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# Sinex (oxymetazoline) ## Overview Oxymetazoline is an alpha-adrenergic agonist that acts as a topical vasoconstrictor. ## Primary Indications * Nasal congestion due to the common cold, hay fever, or other upper respiratory allergies. ## Adult Dosing * **Nasal Spray:** 2 sprays in each nostril every 10-12 hours as needed. Do not exceed 2 doses in 24 hours. ## Pediatric Dosing * **Nasal Spray:** Not recommended for children under 12 years of age unless directed by a physician. * For children under 12, consult a pediatrician for appropriate symptomatic relief. ## Dose Adjustments No dose adjustments are typically needed for hepatic or renal impairment. ## Contraindications * Hypersensitivity to oxymetazoline or any component of the formulation. * Use within 14 days of discontinuing a monoamine oxidase inhibitor (MAOI). ## Adverse Effects * **Common:** Nasal burning or stinging, sneezing, increased nasal discharge. * **Less Common/Serious:** Rebound congestion (rhinitis medicamentosa) with prolonged or excessive use, headache, nervousness, dizziness, insomnia, palpitations, increased blood pressure. ## Key Drug Interactions * **MAOIs and within 14 days of MAOI discontinuation:** Risk of hypertensive crisis. * **Beta-blockers:** May potentiate hypertensive effects. * **Tricyclic Antidepressants:** May potentiate hypertensive effects. ## Monitoring * Monitor for signs and symptoms of rebound congestion, especially with prolonged use. * Monitor blood pressure in patients with underlying cardiovascular conditions, particularly with frequent or prolonged use. ## Clinical Pearls * Limit use to a maximum of 3 consecutive days to minimize the risk of rebound congestion. * If symptoms persist after 3 days, advise patient to discontinue use and consult a healthcare provider. * Store at room temperature. *** **Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and institutional protocols before administering or recommending any medication.