Long-term use of oxy- and xylometazoline nasal sprays induces rebound swelling, tolerance, and nasal hyperreactivity

Rhinology. 1996 Mar;34(1):9-13.


It has been suggested but never confirmed, that the severity of the rebound swelling and rhinitis medicamentosa are directly proportional to the period during which the drug is used, to the frequency of its use, and to the amount of drug administered. However, no studies have been performed to evaluate the effects of various amounts of the vasoconstrictors on the development of rhinitis medicamentosa. Moreover, no in vivo studies have yet been performed to investigate whether benzalkonium chloride in nasal decongestant solutions affects the development of rhinitis medicamentosa. This study shows that rhinitis medicamentosa is a condition of nasal hyperreactivity, mucosal swelling and tolerance induced, or aggravated, by the overuse of topical vasoconstrictors with or without a preservative.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Intranasal
  • Adult
  • Benzalkonium Compounds / administration & dosage
  • Benzalkonium Compounds / adverse effects*
  • Double-Blind Method
  • Drug Tolerance
  • Female
  • Humans
  • Imidazoles / administration & dosage
  • Imidazoles / adverse effects*
  • Male
  • Nasal Decongestants / administration & dosage
  • Nasal Decongestants / adverse effects*
  • Nasal Mucosa / drug effects
  • Nasal Obstruction / chemically induced*
  • Nasal Obstruction / drug therapy
  • Oxymetazoline / administration & dosage
  • Oxymetazoline / adverse effects*
  • Preservatives, Pharmaceutical / administration & dosage
  • Preservatives, Pharmaceutical / adverse effects*
  • Rhinitis / chemically induced*
  • Time Factors


  • Benzalkonium Compounds
  • Imidazoles
  • Nasal Decongestants
  • Preservatives, Pharmaceutical
  • Oxymetazoline
  • xylometazoline