Last update Aug. 23, 2021

Oxymetazoline Hydrochloride

Low Risk

Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

Sympathomimetic with alpha adrenergic activity. It has a vasoconstrictor effect that reduces edema and congestion of the mucous membranes.
Topical nasal spray (2 times a day) or ophthalmic (3 - 4 times a day).
It is also used in facial cream to treat rosacea (Kuang 2018) and, mixed with local anesthetics, in dental anesthesia.

At the date of the last update, no published data was available in relation to breastfeeding.

The small dose and poor plasma absorption of most topical nasal, dermal, or ophthalmic preparations make it unlikely that a significant amount will pass into breast milk.

Measured plasma concentrations of oxymetazoline are low and its systemic effects are not clinically significant at the usual doses (Cartabuke 2019, Kuang 2018, Cacek 2017, Giannakopoulos 2012), so significant concentrations in milk are not to be expected.

Do not exceed the recommended dose and time to avoid undesirable side effects and the possible decrease in breast milk alluded to by some authors (Nice 2000), but not proven in practice.

Expert authors consider the use of this medication safe and probably compatible during breastfeeding (Hale 2019, Briggs 2017, Anderson 2000).

Ophthalmic administration is fully compatible with breastfeeding. Absorption can be minimized by pressing the tear duct (inner corner of the eye) with a finger for 1 minute.

Some authors consider oral and nasal decongestant drugs dispensable drugs, to be avoided in general, not only during lactation, since they expose patients to serious risks (cardiovascular, neurological and intestinal) to treat a benign disorder such as nasal obstruction, which usually progresses favorably within a few days without medication (Prescrire 2018).

A mother reported us irritability and insomnia for about 6 hours in her 7-month-old infant when she took oxymetazoline.

Alternatives

  • Azelastine (Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Budesonide inhaled ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Fluticasone ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Mometasone Furoate ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Sodium Chloride ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Sodium Cromoglicate ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Oxymetazoline Hydrochloride is also known as


Oxymetazoline Hydrochloride in other languages or writings:

Pharmacokinetics

Variable Value Unit
Molecular weight 297 daltons
Protein Binding 57 %
pKa 10,9 -
Tmax 0,1 - 0,2 hours
T1/2 5,2 hours

References

  1. Cartabuke RS, Anderson BJ, Elmaraghy C, Rice J, Tumin D, Tobias JD. Hemodynamic and pharmacokinetic analysis of oxymetazoline use during nasal surgery in children. Laryngoscope. 2019 Feb 20. Abstract
  2. Redaction Prescrire. Pour mieux soigner, des médicaments à écarter : bilan 2018. Prescrire.org. 2018 Full text (link to original source) Full text (in our servers)
  3. Kuang AW, DuBois J, Attar M, Ahluwalia G. Clinical Pharmacokinetics of Oxymetazoline Cream Following Topical Facial Administration for the Treatment of Erythema Associated With Rosacea. J Drugs Dermatol. 2018 Feb 1;17(2):213-220. Abstract
  4. Cacek AT, Gobburu JV, Gopalakrishnan M. Population Pharmacokinetics of an Intranasally Administered Combination of Oxymetazoline and Tetracaine in Healthy Volunteers. J Clin Pharmacol. 2017 Feb;57(2):247-254. Abstract
  5. Allergan. Oximetazoline Cream (Rhode). Drug Summary. 2017 Full text (in our servers)
  6. FDA. Tetracaine and Oxymetazoline Drug Summary. 2016 Full text (in our servers)
  7. Giannakopoulos H, Levin LM, Chou JC, Cacek AT, Hutcheson M, Secreto SA, Moore PA, Hersh EV. The cardiovascular effects and pharmacokinetics of intranasal tetracaine plus oxymetazoline: preliminary findings. J Am Dent Assoc. 2012 Aug;143(8):872-80. Abstract
  8. Pharmex. Oximetazolina. Ficha técnica. 2009 Full text (in our servers)
  9. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000 Nov;16(4):319-31. Review. Erratum in: J Hum Lact 2001 Feb;17(1):90. Abstract
  10. Anderson PO. Decongestants and milk production. J Hum Lact. 2000 Abstract

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