Systemic side effects of locally used oxymetazoline

Abstract

Objectives: The object of the study is to experimentally investigate the possible systemic side effects of Oxymetazoline including its nasal spray which has been in use for a long time both by the physicians and patients. There is no study in the literature to address the damages of oxymetazoline on the end organ.

Materials and methods: The study conducted on 2 groups of rat. Group 1 (n = 8): Control; and Group 2 (n = 8): Oxymetazoline. During 4 week, the control group was applied with 2 drops of saline water on each nasal cavity 3 times a day and the other group was applied with 2 drops of oxymetazoline HCl 3 times a day. At the end of experiment, samples from mandible, parotid and tails of the rats were taken in 10% formalin for histopathological investigations.

Results: In histopathological experiments, when compared with the control group, the oxymetazoline group showed significant increase in many of the histopathological parameters (ischemic changes: P = 0.0001; congestion: P = 0.0006; arterial thrombosis: P = Ns; PNL accumulations: P = 0.001; necrosis: P = 0.0001; and ulceration: P = 0.014). The results of histopathologic tests on the samples taken from mandible and parotid gland, in comparison with the control group, showed no significant increase (focal inflammation: P = Ns; and lymphocyte aggregation: P = Ns).

Conclusion: Due to the damage that the long-term use of nasal spray including oxymetazoline, it may cause injury on the end organ, which we revealed in our histopathological experiments. We believe that it's essential for the physicians to provide information on the side effects of the medicine to their patients who use for a long term.

Keywords: Nasal spray; end-organ injury; oxymetazoline; systemic side effects.

Figure 1

Tail histology of rats. A and B: Control group rats with normal tail histology (Hematoxylin-eosin (H&E), × 100). C and D: Ischemic changes, congestion, arterial thrombosis, neutrophil accumulation, necrosis and ulceration in the rats administered with oxymetazoline (H&E, × 100).

Figure 2

Mandibular and parotid gland histology of rats. A: Control group rats with normal mandibular histology (Hematoxylin-eosin (H&E), × 100). B: Oxymetazoline group rats with normal mandibular histology (H&E, × 100). C and D: Focal inflammation and minimal periductal inflammation in the rats’ parotid gland administered with oxymetazoline (H&E, × 100).