Afrin is one of the trade names of oxymetazoline. Oxymetazoline is a topical nasal decongestant commonly used in the form of oxymetazoline hydrochloride. Its main use is to reduce the congestion in the nostrils due to allergies, a runny nose, or sinusitis.
It is available as nasal spray or drops to reduce the symptoms of nasal blockage and swollen inner lining of the nose. Dilated blood vessels inside the nose lead to swelling and fluid buildup in the tissues of the nose. The action of the drug causes the blood vessel wall to shrink, reducing the blood flow to the nose providing temporary relief from nasal stuffiness almost instantly. However, long-term use of oxymetazoline may in fact result in increased nasal secretions, nasal swelling, and nasal block due to rebound vasodilation (widening of the blood vessels).
Uses of oxymetazoline
Oxymetazoline is indicated for relief from conditions affecting and damaging the nasal lining. It is available in various formulations with a wide variety of clinical implications. It provides rapid and prolonged relief and is significantly more potent than other decongestants such as xylometazoline. Safety of oxymetazoline use in pregnant women is not well established; it is generally not advised during pregnancy. The important uses of oxymetazoline include:
- Due to its vasoconstrictor (narrowing of the blood vessels) activity, it is used as a decongestant and topical hemostatic (stop bleeding) agent.
- It effectively reduces viral rhinitis (a runny nose) and otitis media (middle ear infection).
- The topical formulation of the drug is used for treating persistent facial erythema associated with rosacea in adults.
- It is available as over the counter nasal sprays to reduce nasal and sinus congestion.
- In combination with tetracaine (a local numbing agent), it is used for regional anesthesia during dental procedures in children and adults.
- Ophthalmic formulation of oxymetazoline is used for treating acquired blepharoptosis or ptosis (droopy eye) in adults.
- It has also been used during nasal intubation and during ear, nose, and throat surgery to improve visualization of the airway and minimize postoperative bleeding.
Risks and side effects
Although the action of oxymetazoline causes short-term vasoconstriction of the blood vessels in the nose and reduces leakage of fluid from capillaries, they may be followed by rebound vasodilation and stuffiness. This rebound nasal congestion is known as rhinitis medicamentosa (RM) that is caused by the extended use of topical decongestants. Long-term use of oxymetazoline may cause the nasal tissues to permanently enlarge and not respond to medications. It may need surgical intervention to cure the blocked nose symptoms.
With regular use, some patients may develop RM in 3 days, whereas others may not have symptoms till after 4-6 weeks of use.
Oxymetazoline may also cause some other unwanted effects if used for long:
- Temporary burning, stinging, and dryness in the nose
- Runny nose and sneezing
- Slow/fast/pounding heartbeat
- High blood pressure and lightheadedness
- Anxiety and nervousness
- Trouble sleeping and dizziness
- Tremors and visual disturbances
The side effects are usually alleviated by consultation with a doctor and gradually reduced by using topical decongestants.
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