Afrin Nasal Spray Ingredients And Side Effects

Afrin is a popular nasal spray used for temporary relief of congestion in the nose. There have been a number of cases though where people have had certain side effects as a result of using Afrin or other oxymetazoline based nasal decongestants.

Oxymetazoline hydrochloridealpha-1A adrenoceptor used as nasal decongestant
benzalkonium chloride solutionAn organic salt used as a biocide due to its anti-microbial properties
edetate disodiumworks as a chelating agent to bind free calcium in nasal secretions
polyethylene glycol,A petroleum product used to treat dryness and irritation in the nose
propylene glycolworks as a nasal lubricant by moisturizing the nose
sodium phosphate dibasicused as a saline laxative
sodium phosphate monobasic

Side Effects:

1. Oxymetazoline:

Rebound Congestion:

Overuse of Afrin or other nasal decongestants can result in a condition known as Rhinitis medicamentosa or rebound congestion, which is characterized by inflammation of the nasal mucosa. Afrin and other decongestants work as a vasoconstrictor by shrinking your blood vessels that are swollen and inflamed, providing relief and making it easier to breathe. This vasoconstriction is done by stimulating alpha-adrenergic receptors. However the blood vessels in your nose can become dependent on the ingredients in the nasal spray and when the medication wears off, the blood vessels can swell back up. According to the NIH, this condition can develop by using a nasal decongestant continuously for more than 7 to 10 days. Link


As Oxymetazoline is lipophilic, it can cross the blood-brain barrier and cause a strong stimulating effect on the central nervous system. Link

There was a case of a 41 year old man who had been using a 20ml spray container daily (which should have lasted two weeks at the maximum recommended dosage). He had apparently developed some kind of paranoia that there were thought readers implanted in his ear and they could control his actions and he was extremely fearful of his demise. Link

Thunderclap Headache:

Oxymetazoline can cause reversible segmental cerebral vasoconstriction, resulting in thunderclap headache. A 31 year old woman reportedly had the worst headache of her life which was found to be primarily caused by the use of oxymetazoline. Link

Syncope Development:

Syncope development has been reported in males following the use of nasal oxymetazoline. Link

An Extreme Case Of Cardiac Arrest:

There was a case where a 2 year old child developed cardiac arrest after using oxymetazoline nasal spray. In this incident, oxymetazoline nasal spray 0.025% was administered to a 2-year-old patient during general anesthesia for nasal endoscopy. Severe hypertension with reflex bradycardia progressed to sinus arrest but was successfully treated with atropine and cardiopulmonary resuscitation. Link

Side effects of oxymetazoline can include insomnia, runny nose, dizziness while more serious side effects include an irregular heartbeat, trembling and high blood pressure

2. Benzalkonium Chloride Solution:

Sustained use of BKC alone induces nasal mucosal swelling

3. Edetate Disodium:

For EDTA, the most common side effect is nasal discharge but mild burning sensations in the nose or throat may also occur

4. Polyethylene Glycol:

The most commonly reported side effect from polyethylene glycol is a mild stinging sensation