Oxymetazoline
AFRIN
Pronunciation: ox-i-me-TAZ-oe-leen
What it isAlpha-1 and alpha-2 agonist causing local vasoconstriction; nasal congestion and rosacea erythema.
Why this oneThe same rapid topical vasoconstriction also makes it useful for epistaxis; systemic effects are small at labeled doses, but accidental ingestion by children can be serious.
What limits itContinuous nasal use beyond three days can cause severe rebound congestion and escalating spray dependence.
FDA-approved for
- nasal congestion (1964)
- rosacea erythema (topical) (2017)
Principal riskRebound congestion after three days
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Nasal congestion | Adults & children ≥6 yr (with supervision) | 2-3 sprays each nostril q10-12h PRN | 2 doses per 24 h |
Renal Undefined
Hepatic Undefined
Do not exceed 2 doses in any 24-hour period
Instructions
- Do not tilt head backward while spraying; squeeze bottle quickly and firmly
- Wipe nozzle clean after use and secure cap
- Children under 6 yr: ask a doctor
Available strengths
- spray 0.05 g/100 mL
- drops 0.025, 0.1 %
- sol 0.05 g/100 mL
- sol 0.0005 g/g
- sol 7.5 mg/15 mL
- sol 15.21 mg/30 mL
- sol 0.5, 50 mg/mL
- cream 1 %
- + 7 other marketed forms not shown
Pregnancy Undefined
Lactation Undefined
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 0.05 g/100 mL | spray | per unit | not offered |
Generic entry2021
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Self-check
- Oxymetazoline: What can continuous nasal use beyond three days cause?
Severe rebound congestion. - Oxymetazoline: Why is accidental ingestion by children concerning?
It can cause serious systemic effects.