OXYMETAZOLINE HYDROCHLORIDE
(ox-i-met-az'oh-leen)
Afrin, Dristan Long Lasting, Duramist Plus, Duration, Nafrine

, Neo-Synephrine 12 Hour, Nostrilla, Sinex Long Lasting
Classifications: eye, ear, nose, and throat (eent) preparation; vasoconstrictor, decongestant; sympathomimetic
Prototype: Naphazoline
Pregnancy Category: C

Availability

0.025%, 0.05% solution

Actions

Sympathomimetic agent that acts directly on alpha receptors of sympathetic nervous system. No effect on beta receptors.

Therapeutic Effects

Constricts smaller arterioles in nasal passages and has prolonged decongestant effect.

Uses

Relief of nasal congestion in a variety of allergic and infectious disorders of the upper respiratory tract; used as nasal tampon to facilitate intranasal examination or before nasal surgery. Also used as adjunct in treatment and prevention of middle ear infection by decreasing congestion of eustachian ostia.

Contraindications

Use in children <2 y. Safe use during pregnancy (category C) or lactation is not established.

Cautious Use

Within 14 d of MAO inhibitors, coronary artery disease, hypertension, hyperthyroidism, diabetes mellitus.

Route & Dosage

Nasal Congestion
Adult: Intranasal 2–3 drops or 2–3 sprays of 0.05% solution into each nostril b.i.d. for up to 3–5 d
Child: Intranasal 2–5 y, 2–3 drops or 2–3 sprays of 0.025% solution into each nostril b.i.d. for up to 3–5 d; >6 y, same as for adult

Administration

Instillation

Place spray nozzle in nostril without occluding it and tilt head slightly forward prior to instillation of spray; sniff briskly during administration.
Rinse dropper or spray tip in hot water after each use to prevent contamination of solution by nasal secretions.
Usually given in the morning and at bedtime. Effects appear within 30 min and last about 6–7 h.

Adverse Effects (1%)

Special Senses: Burning, stinging, dryness of nasal mucosa, sneezing. Body as a Whole: Headache, light-headedness, drowsiness, insomnia, palpitations, rebound congestion.

Interactions

Drug: No clinically significant interactions established.

Pharmacokinetics

Onset: 5–10 min. Duration: 6–10 h.

Nursing Implications

Assessment & Drug Effects

Monitor for S&S of excess use. If noted, discuss possibility of rebound congestion.

Patient & Family Education

Wash hands carefully after handling oxymetazoline. Anisocoria (inequality of pupil size, blurred vision) can develop if eyes are rubbed with contaminated fingers.
Do not to exceed recommended dosage. Rebound congestion (chemical rhinitis) may occur with prolonged or excessive use.
Systemic effects can result from swallowing excessive medication.
Do not breast feed while using this drug without consulting physician.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug