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Oxymetazoline

    Brands

    DEA Class;  Rx

    Common Brand Names;

    Ophthalmic: Upneeq

    Intranasal OTC: Afrin, Duramist Plus, Dristan 12 Hr, Cheracol Nasal, Duration, Genasal, QlearQuil 12 Hour Nasal Decongestant Moisturizing Spray, Sinarest 12 Hour, Vicks Sinex 12 Hour

    Topical: Rhofade

    • Alpha Agonists, Ophthalmic
    • Decongestants, Intranasal
    • Alpha Agonists, Topical

    Intravenous catecholamine
    Used for restoration of blood pressure in patients with acute hypotensive states
    Potent alpha-adrenergic receptor agonist with modest beta-agonist activity

    Indicated for acquired blepharoptosis in adults

    Indicated for temporary relief of nasal congestion

    Indicated for the topical treatment of persistent facial erythema associated with rosacea in adults

    Hypersensitivity

    • Punctate keratitis (1-5%)
    • Conjunctival hyperemia (1-5%)
    • Dry eye (1-5%)
    • Blurred vision (1-5%)
    • Instillation site pain (1-5%)
    • Eye irritation (1-5%)
    • Headache (1-5%)
    Intranasal OTC
    • Insomnia
    • Headache
    • Burning
    • Stinging
    • Dryness
    • Sneezing
    • Rebound congestion

    Topical

    • Application-site dermatitis (2%)
    • Worsening inflammatory lesions of rosacea (1%)
    • Application-site pruritus (1%)
    • Application-site erythema (1%)
    • Application-site pain (1%)

    Alpha-adrenergic agonists may impact blood pressure; caution with severe or unstable cardiovascular disease, orthostatic hypotension, and uncontrolled hypertension or hypotension

    Caution with cerebral insufficiency, coronary insufficiency, or Sjögren syndrome

    May increase risk of angle-closure glaucoma in patients with untreated narrow-angle glaucoma

    Advise patients to seek medical care if signs and symptoms of cardiovascular disease, vascular insufficiency, or acute angle-closure glaucoma develop

    Ptosis may be associated with neurologic or orbital diseases such as stroke and/or cerebral aneurysm, Horner syndrome, myasthenia gravis, external ophthalmoplegia, orbital infection and orbital masses; give consideration to these conditions in the presence of ptosis with decreased levator muscle function and/or other neurologic signs

    Ophthalmic

    Data are not available regarding use during pregnancy to inform a drug-associated risk for major birth defects and miscarriage

    Data are unavailable to assess effects on breastmilk quantity or production, or to establish the level of oxymetazoline present in human breastmilk

    Intranasal OTC

    Pregnancy category: C

    Lactation: Not known if excreted in breast milk

    Topical

    No available data on oxymetazoline topical use in pregnant women to inform a drug-associated risk for major birth defects and miscarriage

    Unknown if distributed in human breast milk

    Adults

    8 drops/eye/day of the 0.025% ophthalmic solution; 1 drop/eye/day of the 0.1% ophthalmic solution; 6 sprays/nostril/day of the nasal spray; 1 topical application/day of the cream.

    Geriatric

    8 drops/eye/day of the 0.025% ophthalmic solution; 1 drop/eye/day of the 0.1% ophthalmic solution; 6 sprays/nostril/day of the nasal spray; 1 topical application/day of the cream.

    Adolescents

    8 drops/eye/day of the 0.025% ophthalmic solution; 6 sprays/nostril/day of the nasal spray; safety and efficacy have not been established for the 0.1% ophthalmic solution or the topical cream.

    Children

    6 to 12 years: 8 drops/eye/day of the 0.025% ophthalmic solution; 6 sprays/nostril/day of the nasal spray; safety and efficacy have not been established for the 0.1% ophthalmic solution or the topical cream.
    1 to 5 years: Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Norepinephrine bitartrate 

    ophthalmic solution

    • 0.1% (as HCl salt [0.09% as base])

    Intranasal solution

    • 0.05%

    topical cream

    • 1% (available in a tube or pump bottle)
    • Each gram of cream contains 10 mg (1%) oxymetazoline hydrochloride, which is equivalent to 8.8 mg (0.88%) of oxymetazoline free base