Xylometazoline is a potent, direct-acting sympathomimetic amine used as a topical nasal decongestant. At a concentration of 0.025% w/v, it is primarily indicated for pediatric use. It is a selective alpha-2 adrenergic receptor agonist that causes vasoconstriction of the dilated arterioles in the nasal mucosa, leading to reduced edema, decreased nasal airway resistance, and increased nasal patency. It provides rapid symptomatic relief from nasal congestion associated with various conditions.
Adult: Not recommended for adults at this strength. Adults should use 0.1% w/v formulation.
Note: 1. Blow nose gently to clear nostrils. 2. Tilt head slightly back. 3. For drops: Instill prescribed number of drops into each nostril. For spray: Insert tip into nostril, point away from nasal septum, and spray once while breathing in gently. 4. Avoid touching dropper/spray tip to nasal surface to prevent contamination. 5. Do not share the bottle. 6. Use for the shortest duration necessary, typically not exceeding 5 days.
Xylometazoline is a direct-acting sympathomimetic agent with high specificity for alpha-2 adrenergic receptors. When applied topically to the nasal mucosa, it stimulates postsynaptic alpha-2 adrenoceptors on vascular smooth muscle cells within the nasal turbinates and sinus ostia. This activation leads to the constriction of capacitance vessels (veins and venules) and resistance arterioles, reducing blood flow and vascular engorgement. The resulting decrease in mucosal edema and inflammation opens nasal passages, improves sinus drainage, and facilitates breathing.
Pregnancy: Category C (US FDA). Animal reproduction studies have shown adverse effects, but no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus. Should be used at the lowest effective dose for the shortest duration.
Driving: Usually not affected. However, if systemic absorption occurs (e.g., from overuse), it may cause dizziness, drowsiness, or blurred vision. Patients should not drive or operate machinery if they experience these effects.
| Monoamine Oxidase Inhibitors (MAOIs) e.g., Phenelzine, Tranylcypromine | Risk of severe hypertensive crisis due to potentiation of sympathomimetic effects. | Contraindicated |
| Tricyclic Antidepressants (TCAs) e.g., Amitriptyline, Imipramine | May potentiate pressor effects of xylometazoline, increasing risk of hypertension. | Major |
| Other Sympathomimetics (e.g., Pseudoephedrine, Phenylephrine oral/topical) | Additive adrenergic effects, increasing risk of tachycardia, hypertension, and CNS stimulation. | Moderate |
| Beta-blockers (e.g., Propranolol, Atenolol) | Unopposed alpha-adrenergic stimulation may lead to severe hypertension and bradycardia. | Moderate |
| Methyldopa | May potentiate pressor response. | Moderate |
| Ergot Alkaloids (e.g., Ergotamine) | Increased risk of severe vasoconstriction and ischemia. | Major |
Same composition (Xylometazoline (0.025% w/v)), different brands: