Dihydroergotamine
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
Oxymetazoline
Topical alpha-adrenergic agonist (imidazoline) decongestant · Nasal decongestant; Ophthalmic decongestant
Also known as Oxymetazoline HCl, Afrin, Dristan, Vicks Sinex, Zicam Nasal Swabs
START
Nasal 0.05% 2–3 sprays/nostril q10–12 h; rosacea 1% cream once daily
TYPICAL MAX
Nasal use ≤3 consecutive days (rebound risk)
STOP IF
Worsening rebound congestion, systemic sympathomimetic symptoms
WATCH
Duration of nasal use (≤3 days), BP in cardiac patients, paediatric accidental ingestion
CDSCO approvedOTCATC R01AA05
KDIGO 2024 + manufacturer label
- ONSET
- 9min · decongestion onset
- PEAK
- 1h · peak effect
- t½
- 6h · systemic t½
- DURATION
- 12h · decongestant effect
EXCRETION
Minimal systemic; renal/faecal small fraction
route + CYP
INTERACTIONS
6 major
SEVERE in our sources
PREGNANCY
Short topical use generally low risk; prefer non-pharmacologic; use only if needed
FDA category + note
Top interactionssee all 12 →
- DihydroergotamineSevereDatabaseDDInter
- ErgometrineSevereDatabaseDDInter
- Ergotamine TartrateSevereDatabaseDDInter
- MethylergometrineSevereDatabaseDDInter
Available in India
45 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Direct alpha-1 (and alpha-2) adrenoceptor agonism on nasal/conjunctival vasculature causing vasoconstriction, reduced mucosal blood flow and decongestion; topical formulations also for rosacea facial erythema and ocular redness.
Indications
Nasal congestion (short-term symptomatic)Persistent facial erythema of rosacea (topical cream)Ocular redness (low-concentration drops); acquired blepharoptosis (0.1% drops)
Dosing
- Adult
- Nasal 0.05% : 2–3 sprays per nostril every 10–12 h, MAX 3 consecutive days (rebound congestion). Rosacea 1% cream: thin layer once daily. Ophthalmic per product.
- Pediatric
- ≥6 years nasal 0.05% per product; avoid <6 years (systemic toxicity).
- Renal adjustment
- Not applicable (topical, minimal absorption).
- Hepatic adjustment
- Not applicable.
- Geriatric
- Caution with cardiovascular disease.
- Max dose
- Nasal: ≤3 days; do not exceed labelled sprays/12 h
Pharmacokinetics
Onset
Nasal decongestion within ~5–10 min
Peak effect
~1 h
Duration
Up to ~12 h
Half-life
Systemic ~5–8 h (minimal absorption)
Bioavailability
Low systemic (topical)
Protein binding
Not characterised (low systemic relevance)
Metabolism
Minimal
Excretion
Renal and faecal (small systemic fraction)
Contraindications
- Hypersensitivity to oxymetazoline
- Caution: severe cardiovascular disease, uncontrolled hypertension, MAOI use, narrow-angle glaucoma
Side effects
Common
Nasal dryness/burning/stingingSneezingRebound congestion (rhinitis medicamentosa) with >3 days useApplication-site irritation (cream)
Serious
- Systemic sympathomimetic effects in overdose/paediatric ingestion (bradycardia, hypotension, CNS depression)
- Hypertensive reaction with MAOIs
- Rhinitis medicamentosa (chronic misuse)
Pregnancy & lactation
Pregnancy
Short topical use generally low risk; prefer non-pharmacologic; use only if needed
Lactation
Topical use — minimal systemic exposure; considered low risk
Drug interactions
Ergometrine
Severe
Database
Clinical effect not specified
Source: DDInter
Ergotamine Tartrate
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Methylergometrine
Severe
Database
Clinical effect not specified
Source: DDInter
Methysergide
Severe
Database
Clinical effect not specified
Source: DDInter
Maois
Severe
Database
Potentiated pressor response → hypertensive reaction
Avoid during/within 14 days of MAOI
Source: Kimi deep-research + Cla
Moclobemide
Moderate
Textbook
Systemic effects including rise in BP.
These drugs should be used cautiously in those receiving MAO inhibitors.
Source: KDT 7e · p136
Isocarboxazid
Moderate
Database
Systemic effects including rise in BP.
These drugs should be used cautiously in those receiving MAO inhibitors.
Source: DDInter
Beta Blockers
Moderate
Database
Unopposed alpha → hypertensive response (overdose/systemic)
Caution; monitor BP
Source: Kimi deep-research + Cla
Other Sympathomimetics
Moderate
Database
Additive cardiovascular stimulation
Avoid combination
Source: Kimi deep-research + Cla
Phenelzine
Moderate
Database
Systemic effects including rise in BP.
These drugs should be used cautiously in those receiving MAO inhibitors.
Source: DDInter
Phenylephrine
Moderate
Database
Additive vasoconstriction, hypertension
Avoid combining decongestants.
Related guidelines
Ask House about Oxymetazoline
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19