Pharmacokinetics and pharmacodynamics of topical decongestants xylometazoline and oxymetazoline: a literature review

Abstract

This article provides a review and detailed analysis of scientific publications on the pharmacokinetic and pharmacodynamic characteristics of xylometazoline and oxymetazoline. Xylometazoline and oxymetazoline are two commonly used nasal decongestants used to temporarily relieve nasal congestion caused by colds, allergies, and sinusitis. Both drugs narrow blood vessels in the nasal passages, reducing edema and rhinorrhea. Aims: The aim of the study is to evaluate the pharmacokinetic and pharmacodynamic characteristics of xylometazoline and oxymetazoline based on a literature review. Material and Methods: A retrospective review of literature data was performed using Scopus, Web of Science, PubMed, and ScienceDirect databases. Different keyword combinations, such as "topical decongestants", "xylometazoline", "oxymetazoline", "pharmacokinetics" and "pharmacodynamics", were used to search for information on the problem addressed. When processing search results, either the most recent publications (over the last 10 years) or the latest publications for this topic (regardless of their release) were chosen. Results: After reviewing abstracts and getting acquainted with their full-text articles, 47 scientific sources that met the eligibility criteria were selected. Although there are minor differences between pharmacokinetics and pharmacodynamics of xylometazoline and oxymetazoline according to available literature sources, both drugs exhibit very low systemic exposure, thus reducing the number of side effects due to the lack of systemic action and producing a high local concentration of the drugs in areas of inflammation. Besides, because of its pharmacokinetic properties, xylometazoline has a faster onset of action and a shorter duration of therapeutic effect compared to oxymetazoline.