Cold & respiratory · Topical nasal decongestant (alpha-agonist)
Xylometazoline
Xylometazoline is a nasal spray used for short-term relief of nasal congestion during colds, allergies, or sinusitis.
OTCPregnancy: cautionKidney warningLiver warningAlcohol interactionPaediatric useSenior precautionOverview & typical uses
Xylometazoline is a nasal spray used for short-term relief of nasal congestion during colds, allergies, or sinusitis.
Primary uses
- Short-term relief of a blocked nose (colds, allergic rhinitis, sinusitis)
How it works
Narrows small blood vessels in the nasal lining, reducing swelling and making breathing through the nose easier.
Available forms & strengths
- Nasal spray — 0.05% (paediatric), 0.1% (adult) (Nasal)
- Nasal drops — 0.05%, 0.1% (Nasal)
General precautions & contraindications
Do not use if
- Very young children (unless directed)
- Recent trans-sphenoidal surgery
- Untreated narrow-angle glaucoma
Pregnancy
Use with caution — discuss with clinician. Occasional short-term use is usually acceptable; discuss with a clinician for regular use.
Breastfeeding
Use with caution — discuss with clinician. Very little of a topical dose reaches breast milk; short-term use is usually acceptable.
Kidney considerations
- No specific concern with short-term topical use.
Liver considerations
- No specific concern with short-term topical use.
Paediatric use
Use the paediatric strength; avoid in babies under 2 years unless directed.
Older adults
Extra caution with high blood pressure, heart disease, glaucoma, or prostate enlargement.
Common side effects
- Local nasal burning or dryness
- Sneezing after spraying
- Rebound congestion if used for more than about a week
Serious warnings — seek help if these appear
- Serious allergic reaction (very rare)
- Palpitations or raised blood pressure with excessive use
Drug interactions
Can raise blood pressure — avoid combination.
Additive effects and higher risk of side effects.
Food & alcohol precautions
No notable food interactions recorded.
Alcohol
- No significant interaction.
Storage, missed dose & overdose
Storage
Store below 25 °C, out of reach of children. Do not share nasal sprays.
If a dose is missed
Used as needed for congestion; do not exceed the number of days on the label.
Overdose
Systemic overdose can cause raised blood pressure, palpitations, headache. Seek medical help if in doubt.
What to monitor
- Do not use for more than 5 to 7 days in a row to avoid rebound congestion.
Frequently asked questions
Only for a few days at a time — regular long-term use can worsen congestion.
Medical references
- British National Formulary — Xylometazoline — BNF (NICE)
- WHO Model Formulary — World Health Organization
Content last reviewed: 2025-01-01
Medical disclaimer
This information is for educational purposes only and should not replace professional medical advice. Please consult a licensed pharmacist or clinician for advice tailored to your personal circumstances.