An Overview of Afrin Nasal Spray (Oxymetazoline)

Afrin is a brand name for the over-the-counter medication oxymetazoline. You can find Afrin at almost any grocery or drug store. Its main use is as a decongestant nasal spray. It is sprayed into the nostrils to relieve congestion and other nasal symptoms of the common cold and sinusitis. Many over-the-counter cold remedies, with brand names other than Afrin, also include oxymetazoline.

Man using nasal spray
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How It Works

Afrin causes the blood vessels lining your nasal passages to constrict (get smaller). Sometimes, and especially with excessive use of this drug, the blood vessels can swell after the effects of the medication wear off, causing even more congestion. It then becomes necessary for you to use the medication again to relieve these symptoms. This is called rebound congestion, or sometimes nasal spray addiction because it leads to a cycle where you have to keep using the medication or suffer more bothersome symptoms. To avoid rebound congestion you should never use Afrin or another medication containing oxymetazoline for more than 3 days in a row.

How to Use

Afrin is a liquid that comes in a plastic bottle with a special tip. Hold the bottle in an upright and inverted position, insert the tip into the nostril (so that only about 1/8 inch of the tip is inside the nose), squeeze the bottle to spray the liquid into the nose; take a deep breath as you do this. Afrin nasal spray is only intended for use in the nose and should never be ingested. You should follow the label directions precisely. Afrin nasal spray should not be used for more than three days at a time to avoid the development of a condition called rebound congestion (or rhinitis medicamentosa).

Who Should Not Take Afrin

Children under six years, women who are pregnant or nursing, and people who have had an allergic reaction to Afrin (oxymetazoline) shouldn't use it. This medication should be used with caution in individuals who have kidney or liver disease. It is recommended that individuals with diabetes, thyroid disease, heart problems, and a history of stroke or high blood pressure discuss the use of this medication with their healthcare provider. It is important to clear all medications with your practitioner and pharmacist to make sure that you are not taking a medicine that could result in an adverse reaction when used with Afrin.

Medication Interactions

Afrin should not be taken if you are currently on or have been on an MAOI inhibitor such as isocarboxazid, phenelzin, selegiline, Emsam, and tranylcypromine in the previous two weeks. Before you take Afrin, your healthcare provider and pharmacist should be aware of any other medications you are taking, (both prescription and over-the-counter, and including herbal supplements).

Side Effects

Side effects of Afrin vary but may include: burning or stinging in the nostrils, increased nasal discharge, dry nasal passageways, sneezing, nervousness, nausea, dizziness, headache, and sleeplessness. If these side effects are particularly severe or do not resolve, call your healthcare provider. The following side effects are serious and should be reported to a healthcare professional immediately: racing or pounding heartbeat, or slow heartbeat (less than 60 beats per minute for most people who are not athletic).

As with other medications, a serious allergic reaction (anaphylaxis) to Afrin is possible. If you have symptoms such as swelling of the face, lips, mouth or tongue, difficulty breathing, speaking or swallowing, or noisy breathing (called wheezing), you should call 911 or go to your nearest emergency room.

A Note About Nasal Spray Addiction

As briefly mentioned above, some people have reported an addiction to Afrin (oxymetazoline). This is most likely the result of rebound congestion. After Afrin wears off, your symptoms may become worse than they were before you used the nasal spray. Some people use the spray again, getting caught in a vicious circle that might be seen as an addiction. This is why it is recommended not to use Afrin for more than three days at a time.

Frequently Asked Questions

  • Is oxymetazoline nasal spray a steroid?

    No, Afrin (oxymetazoline) is a decongestant. It does not contain steroids. It constricts blood vessels in the nasal passages, relieving congestion and making it easier to breathe through your nose.

  • Why can you only use Afrin for three days?

    Afrin (oxymetazoline) can cause rebound congestion. The medication initially works by shrinking blood vessels to ease congestion, but the blood vessels can swell as it wears off. This leads to a cycle where you need to continue to take the medication in larger doses or experience even worse symptoms.

    To prevent rebound congestion and addiction, Afrin should not be used for more than three days in a row. 

  • What nasal spray can I use instead of Afrin?

    If you have nasal congestion, a saline nasal spray can help to relieve nasal congestion by helping to thin mucus. If nasal congestion is caused by allergies, a steroid nasal spray may help. Flonase (fluticasone), Nasacort (triamcinolone), and Rhinocort (budesonide) are steroid nasal spray sold over the counter.

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2 Sources
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  2. MedlinePlus, U.S. National Library of Medicine. Oxymetazoline nasal spray.