Uses

Nasal Congestion

Temporary relief of nasal congestion.

As effective as other topical vasoconstrictors.

Nasal decongestants often preferred for short-term treatment; oral agents preferred for prolonged treatment. (See Overuse under Cautions.)

Reduce swelling and facilitate visualization of nasal and pharyngeal membranes prior to surgery or diagnostic procedures.

Open obstructed eustachian ostia in ear inflammation.

Conjunctival Congestion

Temporary relief of conjunctival congestion, itching, and minor irritation.

Used alone or in fixed combination with astringents (i.e., zinc sulfate).

Controls hyperemia in patients with superficial corneal vascularity.

Ineffective in the treatment of delayed hypersensitivity reactions such as contact dermatoconjunctivitis.

Used for vasoconstrictor effect during some ocular diagnostic procedures; phenylephrine may be preferred.

Dosage and Administration

Administration

Apply topically to nasal mucosa or to conjunctiva.

Avoid contamination of the dropper tip or spray dispenser.

Intranasal Administration

Apply topically to the nasal mucosa as drops or spray.

Nasal sprays preferable due to a decreased risk of swallowing the drug and resultant systemic absorption; however, drops are easier to administer to young children.

Apply nasal drops to the dependent (lower) nostril with the patient in a lateral, head-low position. Remain in the same position for 5 minutes, then apply drops to the other nostril in a similar manner. Alternatively, instill drops while in a reclining position, with head tilted back as far as possible.

Administer nasal spray into each nostril while head is erect. Squeeze bottle quickly and firmly and sniff briskly; blow nose thoroughly after 3–5 minutes.

Rinse tips of dispensers or droppers thoroughly with hot water following use.

Ophthalmic Administration

Apply ophthalmic solution topically to the conjunctiva.

Remove contact lenses before administering ophthalmic solution; wait ≥15 minutes to reinsert contact lenses.

Do not administer discolored or cloudy solution.

Dosage

Available as tetrahydrozoline hydrochloride; dosage expressed in terms of the salt.

Pediatric Patients

Nasal Congestion

Intranasal

Children 2–5 years of age: 2–3 drops of a 0.05% solution in each nostril every 3–6 hours (typically 4–6 hours) as needed.

Children ≥6 years of age: 2–4 drops or 3–4 sprays of a 0.1% solution in each nostril every 3–8 hours (typically 4–8 hours) as needed.

Conjunctival Congestion

Ophthalmic

Children ≥6 years of age: 1–2 drops of a 0.05% ophthalmic solution in the affected eye(s) up to 4 times daily.

Adults

Nasal Congestion

Intranasal

2–4 drops or 3–4 sprays of 0.1% solution in each nostril every 3–8 hours (typically 4–8 hours) as needed.

Conjunctival Congestion

Ophthalmic

1–2 drops of a 0.05% ophthalmic solution in the affected eye(s) up to 4 times daily.

Prescribing Limits

Pediatric Patients

Nasal Congestion

Intranasal

Maximum of every 3 hours; maximum duration of 3–5 days.

Conjunctival Congestion

Ophthalmic

For self-medication: Maximum of 4 times daily; maximum duration of 3–4 days, unless directed by a clinician.

Adults

Nasal Congestion

Intranasal

Maximum of every 3 hours; maximum duration 3–5 days.

Conjunctival Congestion

Ophthalmic

For self-medication: Maximum of 4 times daily; maximum duration of 3–4 days, unless directed by a clinician.

Special Populations

No special population dosage recommendations at this time.