Oxymetazoline

Pronunciation: ox-i-met-AZ-oh-leen.

Generic name
oxymetazoline hydrochloride
Drug class
Topical alpha-adrenergic agonist (imidazoline-class decongestant/vasoconstrictor)
Form
Nasal spray (0.025% or 0.05%); ophthalmic solution (0.1%, prescription-only Upneeq product)
Route
Intranasal (spray/drops) or ophthalmic (eye drops), depending on product
Legal status
Over-the-counter (nasal spray, most markets); prescription-only for the ophthalmic blepharoptosis product (Upneeq, United States)

Availability and supply rules vary by country

Trade names by country: United States · Canada

Australia: · Full directory

What oxymetazoline hydrochloride is and how it works

Oxymetazoline is a topical decongestant that narrows (constricts) blood vessels. As a nasal spray, it is used for short-term relief of nasal congestion from colds, hay fever, and upper respiratory allergies. As a separate prescription eye-drop product (Upneeq, 0.1%), it is used once daily to lift a droopy upper eyelid (acquired blepharoptosis) in adults, by stimulating a small muscle that helps hold the eyelid up. (1) (2)

The OTC nasal spray works quickly but is only intended for short-term use (no more than 3-7 days depending on the product and country) -- using it for longer can cause your congestion to come back worse than before (rebound congestion). It is also genuinely dangerous if swallowed by a young child, even in small amounts, and must be stored well out of reach. The prescription eye-drop product (Upneeq) is a different, more concentrated product for a different use and should never be substituted with the nasal spray.

Mechanism of action: how oxymetazoline hydrochloride works

Oxymetazoline is a direct-acting alpha-1 and partial alpha-2 adrenergic receptor agonist. In the nasal mucosa, this produces local vasoconstriction, reducing blood flow and tissue swelling to relieve congestion. In the eye, alpha-adrenergic stimulation of Muller's muscle (superior tarsal muscle) produces eyelid elevation, the mechanism exploited by the Upneeq ophthalmic product for acquired blepharoptosis. (1) (2) (3)

What oxymetazoline hydrochloride is used for

Nasal congestion (colds, hay fever, upper respiratory allergies)

Used for short-term relief of a stuffy, blocked nose and associated sinus pressure from the common cold, hay fever, or other upper respiratory allergies. Works within minutes and lasts up to 12 hours. (1) (4)

Acquired blepharoptosis (droopy upper eyelid) -- prescription ophthalmic product only

Upneeq (oxymetazoline hydrochloride ophthalmic solution 0.1%) is used once daily to temporarily lift the upper eyelid in adults with acquired blepharoptosis, by contracting a small muscle (Muller's muscle) that helps support the eyelid. (2)

Before taking oxymetazoline hydrochloride

Do not take / not appropriate for

  • Do not use the nasal spray if you have a known allergy to oxymetazoline or any ingredient in the product. (all countries) (4)
  • Do not use the nasal spray if you have phaeochromocytoma (a rare adrenal gland tumour), angle-closure glaucoma, or have had recent nasal or sinus surgery. (United Kingdom (and consistent with general product labelling elsewhere)) (4)
  • Do not use the nasal spray together with another nasal decongestant product, or if you have damaged nasal lining or atrophic rhinitis. (United Kingdom (and consistent with general product labelling elsewhere)) (4)
  • Do not use the nasal spray if you are currently taking, or have taken within the last 2 weeks, a monoamine oxidase inhibitor (MAOI) medicine. (all countries) (4)
  • Do not use the nasal spray in children under 12 years old unless directed by a doctor (under-6s: ask a doctor first in the US label; under-12 contraindicated in the UK PIL). (market-dependent -- see labelling) (1) (4)

Tell your clinician about

  • Heart disease, high blood pressure, or a history of stroke.
  • Diabetes or thyroid disease (including hyperthyroidism).
  • Difficulty urinating due to an enlarged prostate.
  • Kidney or liver problems, or if you are elderly.
  • Whether you take a tricyclic antidepressant or an MAOI.
  • Whether you are pregnant or breastfeeding.
(1) (4)

How to take oxymetazoline hydrochloride

  • Nasal spray: 2-3 sprays in each nostril, not more often than every 10-12 hours, with no more than 2 doses in any 24-hour period (US labelling for ages 6 and over).
  • Do not use the nasal spray for more than 3 days in a row (US labelling) to 5-7 days (UK MHRA-mandated limit) -- using it for longer can make your congestion worse (rebound congestion) rather than better.
  • Do not tilt your head backward while spraying; wipe the nozzle clean after each use and avoid sharing your bottle with others (to avoid spreading infection).
  • Upneeq (prescription ophthalmic product only): 1 drop in the affected eye(s) once daily, exactly as your prescriber directs -- never substitute the nasal spray for this product or vice versa.
(1) (4)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Missed dose

The nasal spray is used as needed for symptom relief, not on a strict schedule -- if you miss a planned dose, simply use it when next needed, without exceeding the maximum sprays/doses per day. For the prescription Upneeq eye drop, contact your prescriber for guidance on a missed daily dose rather than doubling up.

Overdose

If swallowed, especially by a child, get medical help or contact a Poison Control Center right away, even if the amount seems small -- as little as 1.0-2.5 mL of the nasal spray has caused serious effects (slow heartbeat, low blood pressure, slowed breathing, extreme sleepiness, low body temperature, or coma) in young children in reported cases. Do not wait for symptoms to appear before seeking help. (1) (3)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Temporary burning, stinging, dryness, or sneezing in the nose after using the spray.

What to notice: Temporary burning, stinging, dryness, or sneezing in the nose after using the spray.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (4)

Increased nasal discharge.

What to notice: Increased nasal discharge.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

With the eye-drop product (Upneeq): eye redness, dry eyes, blurred vision, or eye irritation at the instillation site.

What to notice: With the eye-drop product (Upneeq): eye redness, dry eyes, blurred vision, or eye irritation at the instillation site.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Serious warnings

Signs of accidental overdose or ingestion, especially in a young child — emergency

Symptoms: Unusual sleepiness or difficulty waking, slow or shallow breathing, a very slow heartbeat, low body temperature (feeling unusually cold or clammy), pale or bluish skin, or unresponsiveness.

Action: Get emergency medical help immediately or contact a Poison Control Center -- this is a real, reported, sometimes life-threatening risk in young children even from small amounts (as little as 1.0-2.5 mL of the nasal spray), not a routine or generic warning. (1) (3)

Worsening congestion after several days of use (rebound congestion / rhinitis medicamentosa) — high caution

Symptoms: Nasal congestion that returns or gets worse the more you use the spray, beyond the labelled maximum number of days.

Action: ask the prescriber about stopping $1 spray and speak with a pharmacist or doctor if congestion persists beyond the labelled duration (3 days in the US label; up to 7 days under UK guidance) -- continuing to use it can make the underlying problem worse and, with prolonged overuse, cause lasting damage to the nasal lining. (1) (5) (4)

Signs of a serious allergic reaction — emergency

Symptoms: Swelling of the nose, lips, tongue, or throat; difficulty breathing; widespread rash or hives.

Action: Seek emergency medical help immediately and ask the prescriber about stopping $1 product. (4)

New anxiety, confusion, restlessness, hallucinations, or sleep disturbance during use — high caution

Symptoms: Unusual anxiety, confusion, restlessness, hallucinations, or difficulty sleeping while using the nasal spray, particularly with prolonged or excessive use.

Action: Contact a doctor promptly and follow their advice about whether to continue or stop the product -- these symptoms can reflect systemic absorption/cardiovascular-nervous-system effects beyond the intended local nasal effect. (4)

Interactions

  • Monoamine oxidase inhibitors (MAOIs), including within 2 weeks of stopping one -- combining with oxymetazoline can cause a dangerous rise in blood pressure and must be avoided. (4)
  • Tricyclic antidepressants may need caution alongside oxymetazoline -- discuss with your doctor or pharmacist before combining. (4)
  • Using more than one nasal decongestant product at the same time is not recommended and increases the risk of side effects. (4)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Consult a health professional before using the nasal spray during pregnancy; specific pregnancy safety data for the Upneeq eye-drop product should also be discussed with a prescriber before use. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Children

Nasal spray: not for children under 6 years without a doctor's advice in the US; contraindicated under 12 years in the UK. Genuine, serious accidental-ingestion toxicity risk applies specifically to young children -- store out of reach and out of sight at all times. Upneeq (eye drops) is approved for adults only. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Elderly

Use the nasal spray with caution and discuss with a doctor first, given a higher likelihood of contraindicated conditions (heart disease, high blood pressure, prostate enlargement) in this age group. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Monitoring

Before starting

  • Review of cardiovascular history (heart disease, high blood pressure), thyroid disease, diabetes, and prostate symptoms before regular OTC use.
  • For Upneeq: baseline eyelid position/visual field assessment by the prescribing clinician.

During treatment

  • Self-monitor for rebound congestion or worsening symptoms beyond the labelled maximum duration of use.
  • Self-monitor for any cardiovascular or CNS symptoms (palpitations, raised blood pressure, anxiety, confusion, sleep disturbance) during prolonged or excessive use.
(4) (2)

Storage

Store at room temperature, out of reach and out of sight of children at all times -- this is a genuine, serious precaution given real reports of severe toxicity from accidental child ingestion, not a routine formality. Do not use after the expiry date on the packaging.

Professional information

Clinician-facing context only, sourced from current US DailyMed labels (Afrin OTC monograph label; Upneeq full prescribing information) and the UK EMC PIL/MHRA drug safety update; verify against the current full label before advising a patient.

United States

Indication: OTC nasal decongestant

Dose summary: 0.05% spray, 2-3 sprays per nostril every 10-12 hours, max 2 doses/24h, ages 6+; not for use beyond 3 consecutive days per the OTC monograph label.

Renal context: No specific renal dose adjustment described in the OTC monograph label; caution advised generally in patients with significant comorbidity. (1)

United States

Indication: Acquired blepharoptosis (Upneeq)

Dose summary: 0.1% ophthalmic solution, 1 drop in the affected eye(s) once daily.

Renal context: Not specifically addressed in the prescribing information reviewed. (2)

United Kingdom

Indication: OTC nasal decongestant

Dose summary: 0.05% spray, 2 sprays per nostril up to twice daily or at bedtime, ages 12+; MHRA-mandated maximum continuous use of 5-7 days (product-dependent) due to rebound-congestion risk.

Renal context: Caution advised in renal/hepatic impairment per the PIL; specific dose adjustment not described. (4) (5)

Mechanism of action

Hepatic guidance

No specific hepatic dose adjustment identified in the sources reviewed; general caution advised in hepatic impairment per the UK PIL.

Overdose note

No specific antidote; overdose/accidental ingestion (particularly in children) is managed with supportive care -- cardiovascular and respiratory monitoring, and treatment of bradycardia/hypotension/CNS depression as needed. Genuine case reports of hospitalisation from small-volume paediatric ingestion exist; treat any suspected paediatric ingestion as a medical emergency. (1) (2) (3)

Frequently asked questions

Is oxymetazoline nasal spray available without a prescription?

Yes, the standard nasal decongestant spray (0.025-0.05%) is sold over-the-counter in the United States, United Kingdom, European Union, and Canada. The separate 0.1% ophthalmic solution (Upneeq), used for a droopy eyelid, is prescription-only in the United States. (1) (2) (4) (7)

Why can't I use oxymetazoline nasal spray for more than a few days?

Using it for longer than the labelled maximum (3 days in the US, up to 7 days in the UK) can cause rebound congestion (rhinitis medicamentosa) -- your nose becomes congested again, sometimes worse than before, and with prolonged overuse the nasal lining itself can be damaged. This is a real, regulator-documented risk, confirmed by a UK MHRA drug safety update. (1) (5)

Is it dangerous if a child accidentally swallows oxymetazoline nasal spray?

Yes -- this is a genuine, serious risk, not a routine precaution. Reported cases in young children include a slowed heartbeat, low blood pressure, slowed breathing, low body temperature, extreme sleepiness, and coma, in some cases from as little as 1.0-2.5 mL of the spray. Seek emergency medical help or contact a Poison Control Center immediately if this happens, even if the child seems fine at first. (3) (1)

What is the mechanism of action of oxymetazoline hydrochloride?

Oxymetazoline is a direct-acting alpha-1 and partial alpha-2 adrenergic receptor agonist. In the nasal mucosa, this produces local vasoconstriction, reducing blood flow and tissue swelling to relieve congestion. In the eye, alpha-adrenergic stimulation of Muller's muscle (superior tarsal muscle) produces eyelid elevation, the mechanism exploited by the Upneeq ophthalmic product for acquired blepharoptosis. (1) (2) (3)

What is the generic name of Oxymetazoline?

The generic name is oxymetazoline hydrochloride. (1) (2)

What class of drug is oxymetazoline hydrochloride?

Oxymetazoline is classed as: Topical alpha-adrenergic agonist (imidazoline-class decongestant/vasoconstrictor). (1) (2)

References

  1. AFRIN ORIGINAL - oxymetazoline hydrochloride 0.05% nasal spray -- Drug Facts labelDailyMed (U.S. National Library of Medicine) -- OTC Drug Facts label · United States · accessed 2026-07-30 · source 1
  2. UPNEEQ - oxymetazoline hydrochloride 0.1% ophthalmic solution -- full prescribing informationDailyMed (U.S. National Library of Medicine) -- FDA prescribing information · United States · accessed 2026-07-30 · source 2
  3. Topical Nasal Decongestant Oxymetazoline: Safety Considerations for Perioperative Pediatric UseAmerican Academy of Pediatrics, Pediatrics journal -- peer-reviewed safety review citing FDA case data · United States · accessed 2026-07-30 · source 3
  4. Boots Decongestant 0.05% w/v Nasal Spray -- Patient Information Leafletelectronic medicines compendium (emc), United Kingdom -- Patient Information Leaflet · United Kingdom · accessed 2026-07-30 · source 4
  5. Nasal decongestant sprays and drops containing xylometazoline hydrochloride/oxymetazoline hydrochloride: increased risk of rebound congestion, rhinitis medicamentosa, and tachyphylaxis with overuseMedicines and Healthcare products Regulatory Agency (MHRA), United Kingdom -- Drug Safety Update · United Kingdom · accessed 2026-07-30 · source 5
  6. Oxymetazoline: list of nationally authorised medicinal products (PSUSA/00002258/202008)European Medicines Agency (EMA) -- PSUSA (Periodic Safety Update Single Assessment) nationally-authorised product list · European Union · accessed 2026-07-30 · source 6
  7. Drixoral Decongestant Nasal Spray -- Health Canada Drug Product Database listingHealth Canada -- Drug Product Database (DPD) · Canada · accessed 2026-07-30 · source 7
  8. Nasal Decongestant (Pharmacy Action) -- oxymetazoline hydrochloride 0.5 mg/mL spray solution, product/scheduling pagehealthdirect Australia (Australian Government-funded consumer medicines service) -- product information page · Australia · accessed 2026-07-30 · source 8
  9. Drixine No Drip Original Nasal Spray -- oxymetazoline hydrochloride 500 mcg/mL (0.05%), New Zealand marketNew Zealand retail pharmacy listings (Kiwi Pharmacy, Chemist Warehouse NZ) -- product identification only, not an official regulator source · New Zealand · accessed 2026-07-30 · source 9
  10. Database of Medicine Classifications -- general framework pageMedsafe (New Zealand Medicines and Medical Devices Safety Authority) -- medicine classification framework · New Zealand · accessed 2026-07-30 · source 10

Brand names by country

Single-ingredient oxymetazoline hydrochloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Afrin.05 g00mL, .5 g00mL · jc world bell wholesale co., inc.
  • No Drip Nasal Mist50 mg/mL, .05 g00mL, 50 mg00mL · walgreens company
  • Major Nasal Decongestant.5 mg/mL · major pharmaceuticals
  • Oxymethazoline HCL.05 mg · reliable 1 laboratories
  • nasal decongestant.05 g00mL · a-s medication solutions
  • Rhofade10 mg/g, 1 g00g · mayne pharma
  • 12 Hour Original Nasal Decongestant50 mg00mL · winco foods llc
  • Best Choice.05 g00mL · best choice (valu merchandisers company)
  • signature care nasal decongestant.05 g00mL · safeway
  • Discount Drug Mart Severe Nasal.05 g00mL · discount drug mart

Canada

  • LONG LASTING NASAL MIST
  • SINUFRIN
  • DECONGESTANT NASAL MIST LONG LASTING
  • DRIXORAL DECONGESTANT
  • LONG LASTING DRISTAN NASAL MIST
  • LONG LASTING DRISTAN MENTHOLATED
  • VICKS SINEX DECONGESTANT
  • CLARITIN ALLERGY DECONGESTANT
  • DRIXORAL NO DRIP EXTRA MOISTURIZING
  • DRIXORAL NO DRIP ORIGINAL UNSCENTED
View brands in additional countries.

This page provides general reference information about oxymetazoline and is not a substitute for advice from a pharmacist or doctor. Always follow the specific product's labelled directions and duration limit, and seek emergency help immediately for any suspected accidental ingestion by a child.

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