.05% (22 mL) [contains benzalkonium chloride, edetate disodium, propylene glycol]
Mucinex Sinus-Max Full Force: 0.05% (22 mL) [contains benzalkonium chloride, edetate disodium, menthol, polysorbate 80, propylene glycol]
Mucinex Sinus-Max Moist Smart: 0.05% (22 mL) [contains benzalkonium chloride, disodium edta, propylene glycol]
Nasal Decongestant Spray: 0.05% (15 mL, 30 mL) [contains benzalkonium chloride]
Nasal Decongestant Spray: 0.05% (15 mL, 30 mL) [contains benzalkonium chloride, edetate disodium, polyethylene glycol, propylene glycol]
Nasal Spray 12 Hour: 0.05% (30 mL) [contains benzalkonium chloride, benzyl alcohol, edetate disodium, polyethylene glycol, propylene glycol]
Nasal Spray Extra Moisturizing: 0.05% (30 mL) [contains benzalkonium chloride, benzyl alcohol, edetate disodium, polyethylene glycol, propylene glycol]
Nasal Spray Max Strength: 0.05% (30 mL) [gluten free; contains benzalkonium chloride, benzyl alcohol, disodium edta]
Neo-Synephrine 12 Hour Spray: 0.05% (15 mL)
NRS Nasal Relief: 0.05% (15 mL, 30 mL [DSC]) [contains benzalkonium chloride, benzyl alcohol, disodium edta, propylene glycol]
QlearQuil: 0.05% (15 mL) [contains benzalkonium chloride, disodium edta]
Sinus Nasal Spray: 0.05% (30 mL) [contains benzalkonium chloride, edetate disodium, menthol, polysorbate 80, propylene glycol]
Vicks Sinex 12 Hour Decongest: 0.05% (15 mL) [contains benzalkonium chloride, disodium edta]
Generic: 0.05% (30 mL)
Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1-Agonists may antagonize Alpha1-Blocker vasodilation. Monitor therapy
AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. Monitor therapy
Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Monitor therapy
Ergot Derivatives: May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline. Avoid combination
FentaNYL: Alpha1-Agonists may decrease the serum concentration of FentaNYL. Specifically, fentanyl nasal spray serum concentrations may decrease and onset of effect may be delayed. Monitor therapy
Iobenguane I 123: Sympathomimetics may diminish the therapeutic effect of Iobenguane I 123. Avoid combination
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. Consider therapy modification
MAO Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Exceptions: Linezolid; Tedizolid. Avoid combination
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy
Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Tricyclic Antidepressants: May enhance the vasopressor effect of Alpha1-Agonists. Tricyclic Antidepressants may diminish the vasopressor effect of Alpha1-Agonists. Monitor therapy
Frequency not defined.
Respiratory: Dryness of the nasal mucosa, nasal irritation (temporary), rebound congestion (chronic use), sneezing
Concerns related to adverse effects:
- Rebound nasal congestion: May occur with extended use.
Disease-related concerns:
- Cardiovascular disease: Use with caution in patients with hypertension, heart failure, or coronary artery disease.
- Diabetes: Use with caution in patients with diabetes mellitus.
- Hyperthyroidism: Use with caution in patients with hyperthyroidism.
- Prostatic hyperplasia: Use with caution in patients with benign prostatic hyperplasia.
Dosage form specific issues:
- Benzyl alcohol and derivatives: Some dosage forms may contain benzyl alcohol; large amounts of benzyl alcohol ( ≥99 mg/kg/day) have been associated with a potentially fatal toxicity ( "gasping syndrome " �) in neonates; the "gasping syndrome " � consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP [Inactive" 1997]; CDC, 1982); some data suggests that benzoate displaces bilirubin from protein binding sites (Ahlfors, 2001); avoid or use dosage forms containing benzyl alcohol with caution in neonates. See manufacturer 's labeling.
Other warnings/precautions:
- Accidental ingestion: Accidental ingestion by children of over-the-counter (OTC) imidazoline-derivative eye drops and nasal sprays may result in serious harm. Serious adverse reactions (eg, coma, bradycardia, respiratory depression, sedation) requiring hospitalization have been reported in children ≤5 years of age who had ingested even small amounts (eg, 1-2 mL). Contact a poison control center and seek emergency medical care immediately for accidental ingestion (FDA Drug Safety Communication, 2012).
Adverse fetal or neonatal effects have not been observed following normal maternal doses of oxymetazoline during the third trimester of pregnancy. Adverse events have been noted in case reports following large doses or extended use. Decongestants are not the preferred agents for the treatment of rhinitis during pregnancy. Short-term (<3 days) use of intranasal oxymetazoline may be beneficial to some patients although its safety during pregnancy has not been studied.
Stimulates alpha-adrenergic receptors in the arterioles of the nasal mucosa to produce vasoconstriction
Within seconds
Up to 12 hours
- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
- Patient may experience sneezing, burning, stinging, or rhinorrhea. Have patient report immediately to prescriber angina, tachycardia, passing out, severe headache, or severe nasal irritation (HCAHPS).
- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.