oxymetazoline intranasal (OTC)

Brand and Other Names:Afrin, Duramist Plus, more...Dristan 12 Hr, Cheracol Nasal, Duration, Genasal, QlearQuil 12 Hour Nasal Decongestant Moisturizing Spray, Sinarest 12 Hour, Vicks Sinex 12 Hour
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

intranasal solution

  • 0.05%

Nasal Congestion

Indicated for temporary relief of nasal congestion

2-3 gtt/sprays per nostril q12hr

Not to exceed 2 doses/24 hr for 3-5 days

Dosage Forms & Strengths

intranasal solution

  • 0.05%

Nasal Congestion

Indicated for temporary relief of nasal congestion

<6 years

  • Safety and efficacy not established

≥6 years

  • 2-3 gtt/sprays per nostril q12hr
  • Not to exceed 2 doses/24 hr for 3-5 days
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Interactions

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            Contraindicated (0)

              Serious - Use Alternative (4)

              • isocarboxazid

                isocarboxazid increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. MAOIs cause norepinephrine accumulation within adrenergic neurons. Significant hypertension can result if coadministered with alpha1 agonists.

              • ozanimod

                ozanimod increases toxicity of oxymetazoline intranasal by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

              • phenelzine

                phenelzine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. MAOIs cause norepinephrine accumulation within adrenergic neurons. Significant hypertension can result if coadministered with alpha1 agonists.

              • tranylcypromine

                tranylcypromine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. MAOIs cause norepinephrine accumulation within adrenergic neurons. Significant hypertension can result if coadministered with alpha1 agonists.

              Monitor Closely (19)

              • amitriptyline

                amitriptyline increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

              • amoxapine

                amoxapine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

              • azelastine

                oxymetazoline intranasal, azelastine. Other (see comment). Modify Therapy/Monitor Closely. Comment: Oxymetazoline has been known to slow the rate, but not affect the extent of absorption of concomitantly administered intranasal products. Do not administer other intranasal products with oxymetazoline intranasal.

              • clomipramine

                clomipramine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

              • cromolyn sodium, intranasal

                oxymetazoline intranasal, cromolyn sodium, intranasal. Other (see comment). Modify Therapy/Monitor Closely. Comment: Oxymetazoline has been known to slow the rate, but not affect the extent of absorption of concomitantly administered intranasal products. Do not administer other intranasal products with oxymetazoline intranasal.

              • desipramine

                desipramine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

              • doxepin

                doxepin increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

              • imipramine

                imipramine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

              • ipratropium intranasal

                oxymetazoline intranasal, ipratropium intranasal. Other (see comment). Modify Therapy/Monitor Closely. Comment: Oxymetazoline has been known to slow the rate, but not affect the extent of absorption of concomitantly administered intranasal products. Do not administer other intranasal products with oxymetazoline intranasal.

              • nadolol

                nadolol increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. When beta-2 receptors are antagonized by nonselective beta blockers, alpha1 vasoconstriction may be unopposed, thus increasing hypertensive effect. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use an alternant anesthetic in patients taking nonselective beta blockers.

              • nortriptyline

                nortriptyline increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

              • olopatadine intranasal

                oxymetazoline intranasal, olopatadine intranasal. Other (see comment). Modify Therapy/Monitor Closely. Comment: Oxymetazoline has been known to slow the rate, but not affect the extent of absorption of concomitantly administered intranasal products. Do not administer other intranasal products with oxymetazoline intranasal.

              • penbutolol

                penbutolol increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. When beta-2 receptors are antagonized by nonselective beta blockers, alpha1 vasoconstriction may be unopposed, thus increasing hypertensive effect. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use an alternant anesthetic in patients taking nonselective beta blockers.

              • propranolol

                propranolol increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. When beta-2 receptors are antagonized by nonselective beta blockers, alpha1 vasoconstriction may be unopposed, thus increasing hypertensive effect. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use an alternant anesthetic in patients taking nonselective beta blockers.

              • protriptyline

                protriptyline increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

              • safinamide

                oxymetazoline intranasal and safinamide both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Monitor patients for hypertension if safinamide is prescribed concomitantly with prescription or nonprescription sympathomimetics, including nasal, oral, or ophthalmic decongestants and cold remedies.

              • sotalol

                sotalol increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. When beta-2 receptors are antagonized by nonselective beta blockers, alpha1 vasoconstriction may be unopposed, thus increasing hypertensive effect. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use an alternant anesthetic in patients taking nonselective beta blockers.

              • timolol

                timolol increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. When beta-2 receptors are antagonized by nonselective beta blockers, alpha1 vasoconstriction may be unopposed, thus increasing hypertensive effect. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use an alternant anesthetic in patients taking nonselective beta blockers.

              • trimipramine

                trimipramine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

              Minor (0)

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                Adverse Effects

                Frequency Not Defined

                Insomnia

                Headache

                Burning

                Stinging

                Dryness

                Sneezing

                Rebound congestion

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                Warnings

                Contraindications

                Hypersensitivity

                Cautions

                May cause temporary discomfort, including burning, sneezing, singing, or increased nasal discharge

                Prolonged or frequent use may cause nasal congestion to recur or worsen

                Use caution in patients with hypertension or heart disease

                Use caution in patients with diabetes mellitus

                Use caution in patients with thyroid disease

                Use caution in patients with prostatic hyperplasia and/or genitourinary obstruction

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                Pregnancy & Lactation

                Pregnancy category: C

                Lactation: Not known if excreted in breast milk

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Alpha-adrenergic agonist; stimulates alpha-adrenergic receptors and produces vasoconstriction in the arterioles of the nasal mucosa

                Absorption

                Onset: Within seconds

                Duration: 6 hr

                Elimination

                Excretion: Via kidney

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                Afrin No Drip (oxymetazoline) nasal
                -
                0.05 % solution
                Afrin No Drip (oxymetazoline) nasal
                -
                0.05 % solution
                Afrin No Drip (oxymetazoline) nasal
                -
                0.05 % solution
                Vicks Sinex 12-Hour nasal
                -
                0.05 % liquid
                Nasal Spray (oxymetazoline) nasal
                -
                0.05 % liquid
                Nasal Spray (oxymetazoline) nasal
                -
                0.05 % liquid
                Nasal Spray (oxymetazoline) nasal
                -
                0.05 % liquid
                Nasal Spray (oxymetazoline) nasal
                -
                0.05 % liquid
                Afrin Sinus (oxymetazoline) nasal
                -
                0.05 % liquid
                Afrin (oxymetazoline) nasal
                -
                0.05 % liquid
                Afrin (oxymetazoline) nasal
                -
                0.05 % solution
                Ephrine nasal
                -
                1 % drops
                Sinus Nasal Spray nasal
                -
                0.05 % liquid
                Anefrin nasal
                -
                0.05 % liquid
                Nasal Decongestant (oxymetazoline) nasal
                -
                0.05 % liquid
                Nasal Decongestant (oxymetazoline) nasal
                -
                0.05 % liquid
                No Drip nasal
                -
                0.05 % liquid
                Rhofade topical
                -
                1 % cream

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                oxymetazoline nasal

                DECONGESTANT DROPS - NASAL

                USES: This medication is used for temporary relief of congestion in the nose caused by various conditions including the common cold, sinusitis, hay fever, and allergies. It works by narrowing the blood vessels in the nose area, reducing swelling and congestion.

                HOW TO USE: Use this medication in the nose as directed. Follow all directions on the product package, or use as directed by your doctor. If you have any questions, ask your doctor or pharmacist.To apply nasal drops, wash your hands first. To avoid contamination, do not touch the dropper tip or let it touch your nose or any other surface. If needed, have another person place the drops in your nose.Gently blow your nose before using this drug. Tilt your head back while sitting on a chair or lying down. Hold the dropper over the affected nostril and apply the directed number of drops. Keep your head tilted for a few minutes. Repeat these steps with the other nostril if needed. Do not swallow the medication if it drips into the throat.This medication provides only temporary relief. Do not use more medication or use it more often or for longer than directed because doing so may increase the risk of side effects. Also, do not use this medication for more than 3 days because doing so may cause a condition called rebound congestion. Symptoms of rebound congestion include long-term redness and swelling inside the nose and increased runny nose. If this occurs, stop using this medication and consult your doctor or pharmacist.Inform your doctor if your condition worsens or persists after 3 days.

                SIDE EFFECTS: Temporary burning, stinging, dryness in the nose, runny nose, and sneezing may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: slow/fast/pounding heartbeat, dizziness, nausea, headache, mental/mood changes, trouble sleeping, shaking (tremors), unusual sweating, unusual weakness.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before using this nasal decongestant, tell your doctor or pharmacist if you are allergic to it; or to other sympathomimetics (e.g., pseudoephedrine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.If you have any of the following health problems, consult your doctor or pharmacist before using this product: heart/blood vessel disease (e.g., coronary artery disease), overactive thyroid (hyperthyroidism), diabetes, high blood pressure, difficulty urinating (due to enlarged prostate).Before having surgery, tell your doctor or dentist that you are using this medication.Caution is advised when this drug is used by children because they may be more sensitive to the effects of the drug. Check the product package or consult with your doctor or pharmacist about whether these nasal drops can be used by children.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: If your doctor has directed you to use this product, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: medication for high blood pressure, tricyclic antidepressants (e.g., amitriptyline).Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products or diet aids).This document does not contain all possible interactions. Before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: drowsiness, slow heartbeat, dizziness, fainting.

                NOTES: Do not share this medication with others. Use of this container by more than one person may spread infection.There are many nasal decongestants available, many without a prescription. Talk with your doctor or pharmacist about which product is best for you.

                MISSED DOSE: Not applicable.

                STORAGE: Refer to storage information printed on the package. Protect from heat and light. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.