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Ophthalmic Plastic and Reconstructive...A 72-year-old female with epiphora presented for outpatient punctoplasty with probing and lacrimal stent placement. Oxymetazoline was administered intranasally and the...
A 72-year-old female with epiphora presented for outpatient punctoplasty with probing and lacrimal stent placement. Oxymetazoline was administered intranasally and the case was completed in standard fashion. Postoperatively, the patient desaturated with a workup revealing elevated cardiac enzymes, pulmonary congestion, and sinus bradycardia. However, the final cardiac testing was noncontributory, suggesting flash pulmonary edema secondary to intranasal oxymetazoline. This case highlights a rare presentation of pulmonary compromise secondary to oxymetazoline, emphasizing the importance of intraoperative and postoperative vigilance in simple outpatient procedures.
Topics: Female; Humans; Aged; Oxymetazoline; Pulmonary Edema; Administration, Intranasal; Nose; Lacrimal Apparatus Diseases
PubMed: 37721321
DOI: 10.1097/IOP.0000000000002529 -
Journal of Drugs in Dermatology : JDD Feb 2018Oxymetazoline cream 1.0% is FDA-approved for the topical treatment of persistent facial erythema associated with rosacea in adults. This phase 2, multicenter,... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Oxymetazoline cream 1.0% is FDA-approved for the topical treatment of persistent facial erythema associated with rosacea in adults. This phase 2, multicenter, randomized, double-blind, parallel-group study assessed the pharmacokinetics, safety, and tolerability of oxymetazoline in patients with moderate to severe erythema associated with rosacea.
METHODS
Eligible patients were randomized to 1 of 8 treatment groups (oxymetazoline cream 0.5%, 1.0%, or 1.5% or vehicle applied topically either once or twice daily for 28 days). Pharmacokinetic analyses were conducted in patients receiving oxymetazoline. Plasma samples for pharmacokinetic assessments were collected prior to dosing and 6 times postdose on days 1 and 28.
RESULTS
A total of 356 patients were included in the safety population (oxymetazoline, n=268; vehicle, n=88). Thirty patients (11.2%) in the oxymetazoline group reported treatment-related treatment-emergent adverse events, most of which were mild to moderate application-site reactions. Oxymetazoline, at all concentrations, was generally safe and well tolerated. Mean maximum observed plasma concentrations were ≤115 pg/mL across all groups; the highest mean values for area under the plasma concentration-time curve from time 0 to 24 hours following once- and twice-daily administration of oxymetazoline 1.5% were 1680 pg•h/mL and 2660 pg•h/mL, respectively. Systemic exposure to oxymetazoline increased dose proportionally with once- and twice-daily administration.
CONCLUSION
These findings support the use of oxymetazoline for the treatment of persistent facial erythema associated with rosacea. J Drugs Dermatol. 2018;17(2):213-220.
Topics: Administration, Topical; Adrenergic alpha-Agonists; Adult; Aged; Dose-Response Relationship, Drug; Double-Blind Method; Erythema; Face; Facial Dermatoses; Female; Follow-Up Studies; Humans; Male; Middle Aged; Oxymetazoline; Rosacea; Skin Cream; Treatment Outcome
PubMed: 29462230
DOI: No ID Found -
Drugs Sep 2014Rosacea is a chronic inflammatory skin condition that negatively impacts patients' quality of life. We sought to review important aspects of the pathogenesis of rosacea... (Review)
Review
Rosacea is a chronic inflammatory skin condition that negatively impacts patients' quality of life. We sought to review important aspects of the pathogenesis of rosacea and the role of new treatment options in its management. New, emerging treatments show promise; however, quality randomized controlled trials for many of these drugs are lacking. Brimonidine tartrate is an effective newly approved treatment for erythematotelangiectatic rosacea. Topical oxymetazoline has potential for the treatment of erythematotelangiectatic rosacea, with efficacy described in case reports and randomized controlled trials currently underway. Both oral and topical ivermectin have been studied for the treatment of papulopustular rosacea, both showing benefit; however, only topical ivermectin 1 % cream has been studied in randomized controlled trials. As our understanding of the etiology of rosacea continues to evolve, so will our options for therapeutic interventions. Further studies need to be performed to assess the long-term safety and efficacy of these treatments.
Topics: Administration, Cutaneous; Brimonidine Tartrate; Dermatologic Agents; Drug Design; Humans; Ivermectin; Oxymetazoline; Quality of Life; Quinoxalines; Randomized Controlled Trials as Topic; Rosacea
PubMed: 25154627
DOI: 10.1007/s40265-014-0281-x -
American Journal of Clinical Dermatology Dec 2015Rosacea is a common chronic inflammatory disorder that affects approximately 16 million Americans. The multifactorial pathophysiology of rosacea is not fully understood.... (Comparative Study)
Comparative Study Review
Rosacea is a common chronic inflammatory disorder that affects approximately 16 million Americans. The multifactorial pathophysiology of rosacea is not fully understood. Several new treatment options were recently US Food and Drug Administration approved or are in clinical trials. This paper reviews new treatment options including ivermectin, brimonidine, the new foam formulation of azelaic acid, and oxymetazoline. The potential role in therapy, patient selection, and adverse effects of these agents are discussed.
Topics: Administration, Topical; Brimonidine Tartrate; Clinical Trials, Phase III as Topic; Dermatologic Agents; Dicarboxylic Acids; Drug Approval; Female; Follow-Up Studies; Forecasting; Humans; Ivermectin; Male; Oxymetazoline; Patient Satisfaction; Rosacea; Severity of Illness Index; Treatment Outcome; United States; United States Food and Drug Administration
PubMed: 26396117
DOI: 10.1007/s40257-015-0156-2 -
The Laryngoscope Feb 2005To compare the effectiveness of ciprofloxacin and oxymetazoline solutions instilled after tympanostomy tube placement in the prevention of postoperative otorrhea and... (Comparative Study)
Comparative Study
OBJECTIVE
To compare the effectiveness of ciprofloxacin and oxymetazoline solutions instilled after tympanostomy tube placement in the prevention of postoperative otorrhea and tube occlusion.
STUDY DESIGN
Prospective cross-sectional series.
METHODS
We reviewed all bilateral myringotomy and tube placement operations performed by two full-time attending pediatric otolaryngologists during a 9 month period. Data from 488 patients who underwent surgery for otitis media were collected. Demographic and clinical variables including age, sex, number of tube insertions in the past, previous adenoidectomy, type of effusion present at surgery, and type of drop prescribed postoperatively were recorded. All patients were evaluated in the office 2 to 4 weeks postoperatively. Multivariate logistic regression analysis was used to estimate the relationship of these variables with the occurrence of otorrhea and tube patency. Odds ratios were calculated.
RESULTS
No significant differences in postoperative otorrhea or tube patency were found between ciprofloxacin (Ciloxan) and oxymetazoline solutions (Afrin, Visine LR).
CONCLUSION
Oxymetazoline and ciprofloxacin solutions are equivalent in the prevention of postoperative otorrhea and tube occlusion after tympanostomy tube placement. The implications for medication cost and potential adverse reactions are discussed.
Topics: Administration, Topical; Adolescent; Adrenergic alpha-Agonists; Anti-Infective Agents; Antibiotic Prophylaxis; Child; Child, Preschool; Chronic Disease; Ciprofloxacin; Humans; Infant; Logistic Models; Middle Ear Ventilation; Otitis Media; Otitis Media with Effusion; Oxymetazoline; Postoperative Complications; Recurrence
PubMed: 15689767
DOI: 10.1097/01.mlg.0000154746.55937.4d -
Indian Pediatrics Apr 2016
Topics: Apnea; Humans; Infant, Newborn; Infant, Premature; Male; Oxymetazoline; Retrospective Studies; Sympathomimetics
PubMed: 27156558
DOI: No ID Found -
Hawaii Medical Journal Aug 1999In this retrospective study, 36 patients were given oxymetazoline as a first step in treatment for posterior epistaxis. In 75% of the cases, epistaxis was effectively...
In this retrospective study, 36 patients were given oxymetazoline as a first step in treatment for posterior epistaxis. In 75% of the cases, epistaxis was effectively treated with oxymetazoline with no recurrent bleeding. All cases with recurrence resolved with continued administration of oxymetazoline. The results of this study propose a pharmacologic intervention for the treatment of posterior epistaxis.
Topics: Adult; Aged; Epistaxis; Female; Humans; Male; Middle Aged; Nasal Decongestants; Oxymetazoline; Recurrence; Retrospective Studies; Treatment Outcome
PubMed: 10487000
DOI: No ID Found -
Lasers in Surgery and Medicine Jan 2020Pulsed-dye laser (PDL) and oxymetazoline 1.0% cream are each used for the treatment of erythematotelangiectatic (ET) rosacea. PDL targets oxyhemoglobin and can reduce...
BACKGROUND AND OBJECTIVES
Pulsed-dye laser (PDL) and oxymetazoline 1.0% cream are each used for the treatment of erythematotelangiectatic (ET) rosacea. PDL targets oxyhemoglobin and can reduce facial erythema and telangiectasias. Oxymetazoline 1.0% cream is an α adrenergic agonist, which has shown to reduce facial erythema. The aim of this study was to determine the degree of erythema improvement and telangiectasia clearance after combination treatment with PDL plus oxymetazoline 1.0% cream.
STUDY DESIGN/MATERIALS AND METHODS
This retrospective study was conducted at two sites. Pre- and post-treatment cross-polarized images from subjects on combination treatment with PDL and oxymetazoline 1.0% cream were graded by a board-certified dermatologist at each practice. Blinded images were analyzed using the Clinical Erythema Assessment (CEA) Scale (0 = clear and 4 = severe). Unblinded images were analyzed using the five-point Telangiectasia Scale to determine the degree of improvement post-treatment compared with baseline (1 = <5% clearance and 5 = 75-100% clearance).
RESULTS
Thirty-one subjects (20 females, 11 males) of age 51 ± 13 years (mean ± standard deviation) were included in the study after an average of 4 months (range: 1-13) of daily oxymetazoline 1.0% cream and two (range: 1-4) PDL treatments. At baseline, 87% of subjects had CEA Grade 2 (mild erythema) or higher. For erythema, 55% of subjects improved by at least one CEA grade and 13% achieved two grades of improvement post-treatment. For telangiectasias, 90% of subjects achieved at least a two-point clearance (5-25%), 62% at least a three-point clearance (25-50%), and 41% at least a four-point clearance (50-75%) post-treatment. Compared with subjects with baseline CEA Grade 1-2 (almost clear to mild erythema), significantly more subjects with baseline CEA Grade 3-4 (moderate to severe erythema) achieved at least one CEA grade of improvement (P = 0.021) and two grades of CEA improvement (P = 0.041). A higher percentage of baseline CEA Grade 3-4 subjects achieved at least a two-point clearance in telangiectasias (P = 0.055).
CONCLUSIONS
Combination treatment with PDL and daily oxymetazoline 1.0% cream can safely and effectively reduce erythema and telangiectasias. Limitations include the retrospective design of the study, small sample size, and lack of a control group. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
Topics: Adrenergic alpha-Agonists; Adult; Combined Modality Therapy; Female; Humans; Lasers, Dye; Low-Level Light Therapy; Male; Middle Aged; Oxymetazoline; Retrospective Studies; Rosacea; Treatment Outcome
PubMed: 31709571
DOI: 10.1002/lsm.23176 -
American Journal of Rhinology 1998The topical anticholinergic ipratropium bromide and topical decongestant oxymetazoline were tested to determine whether oxymetazoline alone and the combination were well... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
The topical anticholinergic ipratropium bromide and topical decongestant oxymetazoline were tested to determine whether oxymetazoline alone and the combination were well tolerated and reduced rhinorrhea and middle ear pressure abnormalities during experimental rhinovirus infection. The study was double-bind, placebo-controlled, and double dummy in design. Healthy volunteers (n = 109) with low serum neutralizing antibody titer (< or = 1:2) were. Treatments inoculated with rhinovirus (type 39 or Hank's strain) and randomized to treatment with ipra-tropium bromide 0.06% two sprays per nostril (84 micrograms per treatment) and oxymetazoline 0.05% two sprays per nostril, oxymetazoline alone, or placebo. Treatments were self administered twice daily for 5 days beginning 1 day after rhinovirus inoculation. The overall infection rate was 83% and of those infected, 88% felt that they had a cold. During the 3-hour period after dosing, the increase in nasal discharge was significantly lower in the combined ipratropium and oxymetazoline (0.13 +/- 0.17 gm/3 hr, mean +/- SE) than after oxymetazoline alone (0.60 +/- 0.18 gm/3 hr) or vehicle (0.73 +/- 0.18 gm/3 hr). Over the 5-day observation period, total daily nasal discharge also tended to be lower in the ipratropium plus oxymetazoline group (3.67 +/- 0.70 gm/24 hr, mean +/- SE) compared to oxymetazoline (5.61 +/- 0.73: 35% reduction) or the vehicle (5.04 +/- 0.73; 27% reduction) recipients, but the differences were not statistically significant. Subjective assessments of rhinorrhea indicated that the severity of rhinorrhea was significantly better among patients receiving oxymetazoline alone or with ipratropium compared to the vehicle. No significant difference in the cumulative frequencies of middle ear pressure abnormalities (27-31%) were found among the treatment groups. Oxymetazoline does not consistently stimulate or decrease nasal mucus production, and ipratropium added to oxymetazoline is well tolerated and reduces rhinorrhea during experimental rhinovirus infection.
Topics: Administration, Intranasal; Adolescent; Adult; Double-Blind Method; Drug Combinations; Ear, Middle; Female; Humans; Ipratropium; Male; Nasal Mucosa; Oxymetazoline; Picornaviridae Infections; Pressure; Rhinovirus
PubMed: 9578931
DOI: 10.2500/105065898781390316 -
Journal of the American Academy of... Sep 2018
Topics: Adolescent; Adrenergic alpha-Agonists; Adult; Erythema; Facial Dermatoses; Humans; Oxymetazoline; Rosacea; Severity of Illness Index; Skin Cream; Time Factors; Young Adult
PubMed: 29860043
DOI: 10.1016/j.jaad.2018.05.037