Xylometazoline Hydrochloride

Approved Indications:

• Temporary relief of nasal congestion due to:
• Common cold
• Allergic rhinitis (hay fever)
• Sinusitis
• Upper respiratory tract infections
• Relief of eustachian tube congestion in otitis media (as adjunct)
• Pre-operative or diagnostic nasal preparation (e.g., rhinoscopy)

Clinically Accepted Off-Label Uses:

• To facilitate nasal drug delivery by reducing mucosal edema
• To reduce minor nasal bleeding during procedures
• Pre-operative decongestion before nasal/sinus surgery

রেজিস্টার্ড চিকিৎসকের নির্দেশনা অনুযায়ী ঔষধ সেবন করুন।

Dosage Forms: Nasal spray or drops (commonly 0.05% and 0.1%)

Adults and Adolescents ≥12 years:

• 0.1% spray/drops: 1 spray or 2–3 drops in each nostril every 8–10 hours
• Maximum: 3 doses per day
• Duration: Not to exceed 7 consecutive days

Children 2–11 years:

• 0.05% spray/drops: 1–2 drops or 1 spray per nostril every 8–10 hours
• Use under adult supervision
• Limit to 5 consecutive days

Infants <2 years:

• Contraindicated

Administration Instructions:

• Blow nose gently before use
• Tilt head slightly back during application
• Avoid sharing the applicator
• Do not exceed recommended dose or duration

রেজিস্টার্ড চিকিৎসকের নির্দেশনা অনুযায়ী ঔষধ সেবন করুন।

Xylometazoline is a topical sympathomimetic agent that acts primarily on alpha-1 adrenergic receptors in the nasal mucosa, causing local vasoconstriction. This reduces blood flow, thereby decreasing mucosal swelling and congestion. It restores nasal airflow rapidly, usually within minutes, without significant systemic effects when used as directed.

• Absorption: Minimal systemic absorption with intranasal use
• Onset: Within 5–10 minutes
• Duration: Up to 10 hours
• Distribution: Primarily localized to nasal mucosa
• Metabolism: Hepatic, if systemically absorbed
• Excretion: Renal (as metabolites)

Pregnancy:

• Category C (use only if clearly needed)
• May cause uterine vasoconstriction; avoid prolonged use during pregnancy

Lactation:

• Excretion into breast milk is unlikely in significant amounts
• Occasional, short-term use is generally considered acceptable
• Prolonged or high-dose use should be avoided

• Topical Nasal Decongestant
• Subclass: Sympathomimetic (Alpha-adrenergic agonist)

• Hypersensitivity to xylometazoline or formulation components
• Children under 2 years of age
• Atrophic rhinitis
• Narrow-angle glaucoma
• Recent transnasal surgery involving dura mater (e.g., transsphenoidal hypophysectomy)

• Prolonged use (>7 days) can cause rebound congestion (rhinitis medicamentosa)
• Use with caution in:
• Hypertension
• Hyperthyroidism
• Diabetes mellitus
• Ischemic heart disease
• Prostatic hypertrophy
• Avoid contact with eyes
• Monitor for local irritation or dryness

Common:

• Nasal dryness
• Burning or stinging sensation
• Sneezing
• Transient irritation

Uncommon:

• Headache
• Nausea

Rare/Serious:

• Tachycardia, palpitations
• Insomnia, nervousness
• Elevated blood pressure
• Rebound nasal congestion with prolonged use

• MAO inhibitors (within 14 days): Risk of hypertensive crisis
• Tricyclic antidepressants: May potentiate vasoconstriction
• Beta-blockers and other antihypertensives: May blunt therapeutic effect
• No major CYP enzyme involvement due to limited systemic absorption

• Regulatory authorities emphasize limiting use to 5–7 days to avoid rebound congestion
• Pediatric guidelines discourage use in children under 2 years
• New labeling warnings highlight misuse and overuse risks

• Store at 20–25°C (68–77°F)
• Protect from excessive heat and light
• Do not freeze
• Keep bottle tightly closed
• Discard 1–2 months after opening, depending on the manufacturer’s label