How Afrin (Oxymetazoline) Works

Afrin (oxymetazoline) is an over-the-counter (OTC) nasal spray that relieves congestion by narrowing the blood vessels in the nose and sinuses, which reduces swelling. Afrin works within minutes and can last for up to 12 hours.

How Afrin Relieves Nasal Congestion

Nasal congestion is primarily caused by mucosal inflammation. This occurs when mucus-secreting surface tissues and underlying soft tissues within the nasal passages swell. Afrin works to control this swelling by:

Mechanism of action: The active ingredient in Afrin, oxymetazoline, works by binding to certain receptors in your nose called alpha-adrenergic receptors. This signals your blood vessels to constrict, which reduces inflammation.

Vasoconstriction: Nasal inflammation is caused when tiny blood vessels within mucosal tissues dilate (widen) to make way for larger disease-fighting immune cells. The dilation, in turn, causes fluids to leak out of the walls of the blood vessels, resulting in rapid tissue swelling. Afrin constricts these blood vessels and stops fluid leakage.

Temporary relief: Afrin offers temporary relief from nasal congestion due to upper respiratory infections (like the common cold), allergies (like hay fever), or sinus infections. While it doesn’t address the root cause of the congestion, it helps ease the symptoms.

Duration: Afrin starts to work quickly. After using it, you should start to feel the effects within five to 10 minutes. The effects can last for up to 12 hours.

Rebound congestion: Afrin should not be used on an ongoing basis as it will become less effective and increase the risk of rebound congestion, a cycle in which you need to continue to take the medication in larger doses to avoid experiencing even worse symptoms. If nasal congestion persists after three days, speak with your healthcare provider about alternate solutions.

Recommended Dosage

The recommended dosage is two to three sprays per nostril every 10 to 12 hours. Do not use Afrin more than twice in any 24-hour period.

How to Use Afrin Nasal Decongestant

Afrin is available in a traditional squeeze bottle or in a “no-drip” nasal pump.

Afrin spray bottle: This product uses a flexible plastic bottle with a nasal tip that delivers a spray of medicine whenever you squeeze the sides of the bottle. To use an Afrin squeeze bottle:

1. Remove the twist cap.
2. If you’ve used the bottle before, wipe the nasal tip with a tissue.
3. Place the nasal tip in your nostril. Do not tilt your head back.
4. Squeeze the bottle quickly and firmly, squeezing two to three times in each nostril.
5. Wipe the nasal tip with a tissue and replace the cap.

Afrin no-drip pump mist: This version delivers a metered dose of oxymetazoline in a fine mist. The bottle is firm and topped with a spring-loaded trigger pump that you place in your nostril. To use the Afrin nasal pump:

1. Shake the bottle before use.
2. Remove the cap.
3. If you’ve used the bottle before, wipe the nasal tip with a tissue.
4. Holding the bottle horizontally, place your thumb under the base of the bottle and your index finger and middle finger on either side of the spring-loaded trigger.
5. Prime the pump by compressing the trigger several times.
6. Place the nasal tip in your nostril. Do not tilt your head back.
7. Firmly compress the trigger two to three times in each nostril.
8. Wipe the nasal tip with a tissue, and replace the cap.

Possible Side Effects and Interactions

As with all drugs, Afrin can cause side effects. They tend to be mild to manageable, but for some people, they can be significant. Common side effects of Afrin include:

• Nasal burning or stinging
• Sneezing
• Headache
• Dizziness
• Drowsiness
• Nervousness
• Shakiness or trembling
• Blurred vision
• Trouble sleeping
• Extreme nasal dryness (especially if overused)
• Increased runny or stuffy nose (typically if overused)
• Rapid heartbeat
• Heart palpitations (skipped heartbeats)
• Abnormally slow heartbeat

Certain drugs can also interact with Afrin and worsen the side effects of oxymetazoline. Chief among these is a class of antidepressants called monoamine oxidase inhibitors (MAOIs).

Speak with your healthcare provider before using Afrin if you take any of the following MAOIs:

• Emsam (selegiline)
• Marplan (isocarboxazid)
• Nardil (phenelzine)
• Parnate (tranylcypromine)

Who Should Not Use Afrin

Certain people should not use Afrin. Due to the lack of safety research, Afrin should not be used in children under six years of age and in people who are pregnant or breastfeeding.

Because of its vasoconstriction effects, Afrin can rapidly raise a person’s blood pressure and may need to be avoided in people with uncontrolled high blood pressure (hypertension). If used, Afrin can cause chest pains, blurred vision, nausea, and vomiting.

Afrin should never be used if you have a known allergy to oxymetazoline. Doing so increases the risk of a rare but potentially life-threatening, whole-body allergy known as anaphylaxis.

A Word From Verywell

Afrin is a very effective over-the-counter nasal decongestant. However, there are some caveats to its use. It can only be used for up to three days at a time, and it is not recommended for those with hypertension or heart disease. It’s important to check with your healthcare provider or pharmacist before taking Afrin.