Brand Names: Canada
- Balminil Decongest [OTC];
- Otrivin [OTC]
Pharmacologic Category
-
Alpha-Adrenergic Agonist;
-
Decongestant;
-
Imidazoline Derivative
Dosing: Adult
Nasal congestion
Nasal congestion:
Intranasal: Spray: 2 sprays in each nostril every 8 to 10 hours (maximum: 6 sprays in each nostril daily).
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Dosing: Kidney Impairment: Adult
There are no dosage adjustments provided in the manufacturer's labeling.
Dosing: Liver Impairment: Adult
There are no dosage adjustments provided in the manufacturer's labeling.
Dosing: Older Adult
Refer to adult dosing.
Adverse Reactions
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
1% to 10%:
Gastrointestinal: Nausea
Local: Application-site burning
Nervous system: Headache
Respiratory: Dry nose, nasal discomfort
<1%:
Cardiovascular: Cardiac arrhythmia, increased heart rate
Hypersensitivity: Hypersensitivity reaction (including angioedema)
Ophthalmic: Visual impairment (transient)
Contraindications
Hypersensitivity to xylometazoline or any component of the formulation; patients with transphenoidal hypophysectomy or surgery exposing the dura mater; narrow angle glaucoma; rhinitis sicca or atrophic rhinitis
Warnings/Precautions
Concerns related to adverse effects:
• Rebound nasal congestion: Frequent or prolonged use may cause nasal congestion to recur or worsen.
Disease-related concerns:
• Cardiovascular disease: Use with caution in patients with hypertension or heart disease.
• Diabetes mellitus: Use with caution in patients with diabetes mellitus.
• Thyroid disease: Use with caution in patients with thyroid disease.
• Prostatic hyperplasia/Urinary obstruction: Use with caution in patients with prostatic hyperplasia and/or GU obstruction.
Other warnings:
• Appropriate use: If symptoms persist longer than 3 days consult health care provider. Container should not be used by more than 1 individual.
Product Availability
Not available in the United States.
Dosage Forms: Canada
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Nasal, as hydrochloride [spray]: 0.1%
Administration: Adult
Intranasal: For intranasal use only. Before first use, prime pump by spraying several times into air until a fine mist appears. Blow nose to clear nostrils before use. Tilt head slightly backward and then spray solution into each nostril. After application inhale deeply. Wipe tip of container clean after each use.
Use: Labeled Indications
Note: Not available in the United States.
Nasal Congestion: Temporary relief of nasal and nasopharyngeal mucosal congestion
Medication Safety Issues
Sound-alike/look-alike issues:
Otrivin may be confused with Lotrimin
Metabolism/Transport Effects
None known.
Drug InteractionsNote: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.
Atomoxetine: May increase hypertensive effects of Sympathomimetics. Atomoxetine may increase tachycardic effects of Sympathomimetics. Risk C: Monitor
Atropine (Systemic): May increase hypertensive effects of Alpha1-Agonists. Risk C: Monitor
Bornaprine: Sympathomimetics may increase anticholinergic effects of Bornaprine. Risk C: Monitor
Bromocriptine: May increase hypertensive effects of Alpha1-Agonists. Management: Consider alternatives to this combination when possible. If combined, monitor for hypertension and tachycardia, and do not coadminister these agents for more than 10 days. Risk D: Consider Therapy Modification
Cannabinoid-Containing Products: May increase tachycardic effects of Sympathomimetics. Risk C: Monitor
Cocaine (Topical): May increase hypertensive effects of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Risk D: Consider Therapy Modification
Dihydralazine: Sympathomimetics may decrease therapeutic effects of Dihydralazine. Risk C: Monitor
Doxofylline: Sympathomimetics may increase adverse/toxic effects of Doxofylline. Risk C: Monitor
Ergot Derivatives (Vasoconstrictive CYP3A4 Substrates): May increase vasoconstricting effects of Alpha1-Agonists. Risk X: Avoid
Esketamine (Injection): May increase adverse/toxic effects of Sympathomimetics. Specifically, the risk for elevated heart rate, hypertension, and arrhythmias may be increased. Risk C: Monitor
Esketamine (Nasal): Decongestants (Nasally Administered) may decrease therapeutic effects of Esketamine (Nasal). Management: Patients who require a nasal decongestant on an esketamine dosing day should administer the nasal decongestant at least 1 hour before esketamine. Risk D: Consider Therapy Modification
FentaNYL: Decongestants may decrease serum concentration of FentaNYL. Risk C: Monitor
Guanethidine: May increase hypertensive effects of Sympathomimetics. Guanethidine may increase arrhythmogenic effects of Sympathomimetics. Risk C: Monitor
Iobenguane Radiopharmaceutical Products: Alpha1-Agonists may decrease therapeutic effects of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Risk X: Avoid
Kratom: May increase adverse/toxic effects of Sympathomimetics. Risk X: Avoid
Levothyroxine: May increase therapeutic effects of Sympathomimetics. Sympathomimetics may increase therapeutic effects of Levothyroxine. Levothyroxine may increase adverse/toxic effects of Sympathomimetics. Specifically, the risk of coronary insufficiency may be increased in patients with coronary artery disease. Risk C: Monitor
Linezolid: May increase hypertensive effects of Sympathomimetics. Management: Consider initial dose reductions of sympathomimetic agents, and closely monitor for enhanced blood pressure elevations, in patients receiving linezolid. Risk D: Consider Therapy Modification
Lisuride: May increase hypertensive effects of Alpha1-Agonists. Risk X: Avoid
Metergoline: May increase adverse/toxic effects of Alpha1-Agonists. Risk C: Monitor
Monoamine Oxidase Inhibitors: May increase hypertensive effects of Alpha1-Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Risk X: Avoid
Pergolide: May increase hypertensive effects of Alpha1-Agonists. Risk C: Monitor
Solriamfetol: Sympathomimetics may increase hypertensive effects of Solriamfetol. Sympathomimetics may increase tachycardic effects of Solriamfetol. Risk C: Monitor
Sympathomimetics: May increase adverse/toxic effects of Sympathomimetics. Risk C: Monitor
Tedizolid: May increase adverse/toxic effects of Sympathomimetics. Specifically, the risk for increased blood pressure and heart rate may be increased. Risk C: Monitor
Tricyclic Antidepressants: May increase therapeutic effects of Alpha1-Agonists. Tricyclic Antidepressants may decrease therapeutic effects of Alpha1-Agonists. Risk C: Monitor
Zavegepant: Decongestants (Nasally Administered) may decrease serum concentration of Zavegepant. Management: Avoid the concurrent administration of intranasal decongestants with zavegepant. If combined use is unavoidable, intranasal decongestants should be administered at least 1 hour after zavegepant administration. Risk D: Consider Therapy Modification
Pregnancy Considerations
According to the manufacturer, use during pregnancy is not recommended.
Breastfeeding Considerations
It is not known if xylometazoline is excreted in breast milk. The manufacturer recommends that caution be exercised when administering xylometazoline to nursing women.
Mechanism of Action
Stimulates alpha-adrenergic receptors in the arterioles of the conjunctiva and the nasal mucosa to produce vasoconstriction
Pharmacokinetics (Adult Data Unless Noted)
Onset of action: Intranasal: Local vasoconstriction: Within 2 minutes
Duration: Up to 12 hours
Brand Names: International
International Brand Names by CountryFor country code abbreviations (
show table)
-
(AE) United Arab Emirates: Balkis | Decozal | Olynth | Otrivin | Xylo | Xylo comod | Xylolin | Xylomet;
-
(AR) Argentina: Expectosan descongestivo | Nastizol | Orla-xyl | Otrivina | Otrivina spray nasal | Xylometazolina;
-
(AT) Austria: Easynasan | Hysan | Otrivin | Snup;
-
(AU) Australia: Flo Xylo-Pos | Otrivin | Otrivin junior;
-
(BD) Bangladesh: Antazol | Nazol | Novin | Rhinozol | Xylomet | Xylovin;
-
(BE) Belgium: Nasa rhinathiol | NasaSinutab | Nuso san | Otrivine | Rhinivex | Xylomaris | Xylometazoline eg | Xyloteva;
-
(BF) Burkina Faso: Biomist nd | Biomist ns | Otrivine;
-
(BG) Bulgaria: Olynth | Otrivin | Rhinoxylin | Xylometazolin | Xylomethazolin | Xylopharm | Xylorhin | Xymeral;
-
(BR) Brazil: Orlaxyl | Otrivina;
-
(CH) Switzerland: Coop vitality xylometazolin | Nasenspray Neo | Olynth | Olynth Microdoseur | Otrivin | Rhinostop | Rinosedin | Xylo;
-
(CI) Côte d'Ivoire: Biomist nd | Biomist ns | Rinasan | Xylonet;
-
(CN) China: Nuo tong | Nuotong | Tian cheng nuo er;
-
(CO) Colombia: Colirio azul;
-
(CZ) Czech Republic: Mar rhino | Nasenspray | Nasentropfen | Olynth | Otrivin | Rinoxyl | Xylomax | Xylomax neo | Xylometazolin dr.max;
-
(DE) Germany: Apo rot nasenspray | Axea | Balkis | Balkis nase | Brufasol | Docmorris xylo | Gelonasal | Gib | Hysan Schnupfenspray | Imidin | Imidin N | Klindwort | Medicon Xylometazolin | Medpex | Mein nasenspray vita | Nasan | Nasenspray | Nasenspray Axcount | Nasenspray disapo | Nasenspray e | Nasenspray Elac | Nasenspray ipa | Nasenspray ipa/ba | Nasenspray ipa/klindwort | Nasenspray ipa/mpk | Nasenspray medicamo | Nasenspray Teva | Nasenspray wepa | Nasenspray zentiva | Nasentropfen | Nasentropfen Axcount | Nasentropfen e | Nasentropfen k | Nasentropfen Stada | Neovel + | Neovel med | Olynth | Otriven | Otriven gegen schnupfen | Otriven Sinuspray | Otrivin | Rapako xylo | Rhinex mit Xylometazolin | Rhino Stas | Schnupfen endrine | Stas nase | Xylo | Xylo aiwa | Xylo redcare | Xylomet abz | Xylometazolin | Xylometazolin ap | Xylometazoline adjupharm;
-
(DK) Denmark: Klarigen | Passagen | Zymelin menthol ukonserveret | Zymelin ukonserveret;
-
(DO) Dominican Republic: Nozolin | Otrivina | Rhynofar;
-
(EC) Ecuador: Constrilin | Otrivina | Reppon;
-
(EE) Estonia: Galazolin | Halazolin | Imidin N | Nasenspray e | Nasenspray k | Nasentropfen e | Nasentropfen k | Nasolin | Olynth | Otrivin | Rhino Stas | Sinzyl | Sudafed Xylo | Xylo | Xylomethazoline | Xylorhin | Xymelin;
-
(EG) Egypt: Balkis | Nasostop | Otrivin | Rhinex;
-
(ES) Spain: Amidrin | Frenasal | Otrivin | Rhinovin | Rinoblanco;
-
(ET) Ethiopia: Nosil | Otrivin;
-
(FI) Finland: Nasment | Naso | Nasolin | Otrivin | Rinol | Zymelin;
-
(GB) United Kingdom: Nazo | Nose | Otradrops | Otrivine | Sudafed | Sudafed blocked nose | Sudafed congestion relief | Tixycolds Cold and Allergy | Xylometazolin | Xylometazolin kent;
-
(GR) Greece: Hexarhinal | Otrivin | Otrivin moistur;
-
(HK) Hong Kong: Decongestant | Nasal spray ii | Nazoline | Otrivin | Snup | Xyloma;
-
(HR) Croatia: MaxiRino | Meralys | Meralys HA | Olynth | Olynth ha;
-
(HU) Hungary: Allenasal | Aquaspira | Huma-metazol | Lolimarine ha | Nasan | Novorin | Olynth | Otrivin | Rhino Stas F | Rhino-stas gy | Rinomaris | Snup | Xilomare;
-
(ID) Indonesia: Otrivin | Otrivin microdoser;
-
(IE) Ireland: Otrivine | Sudafed;
-
(IL) Israel: Af Care | Nazalet | Otrivin | Xylovit;
-
(IN) India: Atrovin p | Biomist | Certen | Certen p | Clearnoz | Corex | Corivex | Corivin | Decon | Diconal | Goair | Hynasal XL | Lyftz | Mucoris | Nam Cold | Nam cold nasal drops | Naso wikoryl | Nasoflex | Nasomet | Nasomist x | Nazalin a | Nimza | Noblok | Nosikind | Nosikind P | Nostravin | Nosymed | Nozy | Orinase | Ortinose | Otistar | Otistar p | Otrinoz | Otrivin | Pa cold paediatric | Recofast | Rhinoset | Rhinoset p | Rinostat XL | Sane | Sane p | Sinomet | Sinomet p | Vibotro | Wostrin | Xylo | Xylochek | Xylofree | Xylomist | Xyloris | Xynal | Zeecold | Zml | Zolex-forte | Zylo | Zylonasal;
-
(IQ) Iraq: Otrinose;
-
(IT) Italy: Argotone Dec.Nas | Narhimed naso chiuso | Neo rinoleina | Otrivin | Otrivin ofta | Xilometazolina eg;
-
(JO) Jordan: Decozal | Decozal colds | Decozoline | Otrivin | Xylomet;
-
(KE) Kenya: Decozal | Ivynozvin A | Ivynozvin p | Otrivin | Otrivin children | Rhinovin adult | Rhinovin paediatric | Sinutab | Xylolin;
-
(KR) Korea, Republic of: Bicoolong | Cinocaxylo | Colcare & nasal | Coldaewon cona | Comekina nasal | Cotrobin | Cozatulin | Facol | Gelonasal | Metarivin | Minolnose | Narista xylo | Okotrin | Otrivin | S tuben;
-
(KW) Kuwait: Otrivin | Rhinex | Xylo comod | Xylolin | Xylomet;
-
(LB) Lebanon: Decozal | Otrivine | Xylo comod;
-
(LT) Lithuania: Galasolin | Galazolin | Halazolin | Imidin | Nasan | Nasen tropfen k | Nasenspray | Nomex | Nose | Olynth | Otrivin | Rhino Stas | Rhinostop | Sinzyl | Xylometazolin | Xylopharm | Xymelin;
-
(LU) Luxembourg: Balkis nase | Nasan | Nasenspray | Nasentropfen k | Nasentropfen-k | Otrivine | Sinutab | Xylomaris;
-
(LV) Latvia: Galasolin | Galazolin | Halazolin | Imidin N | Ksilonex | Nasan | Nasengel Rph | Nasenspray | Nasenspray Ratiopharm | Nasentropfen | Nomex | Olynth | Otrivin | Rhino Stas | Rhinostop | Sinzyl | Xylo | Xylometazolin | Xylometazoline | Xylopharm | Xymelin;
-
(MA) Morocco: Otrivine;
-
(MX) Mexico: Otrivina;
-
(MY) Malaysia: Otrivin;
-
(NG) Nigeria: Clarinez | Enaphrin | Otrivin | Xylone;
-
(NL) Netherlands: Albert Heijn Neusspray Xylometazoline HCl | Etos neusspray | Idyl neusdruppels xylometazoline hcl | Kinderneusdruppels | Kinderneusspray xylometazoline hcl htp | Kruidvat xylometazoline hcl | Livsane neusdruppels xylometazoline hcl | Neus | Neusdruppels voor de verstopte neus xylometa | Neusdruppels Xylometazoline HCL | Neusspray voor de verstopte neus xylometazoli | Neusspray Xylometazoline HCl | Otrivin | Otrivin care xylometazoline | Otrivin XylometazolineHCL | San xylometazoline hcl | Xylo comod | Xylometazoline HCL | Xylometazoline Hcl A | Xylometazoline Hcl Actavis | Xylometazoline HCl CF | Xylometazoline Hcl Kring | Xylometazoline hcl linn | Xylometazoline HCl Mdq | Xylometazoline Hcl PCH | Xylometazoline hcl sandoz;
-
(NO) Norway: Naso | Nazaren | Otrivin | Xolin | Xylometazolin norfri;
-
(NZ) New Zealand: Coldrex;
-
(PE) Peru: Sinutab;
-
(PH) Philippines: Otrivin | Xylonas | Xylone;
-
(PK) Pakistan: Lyzo | Metazolin | Nasavin | Xolisan | Xylometazoline | Xylonas | Xynosine;
-
(PL) Poland: Donosan | Otrivin | Sudafed xylospray dla dzieci | Xedine ha | Xylometazolin | Xylometazolin fortis | Xylometazolin vibrocil | Xylometazoline Coldact | Xylorin;
-
(PR) Puerto Rico: Otrivin | Triaminic Decongestant;
-
(PT) Portugal: Nasexilo | Otrivina | Snup | Xymeral;
-
(PY) Paraguay: Otrivina;
-
(QA) Qatar: Decozal | Decozal Menthol | Otrivin Drops | Otrivin Menthol Spray | Otrivin Spray | Xylo-Acino | Xylolin Adult | Xylolin Children | Xylomet Adult | Xylomet Paediatric;
-
(RO) Romania: Bixtonim xylo | Bixtonim xylo aroma | Maresyl | Olynth | Rhinxyl | Snup | Xylo nasal;
-
(RU) Russian Federation: Brizoline | Dlianos | Doctor theiss rhinotheiss | Dr. theiss rino | Espazoline | Eucazolin aqua | Fazin | Galazolin | Grippostad rhino | Halazolin | Influrin | Influrine xylo | Morelor xylo | Nazolin | Nosolin | Nosolin balsam | Olynth | Otrivin | Pharmazolin | Rhinomaris | Rhinonorm | Rhinorus | Rhinostop | Rinonorm | Sanorin xylo | Snup | Suprima nos | Tyzine | Tyzine xylo | Xylen | Xylen aktiv | Xylen neo | Xylobene | Xylometazol bufus | Xylometazolin | Xylometazoline | Xylometazoline Betalek | Xylometazoline bufus | Xylometazoline ds | Xylometazoline solopharm | Xymelin | Xymelin eco | Xymelin eco with menthol | Zvezdochka noz;
-
(SA) Saudi Arabia: Decozal | Otrivin | Xylo | Xylolin | Xylomet;
-
(SE) Sweden: Klarimax | Nasoferm | Otrivin | Teppix | Xylometazolin abece | Xylometazolin Apofri | Xylometazoline HCL | Zymelin;
-
(SG) Singapore: Otrivin;
-
(SI) Slovenia: Maresyl | Maresyl ha | Olynth | Olynth ha | Snup;
-
(SK) Slovakia: Nasenspray | Olynth | Orinox neo | Otrivin | Rinoxyl;
-
(SR) Suriname: Idyl kinder neusspray xylometazoline hcl | Idyl neusdruppels xylometazoline hcl | Idyl neusspray xylometazoline hcl | Kinderneusspray xylometazoline hcl sam | Neusspray Xylometazoline hcl sam | Otrivin | Xylometazoline | Xylometazoline HCL | Xylometazoline hcl apotex | Xylometazoline hcl mylan | Xylometazoline hcl sandoz | Xylometazoline hcl sanias;
-
(TH) Thailand: Actavia | Otrivine;
-
(TN) Tunisia: Decozal;
-
(TR) Turkey: Berkolin | Naze | Otrivine | Otrivine-Menthol | Rinizol | Sinotrin | Xylo comod;
-
(TW) Taiwan: Clomiton | Nasolin | Otrivin | Pen Ke Tong | Snup stada | Suzulex | Xyzoline;
-
(UA) Ukraine: Brizoline | Dlyanos | Dr.theiss nasal spray | Eucabal | Eucaphylipt xylo | Eucaspray | Eucazolin aqua | Evcaspray turbo | Farmazoline mint and eucalyptus | Galopril | Grippostad rhino | Halazolin | Meralys | Meralys advance | Multigrip nasal | Nazonol | Nazoxyl | Otrivin | Pharmazolin | Pharmazolin noviy | Rhinoxil | Rinazal | Rinomystin | Rinosan | Rinostop | Snup | Tyzine xylo | Xylo | Xylohexal | Xylometazolin | Xymelin;
-
(UG) Uganda: Bruzolin | Decozal | Ivynozvin A | Otrivin;
-
(UY) Uruguay: Otrivina | Sinutab;
-
(VN) Viet Nam: Elossy | Mucome | Syfazin | Thekati;
-
(ZA) South Africa: Nazovin | Otrivin | Sinutab nasal spray;
-
(ZM) Zambia: Biomist | Cirovin | Clarinez | Decon nasal drops | Ivynozvin A | Ivynozvin p | Otrivin | Sinutab | Xylone;
-
(ZW) Zimbabwe: Otrivin
