ABS TRACT Topical nasal decongestants, such as xylometazoline and oxymetazoline, exert their therapeutic effect by stimulating -adrenergic receptors in the nasal mucosa, leading to vasoconstriction and a rapid reduction of mucosal edema.Because of their local mode of administration, systemic absorption is minimal, making these agents widely used for the symptomatic relief of acute nasal congestion.Clinical evidence demonstrates their effectiveness in conditions such as the common cold, allergic rhinitis, acute rhinosinusitis, and the postoperative period following nasal surgery, where they improve nasal airflow, sleep quality, and overall patient comfort.Despite their clinical use for many years, concerns persist regarding potential systemic adverse effects, cardiovascular safety, and the development of rhinitis medicamentosa (RM) with prolonged use.However, data from controlled clinical trials indicate that short-term use within the recommended limits, typically 7-10 days, does not consistently result in rebound congestion, permanent mucosal injury, or impaired ciliary function.Importantly, some symptoms attributed to rebound phenomena may instead reflect the natural recurrence of the underlying inflammatory condition.Emerging evidence suggests that concomitant use of topical decongestants with intranasal corticosteroids can enhance therapeutic efficacy while mitigating the risk of RM.From a pharmacological perspective, oxymetazoline exhibits greater receptor affinity, higher lipophilicity, and slower receptor dissociation than xylometazoline, resulting in a longer duration of action and greater potency.Additional anti-inflammatory and antiviral properties have also been proposed for oxymetazoline.Overall, when appropriately and for limited durations, both xylometazoline and oxymetazoline demonstrate favorable benefitrisk profiles in the management of nasal congestion.
Adnan Fuat Büyüklü (Thu,) studied this question.