Drug Safety Update: Nasal decongestant sprays and drops

There have been reports of worsening nasal congestion (rebound congestion) when the effects of nasal decongestant sprays or drops containing xylometazoline hydrochloride and oxymetazoline hydrochloride, referred to hereafter as ‘xylometazoline’ and ‘oxymetazoline’, wear off. This typically occurs when these medicines are used for longer than recommended. Continued use can also lead to more serious and longer-lasting changes to the lining and structures of the nose (rhinitis medicamentosa). In addition, repeated use will result in a rapid and noticeable reduction in the medicine’s effectiveness (tachyphylaxis).

Advice for Patients

• Nasal sprays and drops containing xylometazoline and oxymetazoline are used to help clear a blocked nose, caused by cold, flu and allergies
• You can buy these medicines in shops and pharmacies without needing a prescription
• Only use these medicines for a short time and to help with your symptoms. You should follow the instructions for use in the Patient Information Leaflet and package labelling which comes with the medicine and to not exceed the daily recommended dose and to take note of the minimum time interval between doses
• Do not use these medicines for more than 5 consecutive days
• If you use these medicines for longer than the recommended duration, your nose may become blocked again, and you may get other problems such as runny nose, sneezing, itching and irritation on the inside of the nose or your body can stop responding to the medicine
• These side effects may make you feel like you need to keep using the medication to manage your symptoms – talk to a healthcare professional if you are having trouble stopping the medication, or are using for longer or more than recommended
• Contact your doctor if your symptoms worsen or you do not feel better after 5 days, as you may need a different treatment
• Do not use xylometazoline or oxymetazoline together or with other oral and nasal forms of medicines used to treat a blocked nose, such as pseudoephedrine,
  phenylephrine or ephedrine
• It is important to read the Patient Information Leaflet that comes with your medicine and information on the outer packaging and to talk to a healthcare professional if you experience side effects
• Report suspected side effects associated with xylometazoline and oxymetazoline on a Yellow Card