Hexarhinal Plus (Xylometazoline Hydrochloride, Dexpanthenol)

Hexarhinal Plus is indicated for the temporary relief of nasal congestion caused by various upper‑respiratory conditions.

• Nasal congestion due to seasonal or perennial allergic rhinitis, providing rapid decongestion.
• Nasal blockage associated with non‑allergic (vasomotor) rhinitis, helping to open the nasal passages.
• Congestion and nasal stuffiness that accompany the common cold, reducing the feeling of a “blocked” nose.
• Relief of sinus pressure and mild discomfort during acute rhinosinusitis, supporting easier breathing.
• Adjunctive use after nasal surgery or trauma, when a clinician recommends short‑term decongestion to minimise swelling.

• Xylometazoline hydrochloride acts as an alpha‑adrenergic receptor agonist on the smooth muscle of nasal mucosal blood vessels, causing vasoconstriction and reducing edema. This vasoconstrictive effect decreases blood flow, leading to rapid opening of the nasal airway. Dexpanthenol, a derivative of pantothenic acid, is converted to active coenzyme A in epithelial cells, promoting cellular proliferation and repair, and enhancing mucosal hydration.

Adverse reactions to Hexarhinal Plus are generally mild and transient, but occasional more serious events have been reported, especially with improper or prolonged use.

Common

• Transient nasal burning or stinging sensation.
• Mild nasal dryness or crusting.
• Temporary headache.
• Sneezing or mild irritation of the nasal mucosa.
• Mild taste disturbance or after‑taste.
• Nasal discharge that is clear and watery.

Serious

• Persistent nasal congestion or rebound congestion after prolonged use.
• Severe nasal bleeding (epistaxis).
• Allergic reaction such as rash, itching, or swelling of the face.
• Elevated blood pressure in susceptible individuals.
• Nasal ulceration or perforation with prolonged misuse.
• Systemic effects such as tachycardia or palpitations.

When using Hexarhinal Plus, certain precautions should be observed to minimise risk and ensure safe and effective treatment.

• Do not exceed the recommended duration of three consecutive days to avoid rebound congestion.
• Avoid use in children under six years of age unless directed by a healthcare professional.
• Consult a physician before use if you have hypertension, heart disease, diabetes, or thyroid disorders.
• Discontinue the product and seek medical advice if nasal irritation persists or worsens.
• Use with caution in pregnant or breastfeeding women, as safety data are limited.
• Do not share the nasal spray with others to prevent cross‑contamination.

Hexarhinal Plus may interact with other medications or substances; awareness of potential interactions helps prevent reduced efficacy or increased adverse effects.

Avoid

• Concurrent use of other topical nasal decongestants (e.g., oxymetazoline, phenylephrine) due to risk of excessive vasoconstriction.
• Prolonged use together with systemic sympathomimetic agents (e.g., pseudoephedrine) that may raise blood pressure.

Use with caution

• MAO‑inhibitors or tricyclic antidepressants, as they can potentiate sympathomimetic effects.
• Antihypertensive drugs, because nasal decongestants may counteract blood‑pressure‑lowering actions.
• Nasal corticosteroids, which may be combined under medical supervision but require monitoring for irritation.
• Antihistamine eye drops, as combined use may increase local irritation but generally considered safe.