Classes
DEA Class; Rx
Common Brand Names;
Ophthalmic: Upneeq
Intranasal OTC: Afrin, Duramist Plus, Dristan 12 Hr, Cheracol Nasal, Duration, Genasal, QlearQuil 12 Hour Nasal Decongestant Moisturizing Spray, Sinarest 12 Hour, Vicks Sinex 12 Hour
Topical: Rhofade
- Alpha Agonists, Ophthalmic
- Decongestants, Intranasal
- Alpha Agonists, Topical
Description
Intravenous catecholamine
Used for restoration of blood pressure in patients with acute hypotensive states
Potent alpha-adrenergic receptor agonist with modest beta-agonist activity
Indications
Indicated for acquired blepharoptosis in adults
Indicated for temporary relief of nasal congestion
Indicated for the topical treatment of persistent facial erythema associated with rosacea in adults
Contraindications
Hypersensitivity
Adverse Effects
- Punctate keratitis (1-5%)
- Conjunctival hyperemia (1-5%)
- Dry eye (1-5%)
- Blurred vision (1-5%)
- Instillation site pain (1-5%)
- Eye irritation (1-5%)
- Headache (1-5%)
- Insomnia
- Headache
- Burning
- Stinging
- Dryness
- Sneezing
- Rebound congestion
Topical
- Application-site dermatitis (2%)
- Worsening inflammatory lesions of rosacea (1%)
- Application-site pruritus (1%)
- Application-site erythema (1%)
- Application-site pain (1%)
Warnings
Alpha-adrenergic agonists may impact blood pressure; caution with severe or unstable cardiovascular disease, orthostatic hypotension, and uncontrolled hypertension or hypotension
Caution with cerebral insufficiency, coronary insufficiency, or Sjögren syndrome
May increase risk of angle-closure glaucoma in patients with untreated narrow-angle glaucoma
Advise patients to seek medical care if signs and symptoms of cardiovascular disease, vascular insufficiency, or acute angle-closure glaucoma develop
Ptosis may be associated with neurologic or orbital diseases such as stroke and/or cerebral aneurysm, Horner syndrome, myasthenia gravis, external ophthalmoplegia, orbital infection and orbital masses; give consideration to these conditions in the presence of ptosis with decreased levator muscle function and/or other neurologic signs
Pregnancy and Lactation
Ophthalmic
Data are not available regarding use during pregnancy to inform a drug-associated risk for major birth defects and miscarriage
Data are unavailable to assess effects on breastmilk quantity or production, or to establish the level of oxymetazoline present in human breastmilk
Intranasal OTC
Pregnancy category: C
Lactation: Not known if excreted in breast milk
Topical
No available data on oxymetazoline topical use in pregnant women to inform a drug-associated risk for major birth defects and miscarriage
Unknown if distributed in human breast milk
Maximum Dosage
8 drops/eye/day of the 0.025% ophthalmic solution; 1 drop/eye/day of the 0.1% ophthalmic solution; 6 sprays/nostril/day of the nasal spray; 1 topical application/day of the cream.
8 drops/eye/day of the 0.025% ophthalmic solution; 1 drop/eye/day of the 0.1% ophthalmic solution; 6 sprays/nostril/day of the nasal spray; 1 topical application/day of the cream.
8 drops/eye/day of the 0.025% ophthalmic solution; 6 sprays/nostril/day of the nasal spray; safety and efficacy have not been established for the 0.1% ophthalmic solution or the topical cream.
6 to 12 years: 8 drops/eye/day of the 0.025% ophthalmic solution; 6 sprays/nostril/day of the nasal spray; safety and efficacy have not been established for the 0.1% ophthalmic solution or the topical cream.
1 to 5 years: Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Norepinephrine bitartrate
ophthalmic solution
- 0.1% (as HCl salt [0.09% as base])
Intranasal solution
- 0.05%
topical cream
- 1% (available in a tube or pump bottle)
- Each gram of cream contains 10 mg (1%) oxymetazoline hydrochloride, which is equivalent to 8.8 mg (0.88%) of oxymetazoline free base
