Xylometazoline and oxymetazoline - unusual effects of everyday drugs (literature review)
DOI:
https://doi.org/10.12775/JEHS.2021.11.09.033Keywords
xylometazoline, oxymetazoline, rosacea, anesthesia dentalAbstract
The aim of the study is to systematize the knowledge about xylometazoline and oxymetazoline - commonly used nasal sprays with sympathicomimetic effect, mainly directly on α-adrenergic receptors [1]. A review of recent reports on possible side effects and new therapeutic options will be presented.
Results: Over several years, reports have been published regarding descriptions of unusual cases of side effects, such as angina attack [4], a case of respiratory failure in a newborn [5], ischemic stroke [6], or anaphylactic reaction during routine surgery.
In experiments using rats, on the other hand, it has been shown that these substances can also cause increased inflammation of the lower respiratory tract [7], as well as numerous ophthalmic problems [8].
Recent reports also suggest new uses for xylometazoline and oxymetazoline. In combination with lidocaine, an intranasal solution of xylometazoline has shown efficacy in the anesthesia of maxillary teeth in patients with minor carious lesions [9], and a beneficial therapeutic combination of oxymetazoline and dye laser (PDL) has also been reported for the treatment of rosacea, among others [10].
Conclusions: Although imidazoline derivatives were admitted to the drug list decades ago, still their pharmacological potential has not been fully exploited. Finding applications of these drugs in dermatology and dentistry may not only improve the efficacy and comfort of treatment, but also significantly reduce the costs of the whole therapy. The aforementioned reports on the side effects of xylometazoline and oxymetazoline should not be forgotten. It is possible that the presented examples will increase awareness to use these drugs with more respect, according to the recommendations on the leaflet.
References
Åkerlund A, Bende M. Sustained Use of Xylometazoline Nose Drops Aggravates Vasomotor Rhinitis. American Journal of Rhinology. 1991;5(4):157-160. doi:10.2500/105065891781874983
Dokuyucu R, Gokce H, Sahan M, Sefil F, Tas ZA, Tutuk O, Ozturk A, Tumer C, Cevik C. Systemic side effects of locally used oxymetazoline. Int J Clin Exp Med. 2015 Feb 15;8(2):2674-8. PMID: 25932218; PMCID: PMC4402865.
Wang RF, Lee PY, Taniguchi T, Becker B, Podos SM, Serle JB, Mittag TW. Effect of oxymetazoline on aqueous humor dynamics and ocular blood flow in monkeys and rabbits. Arch Ophthalmol. 1993 Apr;111(4):535-8. doi: 10.1001/archopht.1993.01090040127046. PMID: 8470989.
Duzman E, Anderson J, Vita JB, Lue JC, Chen CC, Leopold IH. Topically applied oxymetazoline. Ocular vasoconstrictive activity, pharmacokinetics, and metabolism. Arch Ophthalmol. 1983 Jul;101(7):1122-6. doi: 10.1001/archopht.1983.01040020124022. PMID: 6347152.
Doshi J. Rhinitis medicamentosa: what an otolaryngologist needs to know. Eur Arch Otorhinolaryngol. 2009 May;266(5):623-5. doi: 10.1007/s00405-008-0896-1. Epub 2008 Dec 19. PMID: 19096862
Bende M, Fukami M, Arfors KE, Mark J, Stierna P, Intaglietta M. Effect of oxymetazoline nose drops on acute sinusitis in the rabbit. Ann Otol Rhinol Laryngol. 1996 Mar;105(3):222-5. doi: 10.1177/000348949610500309. PMID: 8615587.
Umair Wahid, Farah Naz, Ather Akber et al. Efficacy Of Lidocaine And Xylometazoline Intranasal Spray In Anesthetizing Maxillary Teeth: An Open Label Randomized Controlled Trial, 17 February 2021, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-199947/v1]
Galui, S., Biswas, R., Pandey, N., Chatterjee, A. N., Saha, S., & Sarkar, S. (2020). A new horizon in needle-less anesthesia: Intranasal tetracaine/oxymetazoline spray for maxillary dental anesthesia - an overview. Journal of Oral Research and Review, 12(2), 101. https://doi.org/10.4103/jorr.jorr_33_19
Kakkar, S., & Sharma, P. K. (2017). Topical steroid-dependent face: Response to xylometazoline topical. Indian Journal of Drugs in Dermatology, 3(2), 87. https://doi.org/10.4103/ijdd.ijdd_6_16
Kelly A, Pai A, Lertsakdadet B, Choi B, Kelly KM. Microvascular Effects of Pulsed Dye Laser in Combination With Oxymetazoline. Lasers Surg Med. 2020 Jan;52(1):17-22. doi: 10.1002/lsm.23186. Epub 2019 Nov 22. PMID: 31758568; PMCID: PMC8059989.
Suggs AK, Macri A, Richmond H, Munavalli G, Friedman PM. Treatment of Erythematotelangiectatic Rosacea With Pulsed-Dye Laser and Oxymetazoline 1.0% Cream: A Retrospective Study. Lasers Surg Med. 2020 Jan;52(1):38-43. doi: 10.1002/lsm.23176. Epub 2019 Nov 10. PMID: 31709571.
Tanghetti EA, Goldberg DJ, Dover JS, Geronemus RG, Bai Z, Alvandi N, Shanler SD. Oxymetazoline and Energy-Based Therapy in Patients with Rosacea: Evaluation of the Safety and Tolerability in an Open-Label, Interventional Study. Lasers Surg Med. 2021 Jan;53(1):55-65. doi: 10.1002/lsm.23253. Epub 2020 May 6. PMID: 32378241; PMCID: PMC7891417.
Nagrani, Nicole K.; Gonzalez, Adrianna M.; Zito, Patrick M.; Glick, Brad P.; Rubenstein, Richard M. Topical Oxymetazoline (Rhofade) in Rosacea, Journal of the Dermatology Nurses’ Association: 9/10 2020 - Volume 12 - Issue 5 - p 243-245 doi: 10.1097/JDN.0000000000000564
Joshi KS, Ho VWQ, Smith ME, Tysome JR. The effect of topical xylometazoline on Eustachian tube function. J Laryngol Otol. 2020 Jan;134(1):29-33. doi: 10.1017/S0022215120000158. Epub 2020 Jan 22. PMID: 31964436.
Vasanthi HR, Mukherjee S, Das DK. Retraction Notice To: Potential Health Benefits of Broccoli- A Chemico-Biological Overview. Mini Rev Med Chem. 2009 Jun;9(6):749-59. doi: 10.2174/138955709788452685. PMID: 19519500.
Rajpal S, Morris LA, Akkus NI. Non-ST-elevation myocardial infarction with the use of oxymetazoline nasal spray. Rev Port Cardiol. 2014 Jan;33(1):51.e1-4. doi: 10.1016/j.repc.2013.07.011. Epub 2014 Jan 7. PMID: 24405558
Grimaldi-Bensouda L, Begaud B, Benichou J, Nordon C, Dialla O, Morisot N, Hamon Y, Cottin Y, Serrano E, Abenhaim L, Touzé E. Decongestant use and the risk of myocardial infarction and stroke: a case-crossover study. Sci Rep. 2021 Feb 18;11(1):4160. doi: 10.1038/s41598-021-83718-8. PMID: 33603081; PMCID: PMC7893034.
Patel J, Patel I, Desai D, Desai S. Ischemic Stroke Associated with Chronic Xylometazoline Nasal Spray Misuse: A Rare Avoidable Adverse Event. Ann Indian Acad Neurol. 2021 Mar-Apr;24(2):304-307. doi: 10.4103/aian.AIAN_291_20. Epub 2020 Jul 8. PMID: 34220102; PMCID: PMC8232514.
Shah, Siddharth MD; Patel, Kinner MD; Gambhir, Harvir S. MD Oxymetazoline-Induced Asthma, American Journal of Therapeutics: November/December 2018 - Volume 25 - Issue 6 - p e681-e682 doi: 10.1097/MJT.0000000000000628
Haldar R, Bajwa SS, Kaur J. Xylometazoline nasal drops induced anaphylaxis: An atypical perioperative complication. J Anaesthesiol Clin Pharmacol. 2017
Jul-Sep;33(3):399-401. doi: 10.4103/0970-9185.173331. PMID: 29109644; PMCID: PMC5672530.
Fabi, M., Formigari, R., & Picchio, F. M. (2009). Are nasal decongestants safer than rhinitis? A case of oxymetazoline-induced syncope. Cardiology in the Young, 19(6), 633–634. https://doi.org/10.1017/s1047951109990722
Gopalakrishnan S, Sodhi K. Recurrent Apnea in a Neonate Following Intranasal Oxymetazoline. Indian Pediatr. 2016 Apr;53(4):353. PMID: 27156558.
Arslan, S., Güney, G., Ünsal, A. I. A., Demir, E., & Demirci, B. (2019). Adverse effects of ingredients available in single nasal decongestant formulation at trachea and lungs on an experimental rat model. MEDICAL SCIENCE, 23(95), 138-145.
Unsal AIA, Basal Y, Birincioglu S, Kocaturk T, Cakmak H, Unsal A, Cakiroz G, Eliyatkın N, Yukselen O, Demirci B. Ophthalmic adverse effects of nasal decongestants on an experimental rat model. Arq Bras Oftalmol. 2018 Jan-Feb;81(1):53-58. doi: 10.5935/0004-2749.20180012. PMID: 29538595.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 © The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 4651
Number of citations: 0