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Nasal decongestant (alpha-2 adrenergic agonist — topical)

Xylometazoline Hydrochloride 0.1% Nasal Spray (Otrivine)

Brand names: Otrivine, Sudafed Blocked Nose Spray

Xylometazoline nasal spray (Otrivine) is a topical decongestant used for short-term relief of nasal congestion, including that associated with colds, sinusitis and allergic rhinitis.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is a sympathomimetic alpha-adrenoceptor agonist that constricts the dilated blood vessels of the nasal mucosa, reducing mucosal swelling and improving nasal airflow.

Prescribing in practice

  • Limit use to a few consecutive days only, as prolonged use causes rebound congestion (rhinitis medicamentosa) and tolerance.
  • Avoid sharing the device between people to prevent cross-infection, and use cautiously in patients with cardiovascular disease, hypertension, hyperthyroidism or those on certain antidepressants.
  • The higher-strength preparation is intended for adults and older children, and a lower-strength product should be used for younger children per a children's formulary.

Monitoring

No formal monitoring is needed for short-term use; review if congestion persists or recurs after stopping.

Counselling the patient

  • Use it for only a few days in a row to avoid worsening, rebound stuffiness.
  • Do not exceed the recommended frequency on the label.
  • Keep the spray for your own use only.

Evidence & guidelines

Topical decongestants give effective short-term symptomatic relief of nasal congestion but are limited by rebound congestion with prolonged use.

Reference: NICE CKS Common Cold; Otrivine SPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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