Xylometazoline for nasal congestion (Otrivine, Sudafed)

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There are two strengths of xylometazoline nose drops. There is an adult strength of 0.1%, and a child strength of 0.05% which is suitable for children aged 6 or over.

A nasal spray is available for adults and children over 12 years of age.

Do not use xylometazoline drops or spray for longer periods of time than is recommended on the label.

Type of medicineA nasal decongestant
Used forNasal congestion (a blocked nose)
Also calledOtrivine®; Sudafed®
Available asNose drops and nasal spray

A common symptom of a cold is a blocked (congested) nose. A stuffy, blocked-up feeling in your nose can also occur in the absence of a cold. This is because the inside lining of your nose is sensitive to changes in the atmosphere (such as temperature and humidity changes) and this also can lead to symptoms of nasal congestion.

You may find a hot steamy shower or a steam inhalation will help to clear a blocked nose but, where this does not provide sufficient relief, a decongestant such as xylometazoline may be useful. Xylometazoline causes the small blood vessels in your nose to become narrower. This reduces the thickness of the lining of your nose which is causing the congestion, and relieves the blocked-up feelings.

You can buy preparations containing xylometazoline from retail outlets, without a prescription. They should be used for short periods of time only. There is a nasal spray which is available for adults and children over 12 years of age. There are two strengths of xylometazoline nose drops available. The adult strength is 0.1%, which is suitable for adults and children over 12 years of age. The 0.05% strength drops are suitable for children aged 6-12 years. Children aged 6-12 years should not use xylometazoline for longer than five days at a time, but adults and children over 12 years of age can use it for up to seven days if needed. Xylometazoline must not be given to children under 6 years of age.

To make sure this is the right treatment for you, before you start using xylometazoline it is important that you speak with a doctor or pharmacist:

  • If you are pregnant or breast-feeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • If you have diabetes, high blood pressure, or heart disease.
  • If you have an overactive thyroid, or any problems with your prostate or kidneys.
  • If you have increased pressure in your eyes, a condition called glaucoma.
  • If you have ever had an allergic reaction to a medicine.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines. You must not use xylometazoline if you have taken a medicine for depression, known as a monoamine-oxidase inhibitor (MAOI) within the previous two weeks.

Recommended dose for adults and children over 12 years of age using 0.1% drops: use two or three drops into each nostril two or three times a day when required. Do not use the drops for periods of more than seven days. The drops are not suitable for children under 12 years of age.

Recommended dose for children over 6 years of age using 0.05% drops: use one or two drops into each nostril one or two times a day when required. Do not use the drops for periods of more than five days. The drops are not suitable for children under 6 years of age.

Recommended dose for adults and children over 12 years of age using nasal spray: use one spray into each nostril one to three times a day if needed. Do not use the spray for periods of more than seven days. The spray is not suitable for children under 12 years of age.

  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. This will give you a step-by-step guide of how to use the drops or spray, and will also provide you with a full list of the side-effects which you may experience.
  • Preparation containing xylometazoline should be used for short periods of time only. This is because the downside of using such preparations is that nasal congestion can often recur when you stop using them. This is called rebound congestion, and it can lead to cycles of further problems with congestion. Using the spray/drops for only a few days when necessary will help to prevent this from becoming a problem.
  • Nose drops and nasal sprays should only be used by one person. This is to avoid spreading infection from one person to another. Do not share the same bottle or spray with other people.
  • Nasal congestion can be eased by inhaling warm moist air. Many people find that having a hot shower is often the best way to relieve their symptoms.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Xylometazoline side-effects - these are generally mild and occur infrequentlyWhat can I do if I experience this?
Irritation in your nose such as burning, soreness, dryness, stinging, itching or sneezingThese should soon pass. If any become troublesome, ask your pharmacist for advice
Feeling sickAvoid rich or spicy foods
HeadacheAsk your pharmacist to recommend a suitable painkiller

If you experience any other symptoms which you think may be due to xylometazoline, speak with your pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • To avoid contamination, do not keep part-used bottles of nose drops or nasal sprays to use later. Throw away the container after each course of treatment.

Never use more than the recommended dose. If you suspect that someone has swallowed some of the medicine by accident, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are using.

If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • British National Formulary; 68th Edition (Sep 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr John Cox
Document ID:
1516 (v25)
Last Checked:
26/01/2015
Next Review:
25/01/2018
The Information Standard - certified member

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