Xylometazoline hydrochloride

How it works

It is an alpha-adrenoceptor agonist that constricts dilated nasal blood vessels, reducing mucosal swelling and oedema to improve airflow.

Prescribing in practice

• Limit continuous use to a short course only, as prolonged use causes rebound congestion (rhinitis medicamentosa).
• Avoid or use with caution in patients with cardiovascular disease, hypertension, hyperthyroidism, diabetes or those taking monoamine oxidase inhibitors.
• Paediatric formulations of lower strength exist; check a children's formulary for age-appropriate use and avoid in very young children unless specifically indicated.

Monitoring

Routine laboratory monitoring is not required; review symptomatic response and discourage prolonged or excessive use.

Counselling the patient

• Use for only a few days at a time to avoid worsening congestion when you stop.
• Do not share the nasal device with others to prevent spreading infection.
• Seek advice if symptoms persist or worsen.

Evidence & guidelines

Topical nasal decongestants are well established for short-term symptomatic relief of nasal congestion as reflected in the SPC and current prescribing references.