Oxymetazoline 0.05% Nasal 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; Sympathomimetic
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Oxymetazoline is a nasal spray used to relieve stuffy nose caused by colds, allergies, or hay fever. It works by shrinking the blood vessels in your nose, which reduces swelling and helps you breathe easier. It's important not to use it for more than 3 days in a row to avoid making your stuffiness worse.
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's essential to use this medication as directed and follow all instructions carefully.
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 before use. Some products require shaking, so be sure to follow the specific instructions for your medication.
If your medication has a pump, follow the instructions for priming it. Some pumps may need to be primed if they haven't been used for a while. Prime the pump as directed by your doctor or the manufacturer's instructions.
Before using this medication, blow your nose to clear your nasal passages.
When using this 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 store this medication properly:
Keep it at room temperature in a dry place.
Avoid storing it in a bathroom, where it may be exposed to moisture.
Keep all medications in a safe place, 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 doctor or pharmacist. Check with your pharmacist for guidance on the best way to dispose of medications. You may also want to check if there are any drug take-back programs in your area.
Missing a Dose
If you use this medication regularly and miss a dose:
Take the missed dose as soon as you remember.
If it's close to the time for your next dose, skip the missed dose and return to 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's essential to use this medication as directed and follow all instructions carefully.
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 before use. Some products require shaking, so be sure to follow the specific instructions for your medication.
If your medication has a pump, follow the instructions for priming it. Some pumps may need to be primed if they haven't been used for a while. Prime the pump as directed by your doctor or the manufacturer's instructions.
Before using this medication, blow your nose to clear your nasal passages.
When using this 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 store this medication properly:
Keep it at room temperature in a dry place.
Avoid storing it in a bathroom, where it may be exposed to moisture.
Keep all medications in a safe place, 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 doctor or pharmacist. Check with your pharmacist for guidance on the best way to dispose of medications. You may also want to check if there are any drug take-back programs in your area.
Missing a Dose
If you use this medication regularly and miss a dose:
Take the missed dose as soon as you remember.
If it's close to the time for your next dose, skip the missed dose and return to 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 for more than 3 consecutive days to prevent rebound congestion (rhinitis medicamentosa).
- Follow dosing instructions carefully; do not exceed recommended doses.
- Clear nasal passages before use if possible.
- Avoid sharing the nasal spray bottle to prevent the spread of infection.
- If symptoms persist after 3 days, consult a healthcare professional.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
2-3 sprays per nostril every 10-12 hours as needed
Condition-Specific Dosing:
maxFrequency:
Do not exceed 2 doses in 24 hours. Do not use for more than 3 days.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
6 to under 12 years: 2-3 sprays per nostril every 10-12 hours as needed. Do not exceed 2 doses in 24 hours. Do not use for more than 3 days. (Consult physician for use in children under 6 years).
Adolescent:
12 years and older: 2-3 sprays per nostril every 10-12 hours as needed. Do not exceed 2 doses in 24 hours. Do not use for more than 3 days.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed (minimal systemic absorption)
Moderate:
No adjustment needed (minimal systemic absorption)
Severe:
No adjustment needed (minimal systemic absorption)
Dialysis:
No specific considerations (minimal systemic absorption)
Hepatic Impairment:
Mild:
No adjustment needed (minimal systemic absorption)
Moderate:
No adjustment needed (minimal systemic absorption)
Severe:
No adjustment needed (minimal systemic absorption)
Confidence:
Medium
Pharmacology
Mechanism of Action
Oxymetazoline is a direct-acting sympathomimetic amine that acts as an alpha-adrenergic agonist. When applied topically to the nasal mucosa, it causes vasoconstriction of the arterioles, leading to a reduction in blood flow and decreased swelling of the nasal membranes. This action helps to relieve nasal congestion.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption (less than 1%)
Tmax:
Not well-quantified for systemic levels; local onset within minutes
FoodEffect:
Not applicable (nasal spray)
Distribution:
Vd:
Not well-quantified due to minimal systemic absorption
ProteinBinding:
Not well-quantified due to minimal systemic absorption
CnssPenetration:
Limited/Negligible (with proper use)
Elimination:
HalfLife:
Not well-quantified for systemic levels; local duration of action is 10-12 hours
Clearance:
Not well-quantified due to minimal systemic absorption
ExcretionRoute:
Not well-quantified due to minimal systemic absorption; likely renal for any absorbed drug
Unchanged:
Not well-quantified
Pharmacodynamics
OnsetOfAction:
Within minutes (typically 5-10 minutes)
PeakEffect:
Within 10-15 minutes
DurationOfAction:
Up to 10-12 hours
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
- 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. If you experience any of the following side effects or any other unusual symptoms that bother you or do not go away, contact your doctor for advice:
- Nose irritation
- Sneezing
- Burning or stinging sensation
- 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 about side effects, you can also contact your doctor. Additionally, you can report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
- 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. If you experience any of the following side effects or any other unusual symptoms that bother you or do not go away, contact your doctor for advice:
- Nose irritation
- Sneezing
- Burning or stinging sensation
- 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 about side effects, you can also contact your doctor. Additionally, you can 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 or 'rebound congestion' after stopping use
- Nasal burning, stinging, dryness, or sneezing
- Nosebleeds
- Dizziness, lightheadedness
- Nervousness, insomnia
- Palpitations, increased heart rate (rare with proper use)
- Headache
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 can interact with this drug.
To ensure your safety, it is crucial to provide your doctor and pharmacist with a comprehensive list of all your medications, including:
Prescription and over-the-counter (OTC) medications
Natural products
Vitamins
Additionally, inform them about any existing health problems. 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 can interact with this drug.
To ensure your safety, it is crucial to provide your doctor and pharmacist with a comprehensive list of all your medications, including:
Prescription and over-the-counter (OTC) medications
Natural products
Vitamins
Additionally, inform them about any existing health problems. 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 hazardous 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. You and your doctor will need to weigh the benefits and risks of using this medication to ensure the best possible outcome for 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 hazardous 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. You and your doctor will need to weigh the benefits and risks of using this medication to ensure the best possible outcome for both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe drowsiness
- Dizziness
- Slowed heart rate
- Low blood pressure (hypotension)
- Hypothermia
- Coma (rare, especially in children)
- In children, central nervous system depression may be followed by excitation, seizures, and tachycardia.
What to Do:
Seek immediate medical attention or call Poison Control at 1-800-222-1222. Treatment is supportive and symptomatic.
Drug Interactions
Major Interactions
- Monoamine Oxidase Inhibitors (MAOIs): Concurrent use or use within 14 days of MAOIs may potentiate the pressor effects of oxymetazoline, leading to hypertensive crisis. (Though systemic absorption is minimal, caution is advised.)
- Tricyclic Antidepressants (TCAs): May potentiate the cardiovascular effects of oxymetazoline.
Moderate Interactions
- Beta-blockers (non-selective): May increase blood pressure due to unopposed alpha-adrenergic stimulation.
- Other sympathomimetics (e.g., oral decongestants, appetite suppressants): Increased risk of cardiovascular effects (e.g., hypertension, tachycardia).
Confidence Interactions
Monitoring
Symptom Monitoring
- Nasal congestion relief
- Duration of action
- Signs of rebound congestion (worsening congestion after stopping use)
- Nasal irritation, burning, stinging, dryness
- Systemic effects (rare with proper use): increased heart rate, palpitations, dizziness, headache, insomnia, elevated blood pressure
Special Patient Groups
Pregnancy
Use with caution during pregnancy. Oxymetazoline is classified as Pregnancy Category C. While systemic absorption is minimal, there are limited human studies. Use only if the potential benefit justifies the potential risk to the fetus.
Trimester-Specific Risks:
First Trimester:
Limited data; theoretical risk of vasoconstriction affecting placental blood flow, but unlikely with minimal systemic absorption.
Second Trimester:
Limited data; generally considered low risk with proper use.
Third Trimester:
Limited data; generally considered low risk with proper use.
Lactation
Generally considered compatible with breastfeeding when used at recommended doses. Systemic absorption is minimal, making infant exposure unlikely to be significant. Monitor infant for irritability or changes in feeding/sleep patterns, though these are rare.
Infant Risk:
Low risk (L3 - Moderately Safe)
Pediatric Use
Not recommended for children under 6 years of age unless directed by a doctor. For children 6-12 years, use 0.025% concentration or follow specific 0.05% product instructions (often 2-3 sprays of 0.05% for 6-12 years, but always check product label). Risk of overdose is higher in young children due to potential for greater systemic absorption relative to body weight.
Geriatric Use
Use with caution in elderly patients, especially those with pre-existing cardiovascular conditions (e.g., hypertension, coronary artery disease), hyperthyroidism, or diabetes, due to potential for systemic effects, though rare with proper topical use. Start with the lowest effective dose and monitor for adverse effects.
Clinical Information
Clinical Pearls
- The most common and significant adverse effect of oxymetazoline is rhinitis medicamentosa (rebound congestion), which occurs with prolonged or excessive use (typically >3 days). Patients should be strongly advised against exceeding the recommended duration of use.
- Proper administration technique is crucial: tilt head slightly forward, insert nozzle into nostril, spray while sniffing gently, and repeat for the other nostril. Avoid tilting head back too far, which can lead to drug dripping down the throat.
- Oxymetazoline provides rapid and effective relief of nasal congestion, making it a popular choice for acute symptoms.
- Patients with chronic nasal congestion should be evaluated for underlying causes and consider alternative long-term treatments (e.g., nasal corticosteroids, saline rinses) rather than relying on oxymetazoline.
- While systemic absorption is minimal, caution is advised in patients with severe cardiovascular disease, uncontrolled hypertension, hyperthyroidism, or diabetes due to theoretical risk of exacerbating these conditions.
Alternative Therapies
- Saline nasal sprays/rinses (e.g., Neti Pot)
- Oral decongestants (e.g., pseudoephedrine, phenylephrine - note: different side effect profile and systemic absorption)
- Nasal corticosteroids (e.g., fluticasone, mometasone - for allergic rhinitis, slower onset but safe for long-term use)
- Antihistamine nasal sprays (e.g., azelastine, olopatadine - 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:
Not typically covered by insurance (Over-The-Counter drug)
General Drug Facts
If your symptoms or health issues persist or worsen, it's 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 be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to 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 seeking help, be prepared to provide details about the overdose, including the medication taken, the amount, and the time it occurred.