Mucinex Sinus-Max C&c 0.05% Spray
It is used to treat nose stuffiness.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Nasal Decongestant
Pharmacologic Class
Alpha-Adrenergic Agonist
Pregnancy Category
Category C
FDA Approved
Jan 1964
DEA Schedule
Not Controlled
Overview
What is this medicine?
Oxymetazoline is a nasal spray that helps relieve a stuffy nose by shrinking the swollen blood vessels in your nose. This makes it easier to breathe. It works quickly and lasts for several hours.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. It is essential to use this medication as directed.
This medication is for nasal use only. Do not take it by mouth, and avoid getting it in your eyes or mouth, as it may cause burning.
Before using this medication, check if it needs to be shaken. Some products require shaking before use.
If you have a pump-style medication, follow the instructions for priming the pump. Some pumps may need to be primed if they have not been used for a while.
Before using your medication, blow your nose to ensure the nasal passage is clear.
When using the medication, do not tilt your head back. Instead, use it with your head in a normal position.
After using your dose, replace the cap to keep the medication clean and protected.
Storage and Disposal
To maintain the quality and safety of your medication:
Store it at room temperature in a dry place, avoiding bathrooms and areas with high humidity.
Keep all medications in a safe location, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist.
Check with your pharmacist for guidance on the best way to dispose of medications. You may also have access to drug take-back programs in your area.
Missed Dose Instructions
If you use this medication regularly and miss a dose:
Take the missed dose as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
Do not take two doses at the same time or use extra doses.
If you use this medication as needed, do not use it more frequently than directed by your doctor.
To use this medication correctly, follow your doctor's instructions and read all the information provided. It is essential to use this medication as directed.
This medication is for nasal use only. Do not take it by mouth, and avoid getting it in your eyes or mouth, as it may cause burning.
Before using this medication, check if it needs to be shaken. Some products require shaking before use.
If you have a pump-style medication, follow the instructions for priming the pump. Some pumps may need to be primed if they have not been used for a while.
Before using your medication, blow your nose to ensure the nasal passage is clear.
When using the medication, do not tilt your head back. Instead, use it with your head in a normal position.
After using your dose, replace the cap to keep the medication clean and protected.
Storage and Disposal
To maintain the quality and safety of your medication:
Store it at room temperature in a dry place, avoiding bathrooms and areas with high humidity.
Keep all medications in a safe location, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist.
Check with your pharmacist for guidance on the best way to dispose of medications. You may also have access to drug take-back programs in your area.
Missed Dose Instructions
If you use this medication regularly and miss a dose:
Take the missed dose as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
Do not take two doses at the same time or use extra doses.
If you use this medication as needed, do not use it more frequently than directed by your doctor.
Lifestyle & Tips
- Do not use this spray for more than 3 days in a row. Using it for too long can make your stuffy nose worse (rebound congestion).
- Follow the dosing instructions carefully. Do not use more often or more spray than recommended.
- To avoid spreading germs, do not share your nasal spray with others.
- If your symptoms do not improve after 3 days, or if they worsen, stop using the spray and consult a doctor.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
2-3 sprays per nostril, not more often than every 10-12 hours. Do not use for more than 3 days.
Dose Range:
2 - 3 mg
Condition-Specific Dosing:
maximum_frequency:
Every 10-12 hours
maximum_duration:
3 days
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Children 6 to under 12 years of age: 2-3 sprays in each nostril, not more often than every 10-12 hours. Do not use for more than 3 days. Children under 6 years of age: Consult a doctor.
Adolescent:
Adolescents 12 years of age and older: Same as adult dosing.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment recommended for topical nasal use.
Moderate:
No specific adjustment recommended for topical nasal use. Use with caution due to potential for systemic absorption.
Severe:
No specific adjustment recommended for topical nasal use. Use with caution due to potential for systemic absorption and increased risk of adverse effects.
Dialysis:
Not applicable for topical nasal use; minimal systemic absorption.
Hepatic Impairment:
Mild:
No specific adjustment recommended for topical nasal use.
Moderate:
No specific adjustment recommended for topical nasal use. Use with caution due to potential for systemic absorption.
Severe:
No specific adjustment recommended for topical nasal use. Use with caution due to potential for systemic absorption and increased risk of adverse effects.
Pharmacology
Mechanism of Action
Oxymetazoline is a direct-acting sympathomimetic amine that acts on alpha-adrenergic receptors in the arterioles of the nasal mucosa to produce vasoconstriction. This vasoconstriction reduces blood flow to the nasal passages, leading to decreased swelling and congestion.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption from nasal route (<1%)
Tmax:
Not well-defined for local nasal action; systemic absorption is negligible.
FoodEffect:
Not applicable for nasal spray.
Distribution:
Vd:
Not significant for nasal administration due to local action.
ProteinBinding:
Not significant for nasal administration.
CnssPenetration:
Limited
Elimination:
HalfLife:
Not well-defined for nasal administration; systemic half-life is approximately 5-8 hours if absorbed.
Clearance:
Not significant for nasal administration.
ExcretionRoute:
Primarily local action; any systemically absorbed drug is excreted renally.
Unchanged:
Not significant for nasal administration.
Pharmacodynamics
OnsetOfAction:
Within minutes (typically 5-10 minutes)
PeakEffect:
Within minutes
DurationOfAction:
Up to 10-12 hours
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek immediate medical attention:
- Signs of an allergic reaction, such as:
- Rash
- Hives
- Itching
- Red, swollen, blistered, or peeling skin with or without fever
- Wheezing
- Tightness in the chest or throat
- Trouble breathing, swallowing, or talking
- Unusual hoarseness
- Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. Contact your doctor or seek medical help if you experience any of the following side effects or if they persist or bother you:
- Nose irritation
- Sneezing
- Burning or stinging
- Runny nose
Note: This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor for medical advice. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek immediate medical attention:
- Signs of an allergic reaction, such as:
- Rash
- Hives
- Itching
- Red, swollen, blistered, or peeling skin with or without fever
- Wheezing
- Tightness in the chest or throat
- Trouble breathing, swallowing, or talking
- Unusual hoarseness
- Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. Contact your doctor or seek medical help if you experience any of the following side effects or if they persist or bother you:
- Nose irritation
- Sneezing
- Burning or stinging
- Runny nose
Note: This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor for medical advice. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Worsening nasal congestion (rebound congestion)
- Increased heart rate or palpitations
- Dizziness or lightheadedness
- Nervousness or anxiety
- Difficulty sleeping (insomnia)
- Headache
- Nasal burning, stinging, or dryness
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have taken certain medications for depression or Parkinson's disease within the last 14 days, including isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline, as this may increase the risk of very high blood pressure.
If you are currently taking linezolid or methylene blue, as these medications may interact with this drug.
To ensure your safety, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
Your medical history, including any health problems you have
This information will help your doctor determine whether it is safe for you to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have taken certain medications for depression or Parkinson's disease within the last 14 days, including isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline, as this may increase the risk of very high blood pressure.
If you are currently taking linezolid or methylene blue, as these medications may interact with this drug.
To ensure your safety, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
Your medical history, including any health problems you have
This information will help your doctor determine whether it is safe for you to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
To avoid rebound congestion, do not use this medication for more than 3 days. Using it too frequently or for an extended period beyond the recommended duration may lead to the recurrence or worsening of nasal congestion.
This medication can be harmful if ingested or if an excessive amount is used, with a higher risk of adverse effects in children. If ingestion or overdose occurs, immediately contact a doctor or a poison control center.
Before administering this medication to a child under 6 years old, consult with your doctor to discuss the potential risks and benefits.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor. It is crucial to have a discussion with your doctor about the benefits and risks of using this medication to ensure the well-being of both you and your baby.
To avoid rebound congestion, do not use this medication for more than 3 days. Using it too frequently or for an extended period beyond the recommended duration may lead to the recurrence or worsening of nasal congestion.
This medication can be harmful if ingested or if an excessive amount is used, with a higher risk of adverse effects in children. If ingestion or overdose occurs, immediately contact a doctor or a poison control center.
Before administering this medication to a child under 6 years old, consult with your doctor to discuss the potential risks and benefits.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor. It is crucial to have a discussion with your doctor about the benefits and risks of using this medication to ensure the well-being of both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe drowsiness or sedation (especially in children)
- Bradycardia (slow heart rate)
- Hypotension (low blood pressure) followed by hypertension (high blood pressure)
- Dizziness
- Nausea
- Vomiting
- Sweating
- Pupil constriction (miosis)
- Hypothermia
- Coma (in severe cases)
What to Do:
If overdose is suspected, especially in children, seek immediate medical attention. Call 911 or Poison Control (1-800-222-1222). Management is supportive and symptomatic.
Drug Interactions
Major Interactions
- Monoamine Oxidase Inhibitors (MAOIs): Concurrent use or use within 14 days of MAOIs can lead to hypertensive crisis due to potentiated pressor effects.
- Tricyclic Antidepressants (TCAs): May potentiate the pressor effects of oxymetazoline.
Moderate Interactions
- Beta-blockers: May reduce the antihypertensive effect of beta-blockers.
- Other Sympathomimetics: Increased risk of cardiovascular effects (e.g., hypertension, tachycardia) when used concurrently with other sympathomimetic agents (e.g., oral decongestants).
Monitoring
Routine Monitoring
Nasal congestion relief
Frequency: Daily, during use
Target: Improved breathing
Action Threshold: Lack of improvement or worsening congestion after 3 days of use; indicates need to discontinue and consult physician.
Signs of rebound congestion (rhinitis medicamentosa)
Frequency: Daily, during and after use
Target: Absence of worsening congestion or dependence on spray
Action Threshold: Increased congestion, need for more frequent use, or longer duration of use; indicates overuse and need for discontinuation.
Signs of systemic absorption (e.g., increased heart rate, blood pressure, dizziness, headache)
Frequency: Daily, during use
Target: Absence of systemic symptoms
Action Threshold: Presence of systemic symptoms, especially in susceptible individuals (e.g., hypertension, heart disease); indicates need for discontinuation and medical evaluation.
Symptom Monitoring
- Nasal congestion (improvement or worsening)
- Rebound congestion (worsening congestion after initial relief, requiring more frequent use)
- Nasal irritation or dryness
- Headache
- Dizziness
- Nervousness
- Insomnia
- Palpitations
- Increased blood pressure
Special Patient Groups
Pregnancy
Oxymetazoline is classified as Pregnancy Category C. While systemic absorption is minimal, animal studies have shown adverse effects at high doses. Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus. Consult a healthcare provider before use.
Trimester-Specific Risks:
First Trimester:
Limited data; theoretical risk of vasoconstrictive effects on placental blood flow. Use with caution.
Second Trimester:
Limited data; generally considered safer than first trimester, but still use with caution.
Third Trimester:
Limited data; theoretical risk of vasoconstrictive effects. Use with caution.
Lactation
Oxymetazoline is classified as Lactation Risk L3 (Moderately Safe). While systemic absorption is minimal, it is unknown if oxymetazoline is excreted in human milk. Due to the potential for systemic effects in the infant (e.g., irritability, sleep disturbances), use with caution and only if clearly needed. Monitor the infant for adverse effects. Consult a healthcare provider.
Infant Risk:
Low to moderate risk; potential for irritability, sleep disturbances, or other systemic effects if significant absorption occurs in the infant.
Pediatric Use
Use with extreme caution in children, especially those under 6 years of age, due to the risk of systemic absorption and overdose, which can lead to severe adverse effects including sedation, bradycardia, and coma. Always use the appropriate concentration and follow age-specific dosing instructions. Keep out of reach of children.
Geriatric Use
Use with caution in elderly patients, especially those with pre-existing cardiovascular conditions (e.g., hypertension, heart disease), hyperthyroidism, or diabetes, as they may be more susceptible to systemic adverse effects from minimal absorption.
Clinical Information
Clinical Pearls
- The most common and significant adverse effect of prolonged use (more than 3 days) of oxymetazoline is rhinitis medicamentosa, or rebound congestion, where the nasal passages become more congested than before, leading to dependence on the spray.
- Proper administration technique is crucial: clear nasal passages first, tilt head slightly forward, insert nozzle, spray while sniffing gently, and clean nozzle after use.
- Advise patients to limit use to 3 days to prevent rebound congestion. If congestion persists, recommend alternative non-pharmacological methods (e.g., saline rinses) or consult a healthcare provider for other treatment options.
- While systemic absorption is minimal, caution should be exercised in patients with underlying cardiovascular disease, hypertension, hyperthyroidism, or diabetes due to the sympathomimetic effects.
Alternative Therapies
- Saline nasal sprays or rinses (non-medicated, safe for long-term use)
- Oral decongestants (e.g., pseudoephedrine, phenylephrine - may have more systemic side effects)
- Nasal corticosteroids (e.g., fluticasone, budesonide - for allergic rhinitis, slower onset of action but safe for long-term use)
- Antihistamine nasal sprays (e.g., azelastine - for allergic rhinitis)
- Ipratropium bromide nasal spray (for rhinorrhea)
Cost & Coverage
Average Cost:
$5 - $15 per 15-30 mL bottle
Generic Available:
Yes
Insurance Coverage:
Over-the-counter (OTC) products are generally not covered by prescription insurance plans unless specifically prescribed by a physician and deemed medically necessary (rare). May be eligible for FSA/HSA.
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When reporting the incident, be prepared to provide details about the medication taken, the amount, and the time it occurred.