oxymetazoline

Oxymetazoline is a topical sympathomimetic decongestant used in nasal sprays and ocular drops. It acts as an agonist at α-adrenergic receptors on vascular smooth muscle, causing vasoconstriction that reduces mucosal swelling and nasal congestion.

Medical uses and forms: Nasal sprays containing oxymetazoline (commonly 0.05% in adults; lower concentrations in some preparations) are used for short-term relief of nasal congestion due to allergic rhinitis, colds, or sinusitis. An ophthalmic preparation (usually a 0.025% to 0.05% solution) is used for conjunctival hyperemia. Because of risk of rebound congestion, nasal use should be limited to a few days according to product directions.

Safety and cautions: Systemic adrenergic effects may occur, especially with overuse. Potential effects include elevated blood pressure, tachycardia, and palpitations. Contraindications include uncontrolled hypertension or significant cardiovascular disease; use caution in the elderly, in pregnancy or breastfeeding; and avoid use in children unless advised by a clinician. Interactions may occur with monoamine oxidase inhibitors and other sympathomimetics, potentially increasing blood pressure or causing adverse cardiovascular effects.

Adverse effects and pharmacokinetics: Common local adverse effects include burning, stinging, dryness of the nasal mucosa, and sneezing. In the eye, transient burning or irritation may occur. Prolonged use is associated with rebound congestion (rhinitis medicamentosa) and, rarely, systemic effects. Oxymetazoline is rapidly absorbed when applied topically, but systemic exposure is typically low with proper use, and the effect is short acting.