Oxymetazoline is an imidazole derivative and a potent, direct-acting alpha (α)-adrenergic agonist with affinity to both α<sub>1</sub>- and α<sub>2</sub>-adrenoceptors.[A215542] Oxymetazoline is available in various formulations with a wide variety of clinical implications. The topical formulation of the drug is used to treat persistent facial redness in adults.[L15062] As an effective decongestant, oxymetazoline is available in over-the-counter intranasal sprays used to relieve nasal and sinus congestion caused by a wide variety of conditions, such as common cold, hay fever, and upper respiratory allergies.[A215587, L15092] In dentistry, oxymetazoline and tetracaine combination intranasal spray (Kovanaze) is used for regional anesthesia during dental procedures in children and adults.[L15057] In July 2020, the FDA approved the use of an ophthalmic formulation of oxymetazoline (Upneeq) in adults with acquired blepharoptosis, or ptosis, making it the first FDA-approved medical treatment for this medical condition.[L15042, L15067]
Oxymetazoline is indicated for the topical treatment of persistent facial erythema associated with rosacea in adults.[L15062] Ophthalmic oxymetazoline is indicated for the treatment of acquired blepharoptosis in adults.[L15067] When used in combination with tetracaine intranasally, oxymetazoline is indicated for regional anesthesia when performing a restorative procedure on Teeth 4-13 and A-J in adults and children who weigh 40 kg or more.[L15057] Oxymetazoline can be found in over-the-counter nasal products as a nasal decongestant.[L15092] For off-label uses, oxymetazoline has been used during nasal intubation and during ear, nose, and throat surgery to improve visualization of the airway and to minimize post-operative bleeding.[A215542]
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