How Afrin Works and How to Use It

Afrin is an over-the-counter (OTC) decongestant nasal spray that works by attaching to receptors in the blood vessels in the nose and sinuses, causing them to narrow (constrict).

Afrin (a brand name for oxymetazoline) is used for the temporary relief of nasal congestion ("stuffy nose") caused by conditions like the common cold, sinusitis, hay fever, and allergies. It can also be used to stop nosebleeds.

This article explains how Afrin nasal spray works, how to use it, and possible side effects and drug interactions that may limit its use for some people.

An illustration with common side effects of Afrin nasal spray

Verywell / Joules Garcia

How Afrin Works

The active ingredient in Afrin, oxymetazoline, works by binding to certain receptors in your nose called alpha-adrenergic receptors. This signals your blood vessels to constrict, which reduces inflammation.

Afrin starts to work quickly. After using it, you should start to feel the effects within five to 10 minutes.

Nasal congestion is primarily caused by mucosal inflammation. This occurs when mucus-secreting surface tissues and underlying soft tissues within the nasal passages swell in response to upper respiratory infections (like the common cold) or allergies (like hay fever).

The inflammation itself is caused when tiny blood vessels within mucosal tissues dilate (widen) to make way for larger disease-fighting immune cells. The dilation, in turn, causes fluids to leak out of the walls of the blood vessels, resulting in the rapid swelling of these tissues.

When the sinuses and nasal passages are affected, this can lead to nasal congestion and increased mucus secretion ("runny nose"). Itchiness and sneezing are also common.

What Is Oxymetazoline?

Oxymetazoline, the active ingredient in Afrin, belongs to a class of drugs called vasoconstrictors. It works by causing blood vessels to constrict (narrow), relieving nasal inflammation, reducing swollen nasal passages, and improving breathing. Afrin does not contain steroids like some other nasal sprays.

Because of its vasoconstrictive effects, Afrin can also be used to help stop nosebleeds (also known as epistaxis).

How to Use Afrin Nasal Decongestant

Afrin is available in a traditional squeeze bottle or in a "no-drip" nasal pump.

Afrin Spray Bottle

This product uses a flexible plastic bottle with a nasal tip that delivers a spray of medicine whenever you squeeze the sides of the bottle.

To use an Afrin squeeze bottle:

  1. Remove the twist cap.
  2. If you've used the bottle before, wipe the nasal tip with a tissue.
  3. Place the nasal tip in your nostril. Do not tilt your head back.
  4. Squeeze the bottle quickly and firmly, squeezing two to three times in each nostril.
  5. Wipe the nasal tip with a tissue and replace the cap.

Afrin No-Drip Nasal Pump

This version delivers a metered dose of oxymetazoline in a fine mist. The bottle is firm and topped with a spring-loaded trigger pump that you place in your nostril.

To use the Afrin nasal pump:

  1. Shake the bottle before use.
  2. Remove the cap.
  3. If you've used the bottle before, wipe the nasal tip with a tissue.
  4. Holding the bottle horizontally, place your thumb under the base of the bottle and your index finger and middle finger on either side of the spring-load trigger.
  5. Prime the pump by compressing the trigger several times.
  6. Place the nasal tip in your nostril. Do not tilt your head back.
  7. Firmly compress the trigger two to three times in each nostril.
  8. Wipe the nasal tip with a tissue, and replace the cap.

Recommended Dosage

The recommended dosage is two to three sprays per nostril every 10 to 12 hours. Do not use Afrin more than twice in any 24-hour period.

Recommended Duration of Use

Afrin (or any other nasal spray containing oxymetazoline) is only intended for short-term use to provide temporary relief of nasal congestion. Specifically, it should never be used for more than three days in a row. If it is used for longer than three days, it can cause long-lasting severe nasal congestion and even permanent changes in the nasal lining.
Afrin should not be used on an ongoing basis as it will not only become less and less effective but also increase the risk of rebound congestion. This leads to a cycle in which you need to continue to take the medication in larger doses or you'll experience even worse symptoms. If nasal congestion persists after three days, speak with your healthcare provider about alternate solutions.

Possible Side Effects and Interactions

As with all drugs, Afrin can cause side effects. They tend to be mild to manageable, but, for some people, they can be significant.

Common side effects of Afrin include:

  • Nasal burning or stinging
  • Sneezing
  • Headache
  • Dizziness
  • Drowsiness
  • Nervousness
  • Shakiness or trembling
  • Blurred vision
  • Trouble sleeping
  • Extreme nasal dryness (especially if overused)
  • Increased runny or stuffy nose (typically if overused)
  • Rapid heartbeat
  • Heart palpitations (skipped heartbeats)
  • Abnormally slow heartbeat

When to See a Healthcare Provider

On rare occasions, Afrin has been known to cause severely slowed heartbeats (bradycardia) or abnormally fast heartbeats (tachycardia). Any abnormalities in heartbeats following a dose of Afrin should be checked out immediately by a healthcare professional.

Certain drugs can also interact with Afrin and worsen the side effects of oxymetazoline. Chief among these is a class of antidepressants called monoamine oxidase inhibitors (MAOIs).

Speak with your healthcare provider before using Afrin if you take any of the following MAOIs:

  • Emsam (selegiline)
  • Marplan (isocarboxazid)
  • Nardil (phenelzine)
  • Parnate (tranylcypromine)

Who Should Not Use Afrin

There are certain people who should not use Afrin. Due to the lack of safety research, Afrin should not be used in children under 6 years of age and in people who are pregnant or breastfeeding.

Because of its vasoconstriction effects, Afrin can rapidly raise a person's blood pressure and may need to be avoided in people with uncontrolled hypertension (high blood pressure). If used, Afrin can cause chest pains, blurred vision, nausea, and vomiting.

Afrin should never be used if you have a known allergy to oxymetazoline. Doing so increases the risk of a rare but potentially life-threatening, whole-body allergy known as anaphylaxis.

Summary

Afrin (oxymetazoline) is a nasal decongestant used to relieve nasal stuffiness caused by the common cold, sinusitis, hay fever, and allergies. It works by causing the blood vessels in the nose and sinuses to constrict.

Afrin can be used up to twice daily. It should not be used for longer than three days as it can rapidly lose its effectiveness and lead to rebound congestion.

Common side effects include headache, dizziness, nasal stinging or burning, drowsiness, shakiness, and sleep problems. Afrin should not be used in children under 6, those who are pregnant or breastfeeding, or anyone who is allergic to oxymetazoline.

A Word From Verywell

Afrin is a very effective over-the-counter nasal decongestant. However, there are some caveats to its use. It can only be used for up to three days at a time, and it is not recommended for those with hypertension or heart disease. It's important to check with your healthcare provider or pharmacist before taking Afrin.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Oxymetazoline nasal spray.

  2. Kumar RS, Jain MK, Kushwaha JS, et al. Efficacy and safety of fluticasone furoate and oxymetazoline nasal spray: a novel first fixed dose combination for the management of allergic rhinitis with nasal congestion. J Asthma Allergy. 2022;15:783-792. doi:10.2147/JAA.S357288

  3. Druce HM, Ramsey SL, Karnati S, Carr AN. Topical nasal decongestant oxymetazoline (0.05%) provides relief of nasal symptoms for 12 hours. Rhinology. 2018 Dec 1;56(4):343-50. doi:10.4193/Rhin17.150

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Kristin Hayes

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.