Alpha-adrenoceptor agonist (nasal decongestant)

Xylometazoline hydrochloride

Brand names: Otrivin, Sudafed Blocked Nose, Sinex

Adult dose

Dose: 0.1% solution: 2–3 drops or 1 spray each nostril up to TDS

Route: Intranasal

Frequency: Up to TDS; max 7 days

Clinical pearls

OTC nasal decongestant; limit to 7 days to avoid rhinitis medicamentosa
Use 0.05% for children 6–12 years
Not suitable for chronic rhinitis

Contraindications

Angle-closure glaucoma
MAOIs within 14 days
Rhinitis sicca
Children <6 years (0.1% strength)
Hypersensitivity

Side effects

Rebound congestion (rhinitis medicamentosa) with prolonged use
Local irritation
Headache
Hypertension (systemic absorption)
Tachycardia

Interactions

MAOIs
Tricyclic antidepressants
Beta-blockers

Monitoring

Duration of use
BP (hypertensive patients)

Reference: BNF; NICE CKS; https://bnf.nice.org.uk/drugs/xylometazoline-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways