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Tetrahydrozoline (Nasal)

Generic name: tetrahydrozoline nasal

Brand names: Tyzine, Tyzine Nasal, Tyzine Pediatric Nasal

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Nasal, as hydrochloride:

Tyzine: 0.05% (15 mL [DSC]) [contains benzalkonium chloride, edetate disodium]


Mechanism of Action

Stimulates alpha-adrenergic receptors in the arterioles of the nasal mucosa to produce vasoconstriction


Onset of Action

Decongestant: 4-8 hours

Use: Labeled Indications

Symptomatic relief of nasal congestion


Hypersensitivity to tetrahydrozoline or any component of the formulation. The 0.5% solution is contraindicated in children <2 years of age. The 0.1% solution is contraindicated in children <6 years of age.

Dosage and Administration

Dosing: Adult

Nasal congestion: Intranasal: Instill 2-4 drops or 3-4 sprays of 0.1% solution into each nostril every 3-4 hours as needed, no more frequently than every 3 hours

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Nasal congestion: Intranasal:

Children 2-6 years: Instill 2-3 drops of 0.05% solution into each nostril every 4-6 hours as needed, no more frequently than every 3 hours

Children >6 years: Refer to adult dosing.


Do not use if solution changes color or becomes cloudy. Store below 30°C (86°F).

Drug Interactions

Esketamine: Decongestants (Nasally Administered) may diminish the therapeutic effect of Esketamine. Management: Patients who require a nasal decongestant on an esketamine dosing day should administer the nasal decongestant at least 1 hour before esketamine. Consider therapy modification

Monoamine Oxidase Inhibitors: May enhance the hypertensive effect of Tetrahydrozoline (Nasal). Avoid combination

Adverse Reactions

>10%: Respiratory: Sneezing, stinging sensation of the nose

1% to 10%:

Cardiovascular: Hypertension, palpitations, tachycardia

Central nervous system: Headache

Neuromuscular & skeletal: Tremor

Ophthalmic: Blurred vision


Concerns related to adverse effects:

  • Somnolence: Profound sedation may occur in children following overdose. This may be accompanied by diaphoresis, hypotension, and/or shock. Do not exceed recommended dosages.

Disease-related concerns:

  • Cardiovascular disease: Use with caution in patients with cardiovascular disease, including hypertension and coronary artery disease.
  • Endocrine disorders: Use with caution in patients with endocrine disorders, including diabetes and hyperthyroidism.

Other warnings/precautions:

  • Appropriate use: For intranasal use only.
  • Accidental ingestion: Accidental ingestion by children of over-the-counter (OTC) imidazoline-derivative eye drops and nasal sprays may result in serious harm. Serious adverse reactions (eg, coma, bradycardia, respiratory depression, sedation) requiring hospitalization have been reported in children ≤5 years of age who had ingested even small amounts (eg, 1-2 mL). Contact a poison control center and seek emergency medical care immediately for accidental ingestion (FDA Drug Safety Communication, 2012).

Monitoring Parameters

Blood pressure, heart rate, symptom response


Pregnancy Risk Factor


Pregnancy Considerations

Animal reproduction studies have not been conducted.

Patient Education

  • Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
  • Patient may experience sneezing, burning, stinging, or nasal dryness. Have patient report immediately to prescriber severe loss of strength and energy, chest pain, fast heartbeat, passing out, abnormal heartbeat, tremors, severe headache, severe dizziness, pale skin, sweating a lot, trouble sleeping, or fatigue (HCAHPS).
  • Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

Source: Wolters Kluwer Health. Last updated November 13, 2019.