Bradycardia, Hypotension, and Near-Syncope Associated with Afrin (Oxymetazoline) Nasal Spray

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Abstract
To the Editor: Afrin nasal spray is among several over-the-counter long-acting nasal sprays or drops containing 0.05 per cent oxymetazoline. From animal experiments oxymetazoline has been shown to stimulate central alpha-adrenoceptors and thereby produce brady-cardia and hypotension similar to that associated with clonidine, another imidazoline derivative.1 , 2 These effects can be produced in dogs by the nasal instillation of 80 μg of oxymetazoline per kilogram of body weight (Schering–Plough: personal communication). Excessive use in human beings may cause similar bradycardia, hypotension, dizziness, and weakness.A 73-year-old man with cerebellar degeneration and peripheral neuropathy associated with prior alcohol abuse customarily walked 5 . . .

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