What is Xylometazoline

NOTE: This drug is discontinued in the U.S.

Xylometazoline hydrochloride is a topical sympathomimetic vasoconstrictor. It is structurally and pharmacologically related to other imidazoline derivatives such as naphazoline, oxymetazoline, and tetrahydrozoline.

Topical nasal decongestants provide temporary relief of nasal congestion associated with colds, allergies, and sinusitis. Xylometazoline is generally not used for greater than 3 consecutive days since some degree of rebound congestion usually results.

The effectiveness of xylometazoline for relieving nasal congestion and its adverse effect profile are similar to other imidazoline derivatives. Xylometazoline hydrochloride is only available as a preservative free, metered-dose nasal spray.

The solution is isotonic with a pH of 6.1 to 6.4. Sprays may be preferable to drops because of the reduced risk of swallowing the drug and resultant systemic absorption.

Additionally, the metered-dose spray minimizes the overdose potential from a single dose.

Xylometazoline was originally approved by the FDA in 1959.

In 1994, the over-the-counter topical decongestants were reviewed by the FDA and were found to be safe and effective.

Indications & Dosage

  • allergic rhinitis
  • nasal congestion
  • vasomotor rhinitis

For the treatment of nasal congestion and rhinitis (e.g., vasomotor rhinitis or allergic rhinitis) due to colds, hay fever, allergies, or sinusitis

NOTE: Do not use longer than 3 days in a row unless directed by a physician.

Side Effects

  1. anxiety
  2. arrhythmia exacerbation
  3. blurred vision
  4. dizziness
  5. drowsiness
  6. headache
  7. hypertension
  8. hypotension
  9. insomnia
  10. mydriasis
  11. nasal congestion
  12. nasal dryness
  13. nasal irritation
  14. nausea
  15. palpitations
  16. rhinitis
  17. rhinorrhea
  18. sneezing
  19. tolerance
  20. tremor
  21. vomiting
  22. weakness

Monitoring Parameters

  • laboratory monitoring not necessary


  • angina
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • children
  • closed-angle glaucoma
  • coronary artery disease
  • diabetes mellitus
  • geriatric
  • hypertension
  • hyperthyroidism
  • infants
  • MAOI therapy
  • neonates
  • pheochromocytoma
  • pregnancy
  • prostatic hypertrophy
  • thyroid disease


No information is available regarding drug interactions associated with Xylometazoline


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