Last update: Jan. 15, 2020

Oxymetazoline Hydrochloride

Low Risk for breastfeeding


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

A sympathomimetic with alpha-adrenergic activity. It has a vasoconstrictor effect which reduces mucosal swelling and congestion.
Topical use via nasal spray (twice a day) or ophthalmological (3-4 times a day).
It is also used in face cream to treat rosacea (Kuang 2018) and, mixed with local anesthetics, in dental anesthesia.

Since the last update we have not found published data in relation to breastfeeding.

The small dose and low plasma absorption of most topical nasal, dermal or ophthalmological preparations make transfer into breastmilk in significant amounts unlikely.

Recorded plasma concentrations of oxymetazoline are low and their systemic effects are not clinically significant with the usual doses (Cartabuke 2019, Kuang 2018, Cacek 2017, Giannakopoulos 2012), so significant concentrations in milk are not expected.

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

Expert authors consider the use of this medication to be 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 on the tear duct (medial canthus of the eye) with your finger for 1 minute.

Some authors consider decongestant drugs administered orally and nasally to be non-essential medications, to be avoided in general, not only during breastfeeding, since they expose patients to serious risks (cardiovascular, neurological and intestinal) for the treatment of benign disorders such as nasal obstruction, which usually evolves favourably in a few days without medication (Prescrire 2018).

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, 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. 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
  3. 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)
  4. Allergan. Oximetazoline Cream (Rhode). Drug Summary. 2017 Full text (in our servers)
  5. 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
  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. Anderson PO. Decongestants and milk production. J Hum Lact. 2000 Abstract
  10. 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

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