Drug Action
Xylometazoline is a sympathomimetic.
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Drug reference
Xylometazoline is a sympathomimetic.
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Nasal congestion ▶BY INTRANASAL ADMINISTRATION USING NASAL DROPS ▶Child 6–11 years: 1–2 drops 1–2 times a day as required for maximum duration of 5 days, 0.05% solution to be administered into each nostril ▶Child 12–17 years: 2–3 drops 2–3 times a day as required for maximum duration of 7 days, 0.1% solution to be administered into each nostril ▶Adult: 2–3 drops 2–3 times a day as required for maximum duration of 7 days, 0.1% solution to be administered into each nostril ▶BY INTRANASAL ADMINISTRATION USING NASAL SPRAY ▶Child 12–17 years: 1 spray 1–3 times a day as required for maximum duration of 7 days, to be administered into each nostril ▶Adult: 1 spray 1–3 times a day as required for maximum duration of 7 days, to be administered into each nostril
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Angle-closure glaucoma. avoid excessive or prolonged use. cardiovascular disease (in children). diabetes mellitus. elderly. hypertension. hyperthyroidism . ischaemic heart disease (in adults). prostatic hypertrophy (risk of acute retention)(in adults). rebound congestion CAUTIONS, FURTHER INFORMATION ▶Rebound congestion Sympathomimetic drugs are of limited value in the treatment of nasal congestion because they can, following prolonged use (more than 7 days), give rise to a rebound congestion (rhinitis medicamentosa) on withdrawal, due to a secondary vasodilatation with a subsequent temporary increase in nasal congestion. This in turn tempts the further use of the decongestant, leading to a vicious cycle of events.
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The CHM/MHRA has stated that non-prescription cough and cold medicines containing oxymetazoline or xylometazoline can be considered for up to 5 days’ treatment in children aged 6–12 years after basic principles of best care have been tried; these medicines should not be used in children under 6 years of age.
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→Appendix 1: sympathomimetics, vasoconstrictor
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Cardiovascular effects. headache. hypersensitivity. nasal dryness. nausea. paraesthesia. visual impairment SIDE-EFFECTS, FURTHER INFORMATION Use of decongestants in infants and children under 6 years has been associated with agitated psychosis, ataxia, hallucinations, and even death—avoid.
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Manufacturer advises avoid.
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Manufacturer advises caution—no Ear, nose and oropharynx information available.
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There can be variation in the licensing of different medicines containing the same drug. Spray ▶Otrivine (GlaxoSmithKline Consumer Healthcare) Xylometazoline hydrochloride 1 mg per 1 ml Otrivine Congestion Relief 0.1% nasal spray | 10 ml G £3.05 DT = £2.18 Otrivine Adult Measured Dose Sinusitis spray | 10 ml G £2.62 DT = £2.18 Otrivine Allergy Relief 0.1% nasal spray | 10 ml G £2.62 DT = £2.18 Otrivine Adult nasal spray | 10 ml G £2.18 DT = £2.18 Otrivine Adult Metered Dose 0.1% nasal spray | 10 ml G £2.62 DT = £2.18 ▶Sudafed Congestion Relief (McNeil Products Ltd) Xylometazoline hydrochloride 1 mg per 1 ml Sudafed Congestion Relief 0.1% nasal spray | 10 ml G £3.46 DT = £2.18 ▶Sudafed Non-Drowsy Decongestant (xylometazoline) (McNeil Products Ltd) Xylometazoline hydrochloride 1 mg per 1 ml Sudafed Blocked Nose 0.1% spray | 15 ml G £2.76 ▶Sudafed Sinus-Ease (McNeil Products Ltd) Xylometazoline hydrochloride 1 mg per 1 ml Sudafed Sinus-Ease 0.1% nasal spray | 15 ml G £2.80 Nasal drops ▶Otrivine (GlaxoSmithKline Consumer Healthcare) Xylometazoline hydrochloride 500 microgram per 1 ml Otrivine Child nasal drops | 10 ml p £1.91 DT = £1.91 Xylometazoline hydrochloride 1 mg per 1 ml Otrivine Adult 0.1% nasal drops | 10 ml G £2.18 DT = £2.18 Nasal infection Sinusitis (acute) Description of condition Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses. Acute sinusitis (rhinosinusitis) is a self- limiting condition usually triggered by a viral upper- respiratory tract infection such as the ‘common cold’. Occasionally, acute sinusitis may become complicated by a bacterial infection (see Antibacterial therapy for acute sinusitis in Nose infections, antibacterial therapy p. 536). Patients with acute sinusitis usually present with symptoms of nasal blockage or congestion, nasal discharge, dental or facial pain or pressure, and reduction or loss of the sense of smell. Symptoms usually improve within 2 to 3 weeks without requiring treatment. Rarely, acute sinusitis may lead to orbital, intracranial or skeletal complications (e.g. periorbital cellulitis, symptoms or signs of meningitis). Aims of treatment Treatment is aimed at managing symptoms including pain, fever, and nasal congestion as well as treatment of bacterial infection if present. Treatment g Patients presenting with symptoms for around 10 days or less, should be given advice about the usual duration of acute sinusitis, self-care of pain or fever with paracetamol p. 465 or ibuprofen p. 1203, and when to seek medical help. Patients should be reassured that antibiotics are usually not required. Some patients may try nasal saline or nasal decongestants, however there is limited evidence to show they help to relieve nasal congestion. Patients presenting with symptoms for around 10 days or more with no improvement could be considered for treatment with a high-dose nasal corticosteroid, such as mometasone furoate p. 1272 [unlicensed use] or fluticasone p. 1271 [unlicensed use] for 14 days. Supply of a back-up antibiotic prescription could be considered and used if symptoms do not improve within 7 days, or if they worsen rapidly or significantly. If the patient is systemically very unwell, has signs and symptoms of a more serious illness or condition, or is at high-risk of complications, an immediate antibiotic should be given. h(see Antibacterial therapy for acute sinusitis in Nose infections, antibacterial therapy p. 536). g Patients presenting with symptoms of acute sinusitis associated with a severe systemic infection or with orbital or intracranial complications should be referred to hospital. h Useful Resources Sinusitis (acute): antimicrobial prescribing. National Institute for Health and Care Excellence. NICE guideline 79. October 2017. www.nice.org.uk/guidance/ng79 ANTIBACTERIALS › AMINOGLYCOSIDES
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2–3 drops 2–3 times a day as required for
First-line fragment. Read the complete Indications and Dose section above.
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1 spray 1–3 times a day as required for
First-line fragment. Read the complete Indications and Dose section above.
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