An Overview of Afrin Nasal Spray (Oxymetazoline)

Afrin is a brand name for an over-the-counter decongestant nasal spray containing the active ingredient oxymetazoline. It is used for the temporary relief of nasal congestion ("stuffy nose") caused by conditions like the common cold, sinusitis, hay fever, and allergies. It can also be used to stop nosebleeds.

You can find Afrin at almost any grocery store or pharmacy, and there are other nasal spray brands that also contain oxymetazoline. These include Mucinex nasal spray and Vicks sinus nasal spray.

Despite its effectiveness, Afrin can cause side effects, including dizziness and rapid heartbeat, and it may not be appropriate for everyone.

This article explains how Afrin nasal spray works, how it is used, and possible side effects and drug interactions that may limit its use in some people.

How Afrin Works

Nasal congestion is primarily caused by mucosal inflammation. This is when mucus-secreting surface tissues surface and underlying soft tissues within the nasal passages swell in response to upper respiratory infections (like the common cold) or allergies (like hay fever).

The inflammation itself is caused when tiny blood vessels within mucosal tissues dilate (widen) to make way for larger disease-fighting immune cells. The dilation, in turn, causes fluids to leak out of the walls of the blood vessels, resulting in the rapid swelling of these tissues.

When the sinuses and nasal passages are affected, this can lead to nasal congestion and increased mucus secretion ("runny nose"). Itchiness and sneezing are also common.

Because of its vasoconstrictive effects, Afrin can also be used to help stop nosebleeds (also known as epistaxis).

How to Use Afrin Nasal Decongestant

Afrin is available in two different delivery systems: a traditional squeeze bottle or a "no-drip" nasal pump.

Afrin Spray Bottle

This product is familiar to most people. It involves a flexible plastic bottle with a nasal tip that delivers a spray of medicine whenever you squeeze the sides of the bottle.

To use an Afrin squeeze bottle:

1. Remove the twist cap.
2. If you've used the bottle before, wipe the nasal tip with a tissue.
3. Place the nasal tip in your nostril. Do not tilt your head back.
4. Squeeze the bottle quickly and firmly, squeezing two to three times in each nostril.
5. Wipe the nasal tip with a tissue, and replace the cap.

Afrin No-Drip Nasal Pump

This version delivers a metered dose of oxymetazoline in a fine mist. The bottle is firm and topped with a spring-loaded trigger pump that you place in your nostril.

To use the Afrin nasal pump:

1. Shake the bottle before use.
2. Remove the cap.
3. If you've used the bottle before, wipe the nasal tip with a tissue.
4. Holding the bottle horizontally, place your thumb under the base of the bottle and your index finger and middle finger on either side of the spring-load trigger.
5. Prime the pump by compressing the trigger several times.
6. Place the nasal tip in your nostril. Do not tilt your head back.
7. Firmly compress the trigger two to three times in each nostril.
8. Wipe the nasal tip with a tissue, and replace the cap.
   

Recommended Dosage

Afrin (or any other nasal spray containing oxymetazoline) is only intended for short-term use to provide temporary relief of nasal congestion. Specifically it should never be used for more than 3 consecutive days. If it is used longer than three days it can cause long lasting severe nasal congestion and even permanent changes in the nasal lining.

The recommended dosage is two to three sprays per nostril every 10 to 12 hours. Do not use Afrin more than twice in any 24-hour period.

Afrin should not be used on an ongoing basis as it will not only become less and less effective but also increase the risk of rebound congestion. This is a response in which your congestion will suddenly worsen rather than improve.

Possible Side Effects and Interactions

As with all drugs, Afrin can cause side effects. They tend to be mild to manageable, but, for some people, they can be significant.

Common side effects of Afrin include:

• Nasal burning or stinging
  
• Sneezing
• Headache
• Dizziness
• Drowsiness
• Nervousness
• Shakiness or trembling
• Blurred vision
• Trouble sleeping
• Extreme nasal dryness (especially if overused)
• Increased runny or stuffy nose (typically if overused)
• Rapid heartbeat
• Heart palpitations (skipped heartbeats)
• Abnormally slow heartbeat
  

Certain drugs can also interact with Afrin and amplify the effects—and side effects—of oxymetazoline. Chief among these is a class of antidepressants known as monoamine oxidase inhibitors (MAOIs).

Speak with your healthcare provider before using Afrin if you take any of the following MAOIs:

• Emsam (selegiline)
• Marplan (isocarboxazid)
• Nardil (phenelzine)
• Parnate (tranylcypromine)

Who Should Not Use Afrin

There are certain people who should not use Afrin. Due to the lack of safety research, Afrin should not be used in children under 6 years of age and people who are pregnant or breastfeeding.

Because of its vasoconstriction effects, Afrin can rapidly raise a person's blood pressure and may need to be avoided in people with uncontrolled hypertension (high blood pressure). If used, Afrin can cause chest pains, blurred vision, nausea, and vomiting.

Afrin should never be used if you have a known allergy to oxymetazoline. Doing so increases the risk of a rare but potentially life-threatening, whole-body allergy known as anaphylaxis.

Summary

Afrin (oxymetazoline) is a nasal decongestant used to relieve nasal stuffiness caused by the common cold, sinusitis, hay fever, and allergies. It can also help stop nosebleeds.

Afrin can be used up to twice daily. It should not be used for longer than three days as it can rapidly lose its effectiveness and lead to rebound congestion.

Common side effects include headache, dizziness, nasal stinging or burning, drowsiness, shakiness, and sleep problems. Afrin should not be used in children under six, people who are pregnant or breastfeeding, or anyone who is allergic to oxymetazoline.

A Word From Verywell

Afrin is a good and fast solution for nasal congestion but not the only one. Other options include saline nasal irrigation with a neti pot, saline nasal sprays, steam inhalation with eucalyptus oil, and oral antihistamines (if allergies are the cause of your congestion).

These options can be used safely on an ongoing basis and may be a better solution if your symptoms are chronic (such as can occur with seasonal allergies). Speak with your healthcare provider about the best solutions based on the severity and cause of your congestion.