[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Nasal decongestants](https://durgical.com/en/pharmacology/classes/nasal-decongestants/) › Oxymetazoline # Oxymetazoline ## Nasal decongestants? Nasal decongestants A long-acting nasal decongestant spray; used for no more than 3 days to avoid rebound congestion. Updated Nov 1, 2026 ## Quick facts **Group** [Nasal decongestants](https://durgical.com/en/pharmacology/classes/nasal-decongestants/) **Target** Alpha-1A and alpha-2A adrenergic receptors **Used for** Nasal congestion of colds **Key effects** Burning · Sneezing · Runny nose **Monitor** Days of use · Blood pressure in hypertensive patients **ATC** R01AA05 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ◎**Alpha-1A and alpha-2A adrenergic receptors**Oxymetazoline ⓘ The figure shows oxymetazoline bound to the human alpha-1A adrenergic receptor in complex with its G protein (cryo-electron microscopy). **Target in 3D:** Alpha-1A and alpha-2A adrenergic receptors. PDB structure 7YM8 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7YM8) · Drag to rotate · pinch to zoom Oxymetazoline is an imidazoline that directly stimulates alpha-1 and alpha-2 adrenergic receptors on the vessels of the nasal mucosa. The vessels constrict within minutes, mucosal swelling falls and the nose opens for many hours. With use beyond a few days, the vessels rebound when the drug wears off and congestion becomes worse (rhinitis medicamentosa). If swallowed, especially by young children, it can act on central alpha-2 receptors and cause sedation, slow heart rate and low blood pressure. - Oxymetazoline is sprayed onto the nasal mucosa - It activates alpha receptors on the nasal vessels - Vessels constrict and the swelling falls - Use beyond a few days causes rebound congestion ## Indications - Nasal congestion of colds [Common cold (acute viral rhinopharyngitis) →](https://durgical.com/en/conditions/common-cold/) - Nasal congestion of allergic rhinitis (short term) [Allergic rhinitis →](https://durgical.com/en/conditions/allergic-rhinitis/) - Sinus congestion and pressure [Acute rhinosinusitis →](https://durgical.com/en/conditions/acute-rhinosinusitis/) ## Adverse effects ### Common - Burning, stinging or dryness of the nose - Sneezing - Runny nose ### Serious (rare, important) - Rebound congestion (rhinitis medicamentosa) with prolonged use - Fast or slow heartbeat and raised blood pressure - Sedation, bradycardia and low blood pressure if swallowed by young children ## Contraindications - Use longer than 3 days - Children under 6 years unless recommended by a doctor - Caution in heart disease, hypertension, thyroid disease, diabetes and prostate enlargement - MAO inhibitors ## Key interactions **MAO inhibitors** Risk of a dangerous rise in blood pressure **Other decongestants or sympathomimetics** Additive cardiovascular effects ## What is monitored - Days of use - Blood pressure in hypertensive patients ## Administration and safety - Nasal spray only; not swallowed - Used for no more than 3 days - Each bottle is used by one person only, to avoid spreading infection ## Pregnancy and breastfeeding Short topical use is sometimes accepted in pregnancy; the clinician decides. ## Nursing care - Teach the 3-day limit and explain rebound congestion - Store out of reach of children - Ask about hypertension, heart disease and MAO inhibitors ## Pharmacokinetics **Absorption** Acts locally; some is absorbed through the mucosa or swallowed **Onset and duration** Within minutes, lasting many hours ## Memory aid OXYmetazoline: Opens the nose, eXtra days make it worse, Yes to 3 days only. ## Test yourself Think of the answer, then tap the question to see it. ## What is the maximum usual length of oxymetazoline nasal spray use, and why? 3 days, because longer use causes rebound congestion. ## Which receptors does oxymetazoline stimulate? Alpha-1 and alpha-2 adrenergic receptors. ## What can happen if a toddler swallows oxymetazoline? Sedation, slow heart rate and low blood pressure from central alpha-2 stimulation. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/oxymetazoline/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## Connections ## Related drugs 2 - [Xylometazoline](https://durgical.com/en/pharmacology/xylometazoline/) - [Pseudoephedrine](https://durgical.com/en/pharmacology/pseudoephedrine/) ## Related conditions 3 - [Common cold (acute viral rhinopharyngitis)](https://durgical.com/en/conditions/common-cold/) - [Allergic rhinitis](https://durgical.com/en/conditions/allergic-rhinitis/) - [Acute rhinosinusitis](https://durgical.com/en/conditions/acute-rhinosinusitis/) [← Back to the class: Nasal decongestants](https://durgical.com/en/pharmacology/classes/nasal-decongestants/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Oxymetazoline Nasal Spray: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a608026.html) (MedlinePlus (U.S. National Library of Medicine), 2016); [Decongestants - NHS](https://www.nhs.uk/medicines/decongestants/) (NHS, 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=R01AA05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/oxymetazoline/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/oxymetazoline/