Bulletin of Environment, Pharmacology and Life Sciences

Bull. Env. Pharmacol. Life Sci., Vol 6[1] December 2016: 28-32
©2016 Academy for Environment and Life Sciences, India
Online ISSN 2277-1808
Journal’s URL:[Link]
CODEN: BEPLAD
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Universal Impact Factor 0.9804
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ORIGINAL ARTICLE OPEN ACCESS

Xylometazoline: A tropical Nasal Decongestant and an extensive

cause of Rhinitis medicamentosa (RM)
Shehzad Zareen1,Hira Zareen1 ,Muhammad Ateeq2,Hameed Ur Rehman*3, Wali Mohammad
Achakzai,Shagufta Saddozai,
1Department of Zoology, Kohat University of Science and Technology Kohat,KPK, Pakistan.
2Department of Microbiology, Kohat University of Science and Technology Kohat,KPK,Pakistan.
3Department of Chemistry, Kohat University of Science and Technology Kohat,KPK,Pakistan.
4Department of Zoology,Balochistan University,Quetta,Pakistan.
5Department of Zoology,Sardar Bahadur Khan Women University,Quetta,Pakistan.

ABSTRACT
Xylometazoline is a nasal decongestant intranasal spray which is often used to reduce the inflammation of the nasal
mucosa in allergic rhinitis. It is available with different brand names in different countries. In Pakistan it is available
with the brand name of Xynosine. Over use of Xylometazoline cause rebound nasal congestion as the patient gets
addicted to it. This condition is called Rhinitis medicamentosa (RM). Rhinitis medicamentosaoccur when this spray is
used more than 5-6 [Link] patients were investigated in ENT (Ear, Nose and Throat) section, DHQ hospital, of
Kohat city KP Pakistan. All respondents had the same clinical condition, i.e. Rhinitis medicamentosa. All respondents
were interviewed for the excessive use of nasal decongestant sprays.A total of 21/39 (53.85%) male, while 18/39
(46.15%) female respondents were included in this study. All patients were divided into different age groups. In the age
group 10 or less than 10 years old patients only 1 female was suffering from RM (rhinitis medicamentosa).About 53.85%
patients of Rhinitis medicamentosa were male population this percentage was much higher than female population
which was recorded 46.15%. Males were found more effected as compare to the female population.A high prevalence of
Rhinitis medicamentosa (30.33%) was observed in age groups 21-30 as well as 31-40 years. A high percentage (51.28%)
of RM-patients were those who were using Xylometazoline as a nasal decongestant prescribed by a physician, but
physician didn’t advise the maximum use of this [Link] 35.90% patients accepted that they were using
Xylometazoline without prescribed by physician whenever they felt nasal blockage and soon they got addicted to it. To
get rid of nasal congestion people used nasal decongestants more than the recommended time frame and get addicted to
it. This study reveals that rhinitis medicamentosa can be cure by stopping use of nasal decongestant sprays and the use
of other non-addictive [Link] Homeopathic and allopathic medications was found effective to get rid of addiction of
nasal decongestion.
Key Words: Xylometazoline, Xynosine, Rhinitis medicamentosa, Nasal congestion

Received 13.11.2016 Revised 09.12.2016 Accepted 11.12. 2016

INTRODUCTION
Allergicrhinitis is a type of nasal allergy in which there is inflammation nasal mucosa and cause nasal
congestion, itching and swelling around orbits of the eye, sneezing and watery nose. This condition is also
called hay fever [1,2]. Pollens and dust are the root cause of allergic rhinitis [3,4,5]. The best way of
treating Allergic rhinitis is corticosteroidintranasal sprays [6]. Xylometazoline is a nasal decongestant
intranasal spray which is often used to reduce the inflammation of the nasal mucosa in allergic rhinitis. It
is available with different brand names in different countries. In Pakistan it is available with the name of
Xynosine [7]. Over use of Xylometazoline cause rebound nasal congestion as patient get addicted to it.
This condition is called Rhinitis medicamentosa (RM) [8]. Rhinitis medicamentosaoccur when this spray
is used more then 5-6 days [9]. Xylometazoline is one of the OCT (over the counter) drug sold without the
prescription [10]. Looking to the above hazards of over use of Xylometazoline the current study is
designed to investigate the prevalence and risk factors of Rhinitis medicamentosain local population of
Kohat city of District Kohat KP Pakistan.

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MATERIALS AND METHODS

About 39 respondents were included in this study non randomly. Suspected patients were investigated in
ENT (Ear, Nose and Throat) section, DHQ hospital, of Kohat city KP Pakistan. All respondents had same
clinical condition i.e. Rhinitis medicamentosa. all respondents were interviewed for the excessive use of
nasal decongestant sprays.
Results
A total of 21/39 (53.85%) male while 18/39 (46.15%) female respondents were included in this study.
All patients were divided into different age groups. In age group 10 or less than 10 years old patients only
1 female was suffering from RM (rhinitis medicamentosa). In age group 10-20 years 3/5 (60.00%) male,
while 2/5 (40.00%) females were suffering from RM. In age group 21-30 years of age 8/12 (66.67%)
male while 4/12 (33.33%) females were suffering from RM. In 31-40years’ age group 5/12 (41.67%)
male, while 4/12 (58.33%) were suffering from RM. In age group 41-50 years 5/9 (55.56%) male and 7/9
(44.44%) females were suffering from RM. In 51 and above year of age group only 1/1 (100.00%) male
was suffering from RM. Table-1 and graph-1 denotes the prevalence of Rhinitis medicamentosa in both
genders in relation to age groups.

Table-1 Prevalence of Rhinitis medicamentosa in both genders in relation to age groups.

Male Female Overall
Age Groups
n(%) n(%) n(%)
<10 0(0.00) 1(100.00) 1(2.56)
10-20 3(60.00) 2(40.00) 5(12.82)
21-30 8(66.67) 4(33.33) 12(30.77)
31-40 5(41.67) 4(58.33) 12(30.77)
41-50 5(55.56) 7(44.44) 9(23.08)
51< 1(100.00) 4(0.00) 1(2.56)
Grand Total 21(53.85) 18(46.15) 39

About 53.85% patients of Rhinitis medicamentosa were male population this percentage was much
higher than female population which was recorded 46.15%. Males were found more effected as compare
to the female population (Graph-2).

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Intake Cause of Xylometazoline

In this study the cause of intake of Xylometazoline was investigated from all RM effected patients. About
12.83% patients were those who were recommended the use of Xylometazoline by physician for three
days only but due to recurring symptoms of nasal blockage they prolonged the use of Xylometazoline
which lead them to Rhinitis medicamentosa. About 51.28% patients were never advised by physician
about the maximum usage of Xylometazoline, they also extended the use more than a month and they
became addicted. About 35.90% patients were continuously using Xylometazoline as self-medication
without any prescription of physician (Graph-3).

Dust as a Cause of Allergic Rhinitis

About 89.74% patients accepted they have daily exposure to dust while going for their work / School.
While only 10.26% patients were living a dust free life. A high percentage of patients had daily exposure
to dust that lead to many nasal disorders including Allergens like Allergic Rhinitis, to treat Allergic
Rhinitis they used nasal decongestants and got addicted to it (Graph-4).

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Withdrawal from nasal decongestant sprays

Withdrawal from nasal decongestants particularly from Xylometazoline is not difficult but it requires
time and determination to get rid of it. Many other drugs are there which do not have any addictive
quality for a patient. About 20.51% respondent used nasal corticosteroids sprays to treat Rhinitis
medicamentosa, they found corticosteroids very effective against RM. About 41.02% respondents relied
Homeopathic anti-histamines and decongestants to cure root cause of nasal decongestion and nasal
allergies (Allergic Rhinitis) about 38.46% of the patients trusted that Allopathic English medicines
containing anti-histamines and anti-inflammatory tablets are best to cure RM and to get rid of
Xylometazoline.

DISCUSSIONS AND CONCLUSIONS

A high prevalence of Rhinitis medicamentosa (30.33%) was observed in age groups 21-30 as well as 31-
40 years. This high prevalance might de dye to over exposure of these respondents to dust which is the
major cause of Allergic rhinitus. To treat Allergic Rhinitis patients usually use nasal decongestents. Over
use of these nasal decongestents cause Rhinitis [Link] this study it was found that male
population Are at higher risk to get effected from Rhinitis medicamentosa. As compare to female
population. Female usually cover their face that’s why there are less chances to get any nasal infection by
them. Still females are susceptible to get any nasal infection or disease while cleaning houses and their
exposure to dust.A high percentage (51.28%) of RM-patients was those who were using Xylometazoline

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as nasal decongestant prescribed by a physician, but physician didn’t advise the maximum use of this
drug. Patients continued using whenever they felt nasal congestion. As time passed their condition got
worse and they got addicted to Xylometazoline. Self-medication is the most prevailing issue now a day in
Pakistan. About 35.90% patients accepted that they were using Xylometazoline without prescribed by
physician whenever they felt nasal blockage and soon they got addicted to it. This study revealed that
those who had daily exposure to dust, are most affected by nasal disorders / allergies and nasal
congestion. To get rid of nasal congestion people used nasal decongestants more than the recommended
time frame and get addicted to it. This study reveals that rhinitis medicamentosa can be cure by stopping
use of nasal decongestants sprays and use of other non-addictive drugs. Both Homeopathic and allopathic
medication was found effective to get rid of addiction of nasal decongestion.
This study is parallel to the findings of Pamela Brooks [3], Denver Medical Times (2014) [4] and George
Clinton Andrews [5] who highlighted that dust is the root cause of allergic rhinitis. Self medication is
always reported around the globe. According to a report of world self-medication industry [10]
Xylometazoline is one of the OCT (over the counter) drug sold without the prescription. These findings
are quite in agreement to the current study.

RECOMMENDATIONS
Xylometazoline and other nasal decongestant sprays like it are highly addictive drugs, these should not be
used more than the prescribed time duration by a physician. No medication should be used without the
prescription of a physician or a medical spiciest. Self-medication always leads to complications.
Physicians must advise the time frame of the prescribed drug and the adverse effects of prolonged using a
drug. Drug dealers should not sale any sort of medication without a proper prescription. Mask should be
used while travelling to dust zones or while working in dusty area to protect nasal passage from nasal
infections and nasal congestion. Bikers must use helmets to prevent dust enter their nose.

REFERENCES
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2014-04-27.
4. Denver Medical Times: Utah Medical Journal. Nevada Medicine. 2010-01-01. Retrieved 2014-04-27.
5. George Clinton Andrews; Anthony Nicholas Domonkos (1998-07-01). Diseases of the Skin: For Practitioners and
Students. Retrieved 2014-04-27.
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10. ^"What is self-Medication". [Link]. WORLD SELF-MEDICATION INDUSTRY. Retrieved 25 May 2016.

CITATION OF THIS ARTICLE

S Zareen, H Zareen ,M Ateeq, H Ur Rehman, W Mohammad Achakzai, S Saddozai. Xylometazoline: A tropical Nasal
Decongestant and an extensive cause of Rhinitis medicamentosa (RM). Bull. Env. Pharmacol. Life Sci., Vol 6 [1]
December 2016: 28-32

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