Which is better: Xylometazoline or Nazivin

3D visualization of molecule structure

Xylometazoline

(eng. Xylometazoline) - a drug, an alpha-adrenergic stimulant. Its structure is similar to naphazoline. Xylometazoline is included in the list of vital and essential drugs. Used as a remedy to relieve symptoms of nasal congestion, rhinitis and sinusitis, as well as otitis media (to alleviate swelling of the Eustachian tube).[1][2][3] Manufacturers limit continuous use of the substance to 7 days and an interval of 6 hours between doses to avoid side effects.

Side effects

With frequent and/or prolonged use - irritation and/or dryness of the nasopharyngeal mucosa, burning and paresthesia of the nasal mucosa, sneezing, hypersecretion of the nasal mucosa, temporary loss of smell. Rarely - swelling of the nasal mucosa, palpitations, tachycardia, arrhythmias, increased blood pressure, headache, vomiting, insomnia, blurred vision; depression (with long-term use in high doses).

Development of chronic rhinitis.

Overdose

Symptoms: increased side effects. With regular use, the effectiveness of the drug sharply decreases.

Which one should you prefer?

Based on general knowledge about Naphthyzin or Galazolin, it is difficult to make a choice in favor of any of the drugs, except in cases where the active substance of the drug is an allergen for the patient. Also, despite the fact that the vasoconstrictor medications described are similar in the way they affect the body, there are still some subtleties. Therefore, it is worth talking in more detail about these drugs.

Power of action

In terms of the degree of influence, Naphthyzin (Nafazolin, Sanorin, Nafazol) is superior to other imidazolines, including Galazolin (Xylometazoline, Otrivin, Xylin, Snoop, etc.). This is especially noticeable when using the drug for the symptomatic treatment of seasonal rhinitis.

In a number of cases, the combination drug Sanorin with euclyptus (naphazoline + eucalyptus) turns out to be the only remedy that can “break through” the nose with allergies.

addictive

Probably due to the power of its influence, or for other reasons, naphthyzine addiction has become the scourge of patients who abuse modern decongestants. There are people who drip vasoconstrictor substances daily for years, bringing the mucous lining of the nose to atrophy. It is difficult to stop dripping the medicine, because without its administration, swelling develops, even after the influence of the allergen or bacterial-viral agent has ceased.

Xylometazoline is not free from the “addiction complex,” but patients suffer from it 2 times less often. What is the reason for the smaller number of people on Galazolin - the frequency of use or the duration of the course - is unknown. But still, the degree of addiction is no less than when using naphazoline medications.

Effect duration

This indicator is rarely taken into account by patients. But it deserves special attention. Long-acting medications need to be administered less frequently than their rapidly depleting counterparts. When choosing based on this principle which is better, Naphthyzin or Galazolin, you should opt for Galazolin (xylometazoline). Active component duration:

1. For Galazolin, 8–10 hours, according to the instructions for the medication. This means that you need to drip it three times a day.
2. It will be difficult to maintain an interval between the administration of drugs based on naphazoline for more than 4 hours.

The latter medicine will have to be dripped twice as often (up to 6 times a day) than xylometazoline-containing medicines.

Notes

1. Xylometazoline (Xylomethazolinum) - description of the substance, instructions, use, contraindications and formula.. www.rlsnet.ru. Retrieved May 19, 2020.
2. Drugs & Medications (English). www.webmd.com. — “This medication is used for temporary relief of congestion in the nose caused by various conditions including the common cold, sinusitis, hay fever, and allergies.” Retrieved May 19, 2020.
3. Xylometazoline nasal Uses, Side Effects & Warnings - Drugs.com, Drugs.com
   . Retrieved May 19, 2020.
4. https://www.pharmvestnik.ru/publs/lenta/obzory/dsm-group-rejting-aptechnyx-prodazh-mnn-vkljuchennyx-v-zhnvlp.html#.V_ym3OCLTIU rating of pharmacy sales of INNs included in VED

pharmachologic effect

Constricts the blood vessels (anemization) of the nasal mucosa, eliminating swelling and hyperemia of the mucous membrane. Facilitates nasal breathing during rhinitis. The action begins within a few minutes and lasts for several hours.

After several days of use, tachyphylaxis develops and the vasoconstrictor effect of the drug quickly decreases.

Pharmacokinetics

When applied topically, it is practically not absorbed; plasma concentrations are so small that they cannot be determined by modern analytical methods.

Instructions for use of the drug xylometazoline

This drug can be purchased at a pharmacy without a doctor's prescription. At the same time, it is worth remembering that any medicine can harm the body if used incorrectly. This is why it is recommended to consult your doctor before using xylometazoline.

The mechanism of action of xylometazoline

The mechanism of action of this drug is that when applied to the nasal mucosa, it binds to special regulatory structures ( alpha adrenergic receptors

), located in the blood vessels, causing their narrowing. This interrupts the chain of pathological processes developing in the affected mucous membrane, which helps restore normal nasal breathing.

The positive effects of xylometazoline are due to:

Constriction of blood vessels.

This leads to a decrease in their blood supply, as a result of which the volume (
mass
) of the mucous membrane is significantly reduced.
The vasoconstrictor effect of the drug develops quite quickly, so within 2 to 4 minutes after use you can feel an improvement in nasal breathing. Reduced permeability of the vascular wall.
As a result of the narrowing of the blood vessel, its wall becomes denser, which prevents the liquid part of the blood from leaving the vascular bed.
As a result, soon after using the drug, swelling of the mucous membrane is eliminated, which also facilitates nasal breathing. Improving ventilation of the nasal passages.
This is a secondary effect due to the vasoconstrictor effect of the drug.
As a result of constriction of the vessels of the nasal mucosa, oxygen access to the nasal passages and to the paranasal sinuses ( intraosseous cavities located around the nose and also covered by the mucous membrane
) improves, which inhibits the development of infection and promotes a speedy recovery. The duration of action of the drug depends on the form of its release. For example, when using drops, the vasoconstrictor effect persists for 6 to 8 hours. Xylometazoline is then released from specific receptors, causing the blood vessels to dilate and fill with blood again. At the same time, the mucous membrane swells again, that is, nasal congestion resumes.

When using a spray, the duration of the vasoconstrictor effect can also last for 8 hours, while the gel eliminates nasal congestion for 8 to 10 hours.

Indications for the use of xylometazoline

The drug can be used for a variety of diseases in which swelling of the nasal mucosa develops and a feeling of nasal congestion occurs.

Indications for the use of xylometazoline are:

Acute rhinitis.

Acute rhinitis (
inflammation of the nasal mucosa
) usually occurs when the nasal mucosa is damaged by viruses (
for example, colds, flu
) or bacteria.
Rhinitis can also develop with some other infectious and inflammatory diseases ( for example, measles, scarlet fever, diphtheria, and so on
).
Rhinitis manifests itself as pronounced swelling of the nasal mucosa and rhinorrhea, that is, the release of a large amount of mucus from the nasal passages. Acute nasopharyngitis.
This term refers to inflammation of the mucous membrane of the nasopharynx, which develops as a result of exposure to infectious (
viral, bacterial
) or non-infectious (
allergic, chemical
) factors.
In addition to nasal congestion, infectious nasopharyngitis can be manifested by general weakness, headaches, cough, increased body temperature to 38 - 39 degrees, and so on. Acute sinusitis.
Sinusitis is an inflammation of the paranasal sinuses.
These include the maxillary sinuses ( when they are damaged, sinusitis develops
), the frontal (
frontal
) sinuses (
when they are damaged, frontal sinusitis develops
), the sphenoid sinus (
sphenoiditis
) or the cells of the ethmoid bone (
ethmoiditis
).
The mechanism of damage to the paranasal sinuses is also associated with swelling of the mucous membrane. As a result, the entrance to the sinuses, through which their ventilation is normally carried out, is blocked. This creates favorable conditions for the development and spread of infection. Hay fever (
seasonal allergic rhinoconjunctivitis ).
This disease develops as a result of increased sensitivity of the body to the pollen of certain plants. The immediate cause of the development of allergic reactions is the penetration of pollen microparticles into the patient’s nasal cavity along with the inhaled air. When they come into contact with the mucous membrane, a whole complex of immune reactions is triggered, resulting in dilation of blood vessels and swelling of the mucous membrane itself. Other manifestations of hay fever may include redness of the eyes, increased tearing, and increased body temperature. Characteristic of this pathology is the fact that all signs of the disease occur at the same time of year, when certain plants bloom. Other allergic rhinitis.
Allergic swelling of the nasal mucosa can be caused not only by plant pollen, but also by other allergens.
It could be dog hair, house dust, and so on. The mechanism of development of nasal congestion in this case is also due to swelling of its mucous membrane. Otitis media
Otitis media is characterized by inflammation of the mucous membrane of the middle ear (
tympanic cavity
).
The cause of the development of this pathology is usually infectious and inflammatory processes in the nasopharynx or oropharynx. Through a special auditory tube ( which connects the tympanic cavity with the pharynx, ensuring the normal functioning of the hearing organ
), infectious agents (
bacteria, viruses
) can penetrate into the tympanic cavity, which will lead to the development of an inflammatory process in it.
Also, the mucous membrane of the auditory tube itself swells, which further aggravates the course of the disease. The purpose of using xylometazoline in this case is to narrow the vessels of the nasopharynx. This can help relieve swelling in the area of ​​the auditory tubes and restore normal ventilation of the tympanic cavity, which is a necessary condition in the treatment of otitis media. Eustachite.
This is an infectious-inflammatory disease characterized by inflammation of the auditory (
Eustachian
) tube connecting the pharynx to the tympanic cavity.
It manifests itself as congestion in one or both ears, sore throat, and when the nasal mucosa is involved in the pathological process – runny nose and nasal congestion. Preparation for medical procedures.
When performing some diagnostic measures (
for example, rhinoscopy - examination of the nasal mucosa using special instruments
), difficulties may arise due to swelling of the mucous membrane.
In such cases, the use of xylometazoline allows you to temporarily narrow the blood vessels in the nasal cavity, which reduces the risk of bleeding ( which can occur as a result of accidental trauma to the mucous membrane during the examination
), and also allows the doctor to more accurately examine the areas of the nasal cavity of interest.
Stopping nosebleeds.
The use of this drug for moderate nosebleeds (
for example, after injury
) leads to a narrowing of the blood vessels of the mucous membrane, which helps to stop the bleeding as quickly as possible.

Contraindications to the use of xylometazoline

When the drug is applied topically, only a negligible part of it can be absorbed into the systemic circulation. However, in some diseases this can lead to the development of a number of undesirable effects, which limits the use of the drug.

Xylometazoline is contraindicated:

In case of hypersensitivity to the drug.

Hypersensitivity is characterized by the fact that when the body comes into contact with this substance, extremely pronounced allergic reactions are triggered, which can manifest as severe swelling of the mucous membrane, redness of the skin in the facial area, hives, or even anaphylactic reactions.
It is important to remember that in various commercial preparations, xylometazoline is produced together with some auxiliary components, to which you may also be allergic. For arterial hypertension.
This disease is characterized by a persistent increase in blood pressure of more than 140 mmHg.
Xylometazoline, having a vasoconstrictor effect, can aggravate the course of this pathology ( vasoconstriction at the systemic level will lead to an even greater increase in blood pressure
).
With tachycardia (
increased heart rate more than 90 beats per minute ).
Tachycardia itself can occur under certain physiological conditions ( for example, after exercise
), which is not a contraindication to the use of xylometazoline.
At the same time, in case of tachycardia combined with certain diseases of the cardiovascular system ( for example, coronary heart disease
), the use of this drug is not recommended, as this can lead to the development of complications.
With severe atherosclerosis.
This disease is characterized by impaired elasticity of large arteries (
blood vessels through which blood flows from the heart to all organs and tissues
).
In most cases, atherosclerosis is combined with increased blood pressure, and therefore the use of xylometazoline for this pathology is also not recommended. For glaucoma.
Glaucoma is characterized by a pronounced increase in intraocular pressure, resulting from a violation of the outflow of intraocular fluid (
normally it flows through special channels located in the anterior part of the eye at the base of the iris
).
The use of xylometazoline can lead to pupil dilation, which, in turn, can contribute to blocking the outflow pathways of intraocular fluid and further increasing intraocular pressure. For atrophic rhinitis.
This disease is characterized by atrophy (
thinning, destruction
) of the nasal mucosa.
The cause of dryness and a feeling of nasal congestion in this case is a violation of the protective functions of the mucous membrane, as a result of which hard crusts form on it, blocking the nasal passages. The use of vasoconstrictor drugs in this case is ineffective, since with atrophic rhinitis the number of vessels in the mucosa itself is significantly reduced. With thyrotoxicosis.
Thyrotoxicosis is characterized by a pronounced increase in the concentration of thyroid hormones in the blood.
The use of alpha-agonists in this case can provoke the development of adverse reactions from the cardiovascular system. For diabetes mellitus.
Alpha adrenergic receptors are found not only in the walls of blood vessels, but also in some other tissues, including pancreatic cells.
Their stimulation can reduce the amount of insulin produced in the gland ( a hormone necessary for the normal absorption of glucose by cells
), which can aggravate the course of diabetes.
For prostate adenoma.
This disease is characterized by an increase in the size of the prostate gland, which in severe cases may be accompanied by difficulty urinating (
due to compression of the urethra
).
The use of alpha-adrenergic agonists can aggravate this process, and therefore they should be used with extreme caution for prostate adenoma ( for short periods of time, without exceeding the dose prescribed by the doctor
).

Xylometazoline during pregnancy and breastfeeding

It is not recommended to use the drug during pregnancy, as it may adversely affect the fetus. It is immediately worth noting that full-fledged clinical studies have not been conducted to evaluate the effect of xylometazoline on the fetus. However, taking into account the vasoconstrictor effect of the drug, it can be assumed that with prolonged use during pregnancy, as well as in case of overdose, the concentration of the active substance in the blood may increase so much that it will lead to a narrowing of the blood vessels of the placenta ( a special organ that appears in a woman during pregnancy and providing nutrition to the developing fetus

). It is also possible that the drug penetrates the hematoplacental barrier into the fetal bloodstream, which can cause various complications.

In each specific case, the doctor must evaluate the possible benefits of using xylometazoline and the possible harm that it may cause to the developing fetus. In other words, if nasal congestion in a pregnant woman is mild or moderate, it is better not to use this drug. At the same time, if a violation of nasal breathing significantly affects the patient’s normal functioning ( for example, it makes it difficult to sleep at night

), it would be advisable to use vasoconstrictor drugs, but only for a short period of time and in minimal doses.

It is also worth remembering that xylometazoline can be excreted in mother's breast milk. That is why it is also not recommended to use this drug during breastfeeding.

Dosage and method of use of xylometazoline

The drug should be used only topically, applied to the mucous membrane of the nasal cavity. If the drug is used to treat acute rhinitis or other infectious diseases accompanied by the secretion of large amounts of mucus, before use you should clean the nasal passages as thoroughly as possible ( that is, blow your nose, blow your nose

).
The method of administration of the drug depends on the form of release. Dosage and use of xylometazoline

It is important to note that when using xylometazoline, the drug should be injected into both nostrils, even if the nose is blocked on only one side. This is explained by the fact that when the drug is administered only into the blocked nasal passages, the vessels in them will narrow, but this will result in a reflex vasodilation and swelling of the mucous membrane on the other side, as a result of which the nasal passages will also be blocked.

Xylometazoline for children

No special dosage has been developed for children under 2 years of age. The use of the drug in this age group can cause the development of a number of undesirable side reactions, and therefore it should be used only when absolutely necessary, having previously agreed on a treatment regimen with a doctor. In such cases, the medication is prescribed in the form of drops ( 1 - 2 drops of a 0.05% solution in each nasal passage 1 - 2 times a day

) or in the form of a spray (
1 injection of 0.05% solution into each nasal passage 1 - 2 times a day
).

Xylometazoline is prescribed:

Children under 6 years old

– only 0.05% solution in the form of drops or spray, and the frequency and duration of use are determined by the severity of the disease.
Children from 6 to 12 years old
- 0.05% or 0.1% solution in the form of drops, spray or gel.
Children over 12 years of age and adults
– 0.1% solution in any form.

Side effects of xylometazoline

Side effects of the drug are represented mainly by local reactions. Systemic manifestations develop extremely rarely and are usually associated with a violation of the dosage or frequency of use of the medication.

Local side effects of xylometazoline are:

Dryness of the nasal mucosa.

As a result of the narrowing of blood vessels, the amount of mucus produced may decrease, causing the mucous membrane to “dry out.”
Irritation of the nasal mucosa.
This effect may manifest itself as itching or burning in the nasal cavity.
The development of these reactions is associated with dryness of the nasal mucosa, as well as ( possibly
) with the irritating effect of xylometazoline itself.
Paresthesia in the area of ​​the nasal mucosa.
Paresthesia is an unpleasant tingling, cold, or crawling sensation.
The development of this phenomenon when using xylometazoline may be associated with damage to the sensitive nerve fibers of the nasal cavity as a result of disruption of their blood supply. Increased mucus secretion.
This is an abnormal (
atypical
) reaction that is sometimes observed with xylometazoline.
Sneezing.
This is a protective reflex aimed at removing any foreign particles from the nasal cavity.
When using xylometazoline, its microparticles can irritate sensitive nerve endings, triggering the sneeze reflex. Development of tolerance.
This phenomenon is characterized by a decrease in the sensitivity of the nasal mucosa to the vasoconstrictor effect of the drug.
This is due to the fact that with prolonged stimulation of alpha-adrenergic receptors, their total number decreases. As a result, in order to achieve the same therapeutic effect, it is necessary to constantly increase the dose of the medication. The phenomenon of cancellation (
ricochet ).
The essence of this phenomenon is as follows. If, after prolonged use of xylometazoline, its use is abruptly stopped, this will lead to even more pronounced swelling of the mucous membrane, which will persist for several days. Systemic side effects of xylometazoline may include: Increased blood pressure.
May occur in patients with arterial hypertension with prolonged or too frequent use of the drug.
Arrhythmia (
abnormal heart rate ).
Rapid heartbeat may also occur when taking too much of the drug. Headache.
Headaches may be associated with impaired blood supply to the brain, which may be due to the effect of the medication on the blood vessels.
Visual impairment.
Using the drug for severe glaucoma can lead to a critical increase in intraocular pressure, which will cause damage to the retina (
the layer of photosensitive nerve cells that perceive light rays
).
Vomit.
Vomiting is a rare side effect that develops with long-term use of the medication.
Depression (
persistent low mood ).
Depression can develop with prolonged and frequent use of the drug in large doses.

Xylometazoline addiction

The development of this phenomenon is also associated with a decrease in the number of specific alpha-adrenergic receptors. With long-term use of xylometazoline their ( receptors

) becomes so small that in the absence of this medication, the vessels of the nasal mucosa practically do not narrow. As a result, a person can breathe freely through his nose only as long as the next dose of the drug is in effect. If the next dose is not administered in time, severe swelling of the mucous membrane in both nasal passages will occur, as a result of which nasal breathing will become almost impossible.

Speed ​​of development of addiction

) is individual for each person, but on average it lasts 2 – 4 weeks.

Xylometazoline overdose

An overdose of the drug occurs extremely rarely, which is due to its mechanism of action. The fact is that when xylometazoline is applied to the nasal mucosa, its vessels quickly narrow, as a result of which there is practically no further absorption of the drug into the systemic circulation. An overdose can most often occur when using the drug in the form of drops, when, through negligence or due to a malfunction of the built-in pipette, a large volume of solution is poured into the nasal passages. In this case, a certain part of it can penetrate the pharynx, and then will be swallowed and enter the stomach, from where the solution will be quickly absorbed into the blood. This will lead to the development of systemic adverse reactions.

In case of an overdose of xylometazoline, the following may occur:

increased heart rate; increased blood pressure; drowsiness; impaired consciousness; respiratory failure ( rarely

The development of the described reactions is more typical for children, since when the same amount of solution is swallowed, the final concentration of xylometazoline in the child’s blood will be higher than in the blood of an adult (
due to the smaller volume of circulating blood
).

Price of the drug xylometazoline

The price of this medication depends on the company and country of manufacture, as well as on the region ( the further the drug needs to be delivered, the more money is spent on its transportation, and the more expensive it will cost

). It is also worth considering markups, which may vary between pharmacies.

Cost of xylometazoline

Reviews of xylometazoline

Most reviews about the drug xylometazoline are positive, which is due to the rapid onset of the vasoconstrictor effect and the restoration of normal nasal breathing within 2 to 4 minutes after using the medication. Also, many people note that the vasoconstrictor effect of the drug persists for quite a long time, which allows them to perform everyday work without worrying that after an hour or two the nose may become stuffy again.

Negative reviews are rare and are usually associated with various adverse reactions that can occur in case of overdose. For example, some patients who have used the drug for several weeks in a row complain that without it they now cannot breathe normally at all. However, the whole point is that the recommended duration of use of the medication was exceeded, which led to the development of this side effect. At the same time, most people note that if the dosage specified in the instructions is followed, adverse reactions when using xylometazoline are extremely rare, which is undoubtedly a great advantage of the drug.

Reviews of xylometazoline drops

Nasal drops are the most common and accessible form of the drug, due to its relatively low cost (
3 times cheaper than a spray and 6 times cheaper than a gel
). However, despite the low price, the effectiveness of the vasoconstrictor effect of xylometazoline in the form of drops is not inferior to other forms of the drug, which is noted by almost everyone who has used it.

The negative aspects of using xylometazoline drops are related to the fact that during use they often penetrate into the throat, causing an unpleasant, bitter taste to appear within a few minutes.

Reviews of xylometazoline spray

The spray is also quite affordable in terms of price, but is significantly superior to nasal drops in terms of ease of use. Most people note that applying the spray using a special spray nozzle is much more convenient than throwing back your head and putting drops into your nose, while trying to count their number.

Negative reviews are extremely rare and are mainly related to the price of the drug. Single reviews of the ineffectiveness of the spray are questionable, since the absence of a vasoconstrictor effect can only be observed with long-term use of xylometazoline and with the development of tolerance.

Reviews of xylometazoline ointment

Reviews about this ointment are mostly positive, since the drug has a quick and pronounced effect in cases where drops or spray do not help. Negative reviews are mainly associated with the high cost of the medication.