[deng]

Oxymetazoline is different from Xylometazoline, although it was derived from it. Xylometazoline is pretty harmless for adults when not used over extended periods (it is advised to not use it longer than 6 days, but that will cover your typical cold). It is true that if you take it regularly over extended periods, you will have a rebound effect and your nose will get congested when not taking it, so in that way, you develop a "physical dependency", but that's obviously much more harmless than other medication dependencies. Getting off a Xylometazoline dependence means that you'll have to deal with a congested nose for a few weeks...

[sph]

I don't see from your comment how the risk from congested nose for a few weeks deems it "harmless" for you. Two fully congested nostrils is hell for one night alone, imagine a few weeks of that. A few weeks of terrible sleep, if any. It's torture.

It can also cause permanently enlarged turbinates with chronic use.

[deng]

I said it's more harmless than other medication dependencies, like getting hooked on pain medication or benzos. Even here in tightly regulated Germany, Xylometazoline can be bought without a prescription. It is very effective and, compared to other drugs, pretty harmless.

Look, there are always extreme cases. Just look up how many people need a liver transplant or even die each year from misusing paracetamol. So should we make it a prescription drug? Maybe, I don't know, it's always a trade-off.

[gojomo]

Is there any basis to think xylo- is better than the similar oxymetazoline available in the US? Both the efficacy and downsides seem similar from discussion so far.

[sph]

> I said it's more harmless than other medication dependencies, like getting hooked on pain medication or benzos.

I've never taken any opiod, but two weeks of being unable to breathe properly or sleep sounds as hellish as my idea of quitting heroin.

I mean, I quit smoking, hardest thing I've ever done, and the physical withdrawal effects were insignificant compared to that.

It's funny; looking back, I quit smoking exactly BECAUSE I was suffering from crazy congestion, and after a week of Afrin and poor sleep I thought quitting smoking altogether would help me regain my sanity.

[deng]

> I've never taken any opiod, but two weeks of being unable to breathe properly or sleep sounds as hellish as my idea of quitting heroin.

Let me assure you that there's (yet?) no Xylometazoline epidemic ravaging though Europe, with tens of thousands of people dying each year, destroying families and communities, in effect causing endless grief for people and huge profits for pharma companies. There's also no black market for Xylometazoline, with people overdosing because there's nasal spray on the street that is contaminated with a much more potent derivative than can kill pretty much instantly. I've also never heard of babies born with congested noses that spend their first weeks of life going through a Xylometazoline withdrawal.

So to summarize, I think my initial statement that a physical dependence on Xylometazoline is less harmful than a dependence on opioids is probably correct.

[sph]

Not very harmful on an absolute scale != harmless. There is a whole spectrum between harmless and bloody heroin.

[deng]

OK, this is getting ridiculous, but stop putting words in my mouth. So for the third time: less harmful than a dependence on pain killers. How this could be even a controversial statement is completely beyond me, but HN never stops to surprise me.

[qwerty456127]

Many medicines pose some risk to some people who would abuse it for too long. Xylometazoline just is crazy effective (instantly eliminates congestion and running nose completely in most cases) and completely harmless in what looks like 99% cases of usage - nearly-everyone here in the EU uses it happily and has no problems. I would really dread a cold without it and never travel without having it with me. Just try to not over-use habitually. The sense of measure is always a key to healthy and happy living.

[jorvi]

That’s why if you developed a dependence you don’t quit cold turkey.

The strategy I’ve heard is purchasing a normal bottle, and refilling it with boiled cool water when it’s ½ empty. Then refilling it again when it’s ¾ empty.

Xylometazoline is an absolute godsend, and has even more efficacy in a dual-action spray with saline water.

It feels nothing short of magical to do one spray per nostril, and be completely uncontested in less than 10 minutes.

[gojomo]

In my experience oxymetazoline has similar fast-action - even "10 minutes" seems a bit on the long side.