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Medication Safety Issues
Sound-alike/look-alike issues:
Oxymetazoline may be confused with oxymetholone
Afrin® may be confused with aspirin
Afrin® (oxymetazoline) may be confused with Afrin® (saline)
Neo-Synephrine® (oxymetazoline) may be confused with Neo-Synephrine® (phenylephrine)
Visine® may be confused with Visken®
Pronunciation
(oks i met AZ oh leen)
U.S. Brand Names
Index Terms
Generic Available
Yes: Nasal spray
Canadian Brand Names
Pharmacologic Category
Use: Labeled Indications
Adjunctive therapy of middle ear infections, associated with acute or chronic rhinitis, the common cold, sinusitis, hay fever, or other allergies
Ophthalmic: Relief of redness of eye due to minor eye irritations
Use: Dental
Symptomatic relief of nasal mucosal congestion
Contraindications
Hypersensitivity to oxymetazoline or any component of the formulation
Warnings/Precautions
Dosage form specific issues:
• Nasal: Rebound congestion may occur with extended use (>3 days). Prior to self-medication (OTC use), contact healthcare provider in the presence of hypertension, diabetes, hyperthyroidism, heart disease, coronary artery disease, cerebral arteriosclerosis, or long-standing bronchial asthma.
• Ophthalmic: Prior to OTC use, contact healthcare provider in the presence of glaucoma or if needed for >72 hours.
Adverse Reactions
Frequency not defined.
Cardiovascular: Hypertension, palpitation
Local: Transient burning, stinging
Respiratory: Dryness of the nasal mucosa, rebound congestion with prolonged use, sneezing
Drug Interactions
Atomoxetine: May enhance the hypertensive effect of Sympathomimetics. Atomoxetine may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
Cannabinoids: May enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
Iobenguane I 123: Sympathomimetics may diminish the therapeutic effect of Iobenguane I 123. Risk X: Avoid combination
MAO Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. Risk X: Avoid combination
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Risk C: Monitor therapy
Tricyclic Antidepressants: May enhance the vasopressor effect of Alpha1-Agonists. Risk D: Consider therapy modification
Storage
Store at room temperature.
Mechanism of Action
Stimulates alpha-adrenergic receptors in the arterioles of the nasal mucosa to produce vasoconstriction
Pharmacodynamics/Kinetics
Onset of action: Intranasal: 5-10 minutes
Duration: 5-6 hours
Dosage
Intranasal (therapy should not exceed 3 days): Children ?6 years and Adults: 0.05% solution: Instill 2-3 sprays into each nostril twice daily
Ophthalmic: Children ?6 years and Adults: 0.025% solution: Instill 1-2 drops in affected eye(s) every 6 hours as needed or as directed by healthcare provider
Dental Usual Dosing
Symptomatic relief of nasal mucosal congestion: Children ?6 years and Adults: Intranasal (therapy should not exceed 3 days): 0.05% solution: Instill 2-3 sprays into each nostril twice daily
Geriatric Considerations
Evaluate the patient's ability to self-administer. Use with caution in patients with cardiovascular disease.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
None reported
Mental Health: Effects on Psychiatric Treatment
May increase toxicity if used with MAO inhibitors (hypertension)
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Gel, intranasal, as hydrochloride [spray]:
Vicks® Early Defense™: 0.05% (14.7 mL) [microgel; contains benzyl alcohol and menthol]
Solution, intranasal, as hydrochloride [spray]: 0.05% (15 mL, 30 mL)
Afrin® Extra Moisturizing: 0.05% (15 mL) [contains benzyl alcohol and glycerin; regular or no drip formula]
Afrin® Original: 0.05% (15 mL, 30 mL) [contains benzalkonium chloride]
Afrin® Original: 0.05% (15 mL) [contains benzyl alcohol and benzalkonium chloride; no drip formula]
Afrin® Severe Congestion: 0.05% (15 mL) [contains benzyl alcohol and menthol; regular or no drip formula]
Afrin® Sinus: 0.05% (15 mL) [contains benzyl alcohol, benzalkonium chloride, camphor, phenol; regular or no drip formula]
Dristan™ 12-Hour: 0.05% (15 mL) [contains benzyl alcohol and benzalkonium chloride]
Duramist® Plus, Neo-Synephrine® 12 Hour, N?strilla®, Vicks Sinex® 12 Hour Ultrafine Mist, Vicks Sinex® 12 Hour, 4-Way® 12 Hour: 0.05% (15 mL) [contains benzalkonium chloride]
Genasal, NRS®: 0.05% (15 mL, 30 mL) [contains benzalkonium chloride]
Mucinex® Full force™: 0.05% (22 mL) [contains benzalkonium chloride, camphor, and menthol] [DSC]
Mucinex® moisture smart™: 0.05% (22 mL) [contains benzalkonium chloride and glycerin] [DSC]
Neo-Synephrine® 12 Hour Extra Moisturizing: 0.05% (15 mL) [contains glycerin]
Solution, ophthalmic, as hydrochloride:
Visine® L.R.: 0.025% (15 mL, 30 mL) [contains benzalkonium chloride]
International Brand Names
Lexi-Comp.com
Last full review/revision November 2009
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