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Xylometazoline for nasal congestion

Otrivine, Sudafed

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 years or over.

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

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

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About xylometazoline

Type of medicine

A nasal decongestant

Used for

Nasal congestion (a blocked nose)

Also called

Otrivine®; Sudafed®

Available as

Nose 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 feeling.

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 for 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 for 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.

Before using xylometazoline

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 breastfeeding. 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 gland, or any problems with your prostate gland or kidneys.

  • If you have increased pressure in your eyes, a condition called glaucoma.

  • If you have been told you have a tumour on your adrenal gland, called phaeochromocytoma.

  • 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, as well as herbal and complementary medicines. You must not use xylometazoline if you have taken a medicine known as a monoamine-oxidase inhibitor (MAOI), within the previous two weeks.

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Recommended dose for adults and for 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 for 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.

Getting the most from your treatment

  • 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.

  • Preparations 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.

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Can xylometazoline cause problems?

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 infrequently

What can I do if I experience this?

Irritation in your nose such as burning, soreness, dryness, stinging, itching or sneezing

These should soon pass. If any become troublesome, ask your pharmacist for advice

Feeling sick (nausea)

Avoid rich or spicy foods


Drink plenty of water. If the headaches continue, stop using the product and ask your pharmacist for advice on other treatments

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

How to store xylometazoline

  • 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.

Important information about all medicines

Important information about all medicines

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.

MHRA - Reporting adverse reactions

Report suspected side effects to medicines, vaccines, e-cigarettes, medical device incidents, defective or falsified (fake) products to the Medicines and Healthcare products Regulatory Agency to ensure safe and effective use.

Further reading and references

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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