Over-the-counter (OTC) medicine monograph: topical nasal decongestants

This monograph only applies to medicines containing oxymetazoline hydrochloride (CAS No. 2315-02-8) or xylometazoline hydrochloride (CAS No. 1218-35-5) as a single active ingredient and excludes medicines containing any other salts or derivatives of these active ingredients.

Acceptable dosage forms and strengths are shown in the table below.

Therapeutic indications for inclusion in the Australian Register of Therapeutic Goods (ARTG)

Temporary relief of nasal and sinus congestion due to colds, influenza, sinusitis and allergies.

Label indications

• Label indications should be consistent with the indications above. References to 'runny nose', 'blocked nose', 'stuffy nose', 'flu' and 'hayfever' are also acceptable.
• References to 'fast relief', 'starts to work in minutes', 'relief in minutes' or similar, are acceptable.
• References to 'long lasting', '12 hour relief, or similar, are acceptable for oxymetazoline HCl.
• Reference to 'long lasting', 'lasts up to 10 hours' or similar, are acceptable for xylometazoline HCl.
• Reference to 'temporary' relief must be included at least once on the label in association with the label indications.

Directions for use and advisory statements, as detailed below, are required on the carton and container labels. However, for small containers where label space may be limited, abbreviation or omission of some information may be appropriate. As much information as possible should be included on the container label while still maintaining readability.

Dosage

Additional instructions

• Include instruction to blow the nose before administering.
• Instructions regarding use of the pump and other safety statements may be included as appropriate.
• The statement 'This product should be used by only one person. Sharing may spread infection' may be included.

Advisory statements

The following advisory statements are required:

• 'Do not use for more than three days at a time unless advised by a doctor or pharmacist.'
• 'If congestion persists, consult your doctor or pharmacist.'
• 'Frequent or prolonged use may cause nasal congestion to recur or worsen.'
• 'If you are pregnant or breastfeeding, check with your doctor or pharmacist before using this product.' (only required on the primary (outer) pack label)

Note: this monograph currently includes all required advisory statements for oxymetazoline hydrochloride and xylometazoline hydrochloride, including those specified in the 'Australian regulatory guidelines for OTC medicines' (ARGOM) and the 'Required advisory statements for medicine labels' (RASML).

Labelling must comply with all relevant Australian regulatory requirements, as detailed in the document Requirements for OTC new medicine N2 applications.

Note: labelling for metered-dose sprays should include the minimum number of sprays in the container, in accordance with the definition for 'quantity of the goods' in 2(1) of TGO69 (this refers to number of 'doses', but 'sprays' is most appropriate). Fill volume should also be included.

In addition to the quality requirements outlined in the document Requirements for OTC new medicine N2 applications, the following specific requirements apply to topical nasal decongestant monograph medicines:

Finished product specifications

In addition to other requirements specified in the document Requirements for OTC new medicines N2 applications, the finished product specifications must comply, at a minimum, with the relevant set of requirements below.

The requirements below include all relevant BP general monograph/USP General Chapter requirements. Further reference to these is not required. References to pharmacopoeial monographs below refer to the current monograph at time of application.

Oxymetazoline hydrochloride spray

The tests and limits in the USP monograph Oxymetazoline Hydrochloride Nasal Solution with the addition of:

• solution appearance
• delivered dose uniformity, in accordance with USP General Chapter. Where the label does not specify a dose per actuation, the 'label claim' referred to in the USP test should be calculated from the volume delivered per actuation and the concentration of the solution
• BP impurity A (see BP Medicinal and Pharmaceutical Substances monograph for Oxymetazoline Hydrochloride; NMT 1.5%); other individual impurities (NMT 1.0%); and total impurities (NMT 3.0%)
• content of any preservatives included in the formulation
• microbiological quality, in compliance with TGO 77

Xylometazoline hydrochloride spray

The tests and limits in the USP monograph Xylometazoline Hydrochloride Nasal Solution with the addition of:

• solution appearance
• delivered dose uniformity, in accordance with USP General Chapter. Where the label does not specify a dose per actuation, the 'label claim' referred to in the USP test should be calculated from the nominal volume delivered per actuation and the concentration of the solution
• BP impurity A (see BP Medicinal and Pharmaceutical Substances monograph for Xylometazoline Hydrochloride; NMT 3.0%²); other individual impurities (NMT 1.0%); and total impurities (NMT 3.0%)
• content of any preservatives included in the formulation
• microbiological quality, in compliance with TGO 77

Xylometazoline hydrochloride drops

The tests and limits in the USP monograph Xylometazoline Hydrochloride Nasal Solution with the addition of:

• solution appearance
• BP impurity A (see BP Medicinal and Pharmaceutical Substances monograph for Xylometazoline Hydrochloride; NMT 3.0%1); other individual impurities (NMT 1.0%); and total impurities (NMT 3.0%)
• content of any preservatives included in the formulation
• microbiological quality, in compliance with TGO 77

or

The tests and limits in the BP monograph Xylometazoline Nasal Drops with the addition of:

• solution appearance
• other individual impurities (NMT 1.0%); and total impurities (NMT 3.0%)
• content of any preservatives included in the formulation
• microbiological quality, in compliance with TGO 77

Container

Nasal sprays are to be in metered dose spray containers with target volume per actuation as follows:

• Oxymetazoline hydrochloride 0.5 mg/mL: 50 - 100 µl per spray
• Xylometazoline hydrochloride 0.5 mg/mL: 60 - 80 µl per spray
• Xylometazoline hydrochloride 1 mg/mL: 130 - 150 µl per spray

1. For use in children aged 6-11 years only
2. Consistent with the limit for this impurity (specified as N-(2-Aminoethyl)-4-tert-butyl-2,6-xylylacetamide) in Xylometazoline Nasal Drops BP.