Xylometazoline is a potent, direct-acting sympathomimetic amine used as a topical nasal decongestant. The 0.01% w/v concentration is specifically formulated for pediatric use. It is an alpha-2 adrenergic receptor agonist that causes vasoconstriction of the dilated arterioles in the nasal mucosa, leading to reduced blood flow, decreased edema, and relief of nasal congestion. It has a rapid onset and a relatively long duration of action compared to other topical decongestants.
Adult: Not indicated for adults at this strength. Use 0.1% w/v formulation.
Note: 1. Clear nasal passages gently before use. 2. Tilt head slightly back. 3. For drops: Instill prescribed drops without touching dropper to nostril. 4. For spray: Insert tip into nostril, point away from nasal septum, and spray while breathing in gently. 5. Avoid sneezing or blowing nose immediately after administration. 6. Rinse dropper/spray tip with hot water after use.
Xylometazoline is a selective alpha-2 adrenergic receptor agonist. It acts locally on alpha-adrenergic receptors in the vascular smooth muscle of the nasal mucosa. Stimulation of these receptors activates the G-protein coupled pathway, leading to increased intracellular calcium levels. This results in sustained vasoconstriction of the dilated arterioles and capacitance vessels (venous sinusoids) within the nasal turbinates and mucosa.
Pregnancy: Category C (US FDA). Animal studies have shown adverse effects. 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 side effects like dizziness, blurred vision, or drowsiness occur, patient should not drive or operate machinery.
| Monoamine Oxidase Inhibitors (MAOIs) - e.g., Phenelzine, Tranylcypromine | Potentiates pressor effects, risk of severe hypertensive crisis. | Contraindicated |
| Tricyclic Antidepressants (TCAs) - e.g., Amitriptyline | May potentiate pressor effects of xylometazoline. | Major |
| Other Sympathomimetics (Oral decongestants - Pseudoephedrine, Phenylephrine) | Additive adrenergic effects, increasing risk of hypertension, tachycardia, and CNS stimulation. | Major |
| Beta-blockers (non-selective) - e.g., Propranolol | Unopposed alpha-adrenergic stimulation can lead to severe hypertension and bradycardia. | Major |
| Methyldopa | May potentiate pressor response. | Moderate |
| Ergot Alkaloids (e.g., Ergotamine) | Increased risk of peripheral ischemia and severe vasoconstriction. | Major |
Same composition (Xylometazoline (0.01% w/v)), different brands: