Summary of medicine characteristics - OTRIVINE ADULT MENTHOL NASAL SPRAY
1 NAME OF THE MEDICINAL PRODUCT
Otrivine Adult Menthol Nasal Spray
2 QUALITATIVE AND QUANTITATIVE COMPOSITION
Active ingredient: 0.1% w/v Xylometazoline Hydrochloride
3 PHARMACEUTICAL FORM
Nasal spray, solution
4 CLINICAL PARTICULARS
4.1 Therapeutic indications
For the symptomatic relief of nasal congestion, perennial and allergic rhinitis (including hay fever), sinusitis.
4.2 Posology and method of administration
Adults and the elderly: One application in each nostril up to 3 times daily. Do not exceed 3 applications daily into each nostril. Not suitable for children under 12 years of age.
0.1% xylometazoline hydrochloride should not be used for more than seven consecutive days. (see Warnings and precautions). The recommended dose should not be exceeded, especially in children and the elderly.
Route of administration: Nasal use.
4.3 Contraindications
Known sensitivity to xylometazoline.
Patients with trans-sphenoidal hypophysectomy or surgery exposing the dura mater.
Narrow-angle glaucoma, Rhinitis sicca or atrophic rhinitis.
Otrivine 0.1% is contraindicated in children aged less than 12 years.
People with phaeochromocytoma or prostatic hypertrophy or receiving monoamine oxidase inhibitors (MAOI) treatment or who have received them in the last two weeks.
4.4 Special warnings and precautions for use
Patients are advised not to take decongestants for more than seven consecutive days. Otrivine, like other preparations belonging to the same class of active substances, should be used only with caution in patients showing a strong reaction to sympathomimetic agents as evidenced by signs of insomnia, dizziness, tremor, cardiac arrhythmias or elevated blood pressure etc. Caution is recommended in patients with hypertension, cardiovascular disease, hyperthyroidism, narrow angle glaucoma or diabetes mellitus., phaeochromocytoma, prostatic hypertrophy, monoamine oxidase inhibitors (MAOI) treatment or who have received them in the last two weeks. (see Interactions).
Patients with long QT syndrome treated with xylometazoline may be at increased risk of serious ventricular arrhythmias.
0.1% should not be used for more than seven consecutive days: prolonged or excessive use may cause rebound congestion and/or atrophy of the nasal mucosa.
Keep out of the sight and reach of children.
Information concerning excipients
Otrivine contains benzalkonium chloride. This may cause irritation of the nasal mucosa.
4.5 Interaction with other medicinal products and other forms of interaction
The concomitant use of xylometazoline with monoamine oxidase (MAO) inhibitors or tri- and tetra-cyclic antidepressants, may cause an increase in blood pressure due to the cardiovascular effects of these substances (see Contraindications).
4.6 Fertility, pregnancy and lactation
No foetal toxicity or fertility studies have been carried out in animals. In view of its potential systemic vasoconstrictor effect, it is advisable to take the precaution of not using Otrivine during pregnancy.
No evidence of any adverse effect on the breast-fed infant. However, it is not known if xylometazoline is excreted in breast milk, therefore caution should be exercised and Otrivine should be used only on the advice of a doctor whilst breastfeeding.
4.7 Effects on ability to drive and use machines
Otrivine has no or negligible influence on the ability to drive and use machines.
4.8 Undesirable effects
The adverse effects listed below are classified by system organ class and frequency according to the following convention: very common (>1/10), common (>1/100 to <1/10), uncommon (>1/1,000 to <1/100), rare (>1/10,000 to <1/1,000) or very rare (<1/10,000).
| MeDRA SOC | Adverse reaction | Frequency |
| Immune System Disorders | Hypersensitivity reaction (angioedema, rash, pruritus) | Very rare |
| Nervous System Disorders | Headache | Common |
| Eye Disorders | Transient visual impairment | Very rare |
| Cardiac Disorders | Heart rate irregular Heart rate increased | Very rare Very rare |
| Respiratory, thoracic and mediastinal disorders | Nasal Dryness Nasal Discomfort | Common Common |
| Gastrointestinal disorders | Nausea | Common |
| General disorders and administration site | Application site burning | Common |
Other side effects include:
A burning sensation in the nose and throat
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App store.
4.9 Overdose
4.9 OverdoseSymptoms and Signs
Excessive administration of topical xylometazoline hydrochloride or accidental ingestion may cause severe dizziness, perspiration, severely lowered body temperature, headache, bradycardia, hypertension, respiratory depression, coma and convulsions. Hypertension may be followed by hypotension. Small children are more sensitive to toxicity than adults.
Treatment
Appropriate supportive measures should be initiated in all individuals suspected of an overdose, and urgent symptomatic treatment under medical supervision is indicated when warranted. This would include observation of the individual for several hours.
5.1 Pharmacodynamic properties
Otrivine is a sympathomimetic agent with marked alpha-adrenergic activity, and is intended for use in the nose. It constricts the nasal blood vessels, thereby decongesting the mucosa of the nose and neighbouring regions of the pharynx. This enables patients suffering from colds to breathe more easily through the nose. The effect of Otrivine begins within a few minutes and lasts for up to 10 hours. Otrivine is generally well tolerated and does not impair the function of ciliated epithelium.
5.2 Pharmacokinetic properties
Systemic absorption may occur following nasal application of xylometazoline hydrochloride solutions. It is not used systemically.
5.3 Preclinical safety data
5.3 Preclinical safety dataNot applicable.
6.1
Benzalkonium chloride solution
Disodium phosphate dodecahydrate
Disodium edetate
Sodium dihydrogen phosphate
Sodium chloride
Menthol
Eucalyptol
Sorbitol
Macrogol glycerol hydroxystearate
Purified water
6.2 Incompatibilities
None.
6.3 Shelf life
Unopened: 30 months.
Opened: 28 days.
6.4 Special precautions for storage
Store below 25°C.
6.5 Nature and contents of container
Squeeze bottle of high density polyethylene and polypropylene, with a polyethylene nose piece.
Pack size: 10ml
6.6 Special precautions for disposal
6.6 Special precautions for disposalMedicines should be kept out of the reach of children