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# Sinex (oxymetazoline) ## Overview Sinex is a nasal spray containing oxymetazoline, a topical decongestant that acts as an alpha-adrenergic agonist. It causes vasoconstriction of nasal blood vessels, reducing swelling and congestion. ## Primary Indications * Nasal congestion due to the common cold, hay fever, or other upper respiratory allergies. ## Adult Dosing * **Dosage Form:** Nasal spray. * **Dosing:** Prime the pump before first use by actuating 4 times. Apply 2 sprays into each nostril. * **Frequency:** Every 10-12 hours as needed. * **Maximum Duration:** Do not use for more than 3 consecutive days. ## Pediatric Dosing * **Ages 6-12 years:** 1-2 sprays into each nostril every 10-12 hours. Do not use for more than 3 consecutive days. * **Under 6 years:** Consult a healthcare provider. ## Dose Adjustments No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised in patients with underlying cardiovascular conditions. ## Contraindications * Hypersensitivity to oxymetazoline or any component of the formulation. * Patients with narrow-angle glaucoma. * Use with monoamine oxidase inhibitors (MAOIs) or within 2 weeks of discontinuing MAOIs. ## Adverse Effects * **Common:** Nasal burning, stinging, dryness, sneezing, increased nasal discharge. * **Less Common:** Rebound nasal congestion (rhinitis medicamentosa) with prolonged use, headache, insomnia, nervousness, dizziness. * **Rare:** Tachycardia, palpitations, hypertension. ## Key Drug Interactions * **MAOIs:** Concomitant use or use within 2 weeks of MAOIs can cause a hypertensive crisis. * **Tricyclic Antidepressants (TCAs):** May potentiate the pressor effects of oxymetazoline. * **Beta-blockers:** May lead to exaggerated hypertensive response or bradycardia. ## Monitoring * Monitor for signs of rebound congestion (rhinitis medicamentosa) with prolonged use. * Monitor blood pressure, especially in patients with pre-existing hypertension or cardiovascular disease. ## Clinical Pearls * Limit use to 3 days to prevent rhinitis medicamentosa. * Prime the pump before each use. * Avoid spraying into the eyes. *** *Please verify the current prescribing information for the most up-to-date recommendations.*