Oxymetazoline

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Oxymetazoline
Systematic (IUPAC) name
3-(4,5-dihydro-1H-imidazol-2-ylmethyl)- 2,4-dimethyl-6-tert-butyl-phenol
Identifiers
CAS number	1491-59-4
ATC code	R01 AA05 R01 AB07, S01 GA04
PubChem	4636
DrugBank	APRD01158
Chemical data
Formula	C₁₆H₂₄N₂O
Mol. weight	260.375 g/mol
Pharmacokinetic data
Bioavailability	?
Metabolism	?
Half life	?
Excretion	?
Therapeutic considerations
Pregnancy cat.	?
Legal status
Routes	?

Oxymetazoline is a topical decongestant used, in the form of Oxymetazoline hydrochloride, in products such as Vicks Sinex and Afrin. Oxymetazoline is generally available as a nasal spray. If overused (usually for a period of more than 3 days) it can cause a "rebound congestion" (rhinitis medicamentosa) where the tissues of the sinus are damaged, become swollen, and therefore the person becomes congested after the drug wears off. As a result, a user can become addicted to the drug, in the sense that he/she cannot breathe through the nose without constant use of the spray. (See the discussion of the effect of benzalkonium chloride, a common additive to oxymetazoline nasal sprays, in the article Rhinitis medicamentosa.)

The medication has sympathomimetic properties, and thus constricts the blood vessels of the nose and sinuses via activation of alpha1 adrenergic receptors, in turn causing less production of mucous. It is frequently used by anaesthesiologists to reduce nasal bleeding during nasal endotracheal intubations.

Since no clinical data on exposed pregnancies are available with oxymetazoline, the safe use of oxymetazoline during pregnancy has not been established. Oxymetazoline is not to be used during pregnancy unless the potential benefits outweigh the risks.

If accidentally ingested, standard methods to remove unabsorbed drugs should be considered. There is no specific antidote for oxymetazoline. In children, oxymetazoline may produce profound central nervous system depression.

Jala neti, a yoga technique of rinsing out the nasal cavity with salt water (now often referred to as simply nasal irrigation), is sometimes recommended as an alternative to oxymetazoline, especially to those who have had problems with "rebound congestion" and dependency.