Indications

Xylometazoline is indicated in-
  • Nasal congestion in colds, rhinitis, sinusitis, headache.
  • Tubal block and serous otitis media associated with nasal congestion.

Description

Xylometazoline is a sympathomimetic agent with marked alpha-adrenergic activity and is intended for use in the nose. It constricts the nasal blood vessels, thereby decongesting the mucosa of the nose and neighboring regions of the pharynx. This enables patients suffering from colds to breathe more easily through the nose. The effect of Xylometazoline begins within a few minutes and persists for several hours.

Pharmacology

Nasal congestion is caused by various etiologies, such as rhinosinusitis and allergic or non-allergic rhinitis, leading to congestion of the venous sinusoids lining the nasal mucosa. Activation of α-adrenergic receptors leads to vasoconstriction of the blood vessels of the nasal mucosa and resumption of nasal airflow. As the most abundantly expressed in the human nasal mucosa, α1A- and α2B-adrenoceptors may play the most important role in vasoconstriction of the human nasal mucosa. Xylometazoline is a more selective agonist at α2B-adrenoceptors, with affinity at α1A-, α2A-, α2C-, α1B-, and α1D-adrenoceptors. Xylometazoline decreases nasal resistance during inspiration and expiration and increases the volume of nasal airflow. Compared to oxymetazoline, another imidazoline nasal decongestant, xylometazoline had a slightly faster onset of action although they had a similar duration of action. In one study, subjects with nasal congestion reported relief of earache and sore throat in addition to nasal decongestion: it is speculated that oxymetazoline mediates this effect by causing vasoconstriction of the nasal mucosa that contains the venous sinuses and nasal decongestion allows breathing through the nose, providing relief from sore throat caused by mouth breathing that dries and irritates the throat.

Dosage & Administration

Adults: Xylometazoline 0.1%: 2 or 3 drops in each nostril two to three times daily. Xylometazoline 0.1% should not be used for children under the age of 12 years.

Children 6 to 12 years of age: Xylometazoline 0.05%: 2 or 3 drops in each nostril two or three times daily.

Children less than 6 years of age: Xylometazoline 0.05%: 1 drop in each nostril two or three times daily.

Infants less than 3 months: Not to be used in infants less than 3 months.

Interaction

No drug interactions have been reported.

Contraindications

Xylometazoline nasal drops is contraindicated in patients with transsphenoidal hypophysectomy or surgery exposing the dura mater. It is also contraindicated in patients who are hypersensitive to Xylometazoline. Each Xylometazoline nasal drop should be used by one person only to prevent any cross-infection. Patients are advised not to take decongestants for more than seven consecutive days.

Side Effects

The following side-effects have occasionally been encountered:
  • A burning sensation in the nose and throat
  • Local irritation
  • Nausea and dryness of the nasal mucosa.

Pregnancy & Lactation

Pregnancy category C. Xylometazoline should not be used during pregnancy. The use of Otrivin while breastfeeding should only take place on the instructions of a doctor.

Precautions & Warnings

Xylometazoline Hydrochloride nasal drops for adults (0.1%) should not be used for children below 12 years. Drops should not be used for long time in cases with chronic rhinitis. Prolonged use of the drops may cause rebound congestion and drug induced rhinitis.

Therapeutic Class

Nasal Anti-histamine preparations

Storage Conditions

Protect from light. For reasons of hygiene, do not use the bottle more than 28 days after opening it.