OXYMETAZOLINE
Drugs in Pregnancy and Lactation.
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Name: OXYMETAZOLINE
Class: Sympathomimetic (Adrenergic)
Risk Factor: C
Fetal Risk Summary
Oxymetazoline, an a-adrenergic agent, is a long-acting vasoconstrictor used topically in nasal decongestant sprays. No reports associating oxymetazoline with congenital abnormalities have been located. The Collaborative Perinatal Project recorded only 2 cases of exposure from 50,282 mother-child pairs (1). Although there was no indication of risk for malformations, the number of women exposed is too small for any conclusion.
Uterine vessels are normally maximally dilated and have only a-adrenergic receptors (2). Use of the a-adrenergic agent, oxymetazoline, could cause constriction of these vessels and reduce uterine blood flow, thus producing fetal hypoxia and bradycardia. A 1985 case report illustrated this toxicity when a nonreactive nonstress test and a positive contraction stress test were discovered in a 20-year-old woman at 41 weeks' gestation (3). Persistent late fetal heart rate decelerations were observed, and blood obtained from the fetal scalp revealed a pH of 7.23. The mother had self-administered a nasal spray containing 0.05% oxymetazoline, two sprays in each nostril, 6 times in a 15.5-hour interval before the nonstress test with the last dose administered 0.5 hour before testing. The recommended dosage interval for the preparation was every 12 hours. Approximately 6 hours after the last dose, the late decelerations disappeared and the normal beat-to-beat variability returned about 0.5 hour later. A normal male infant with Apgar scores of 9 and 9 at 1 and 5 minutes, respectively, was spontaneously delivered 14 hours after the last dose.
In contrast to the above case, a 1990 report described the results of a single dose (two full squirts) of 0.05% oxymetazoline (4). The drug was self-administered by 12 women with allergic rhinitis, sinusitis, or an upper respiratory tract infection. The otherwise healthy women were between 27 and 39 weeks' gestation. The effects of this dose on the maternal and fetal circulations were measured at 15-minute intervals for 2 hours after the dose. No significant changes were observed for maternal blood pressures or pulse rates, fetal aortic blood flow velocity, and fetal heart rate, or for the systolic-to-diastolic ratios in the uterine arcuate artery and umbilical artery. The investigators concluded that oxymetazoline, when administered at the recommended frequency, did not pose a risk for the healthy patient. Women with borderline placental reserve, however, should use the agent cautiously (4).
Breast Feeding Summary
No data are available.
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References
- Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977:346.
- Smith NT, Corbascio AN. The use and misuse of pressor agents. Anesthesiology 1970;33:58–101.
- Baxi LV, Gindoff PR, Pregenzer GJ, Parras MK. Fetal heart rate changes following maternal administration of a nasal decongestant. Am J Obstet Gynecol 1985;153:799–800.
- Rayburn WF, Anderson JC, Smith CV, Appel LL, Davis SA. Uterine and fetal doppler flow changes from a single dose of a long-acting intranasal decongestant. Obstet Gynecol 1990;76:180–2.
Q&A about Oxymetazoline
n.
A vasoconstricting drug that is used topically in the form of its hydrochloride to reduce nasal congestion.
The American Heritage® Stedman's Medical Dictionary, 2nd Edition Copyright © 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.
I've been using nasal spray containing Oxymetazoline HCl, found in products such as Afrin. The spray is extremely efficient at clearing up my nasal passages, however it leads to chronic congestion as the blood vessels in the nasal passage will no longer shrink on their own (without the spray). But I can't get relief from saline solutions as they are not strong enough. I found bloody mucous membranes in my tissue yesterday and I'm concerned that Oxymetazoline HCl has caused tissue damage. I've been prone to urinating blood over the last year, and think it's connected with the nasal spray. Could drippage from the nasal cavity into my stomach weaken my immune system thereby making me susceptible to Urinary Tract Infection or bloody urine? Or is it something else that is causing the blood in the urine? The time frame from when I started getting urine in the blood seems to equate to when I started using nasal sprays with Oxymetazoline HCl. It is highly addictive! How do I break it?
The compound seems to have a phenol and secondary and tertiary amines.
I hope this helps!
Good luck! :)
Love,
Mary ♥
Im taking an over the counter nose spray Hci & when it wears off my nose gets pluged up. so then I have to use it again then it gose away the my nose then get stuffy again. Im taking to sinus medication PE & psudefedrine there 2 different drugs. but they dont clear my nose up after using the nose spray. what should I do. is there any thing better. ?????
You can use at a stretch for not more than 7 days. Frequent use should not be done.
They are of limited value because they can give rise to a rebound congestion on withdrawal.This in turns tempts you to use this again and as a result the nasal congestion can become more frequent
leading to a vicious cycle.
Those who are frequently getting these symptoms should preferably use a steroid nasal spray like Rhinocort or Beconase for abut three months continuously when you may get a perfect cure.
In addition you can use Sudafed syrup (pseudoephedrine) for short term effect.
A person who is having frequent nasal congestion should stop using this repeatedly but should be used in a special situation as on a special occassion like a conference etc. when you require some immediate relief.
so far, ive hear the psuedophedrine works, and some bronchial inhalers. we used lots of steam and tea steam, but one thing saved her life for now, and thats a nasal decongestent oxymetazoline. didnt know if it was going to help or hurt her, but she was dying, so i risked it. and it worked. shes doing fine now, in case youre also looking. any other ideas? the vet already injected antibiotics.
Oxymetazoline hydrochloride and pseudoephedrine sprays cause rebound congestion. Oral pseudoephedrine and loratadine do not work.
Does ANYTHING work that can be taken for long periods of time for completely eliminating nasal congestion?
Generally, you should see a qualified Physician who can put you on a short course of oral steroids in combination with a non-addictive nasal steroid spray.
This works quickly to reduce the chronic inflammation in the nasal passages caused by the prolonged use of the Afrin.
You do not have to worry about steroid side effects because you take it for only a few days.
Then you must never use these over the counter nasal sprays for more than a couple of days to avoid the 'rebound' affect that they cause.
I am 21 and healthy. I have to spray Nasal Spray or I can't breath through my nose at all. It completely plugs up. My dad is the same way, so I guess that I get it from him.
Someone told me that nasal spray is bad for you and that it could cause heart strain. Is that true?
The chemical in it is Oxymetazoline Hydrochloride 0.05% if you need to know that.
My best recommendation is to rinse out your nasal passages 2 x day, once in the morning and evening (hours before you go to bed as your passages will drain afterwards). Then I also recommend that you get some Grapefruit Seed Extract to keep your nasal passages from getting infected. Get the liquid and use 3-4 drops into the nasal rinse saline using only bottled water, not tap and see if it doesn't alleviate some of your problem. The other problem it sounds like you have is something you're eating that is causing too much mucous to develop. Usually that is an allergic reaction to some food. You need to find out what food it is and avoid it so you can reduce the amount of mucous in your nose.
You can continue to do what you've been doing as you are 21, but later as you get older, it gets worse if you don't correct it now.
The main ingredient Oxymetazoline hydrochloride is known to have a rebound effect. Meaning that symptoms could get worse if prolong use of the product extends beyond 5 days or so.
Could the damage be permanent?
