{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:10:49Z","timestamp":1788793849256,"version":"build-2803163510"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Drug Safety"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Topical nasal decongestants containing \u03b1-adrenergic agonists such as oxymetazoline are widely available over the counter and are generally perceived as safe when used as directed. Manufacturer instructions typically recommend limited dosing frequency and short-term use (e.g. up to twice daily for no more than 3\u20137\u2009days, depending on product labelling). This report describes a signal-generating case of clinically significant but reversible hypertension temporally associated with prolonged use of oxymetazoline nasal spray in a previously normotensive adult. After 16 consecutive days of exposure exceeding the manufacturer-recommended duration and frequency stated on the product packaging, the patient developed diastolic-predominant hypertension peaking at 160\/110\u2009mmHg, accompanied by headache and autonomic symptoms. Serial fasting-morning home blood pressure measurements obtained using a validated automated upper-arm device documented the onset, peak and progressive normalization of blood pressure following discontinuation of oxymetazoline without initiating antihypertensive therapy, consistent with a positive dechallenge. The temporal relationship between exposure and blood pressure elevation, together with the plausible pharmacological mechanism involving systemic \u03b1-adrenergic vasoconstriction, supports classification as a probable adverse drug reaction. Prolonged oxymetazoline nasal spray use may represent an under-recognized safety risk and a potential confounder in the evaluation of new-onset hypertension. Clinicians should routinely inquire about over-the-counter medication use and duration when assessing unexplained blood pressure elevations.<\/jats:p>","DOI":"10.1177\/20420986261435799","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:24:52Z","timestamp":1775535892000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Rebound hypertension following prolonged oxymetazoline use: a signal-generating case report"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5744-3222","authenticated-orcid":false,"given":"Domenico","family":"Merante","sequence":"first","affiliation":[{"name":"Independent Clinical Development Consultant Physician, Zug 6300, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2006.02833.x"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.2165\/00151829-200504010-00003"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.15.1686"},{"issue":"1","key":"e_1_3_4_5_2","first-page":"22","article-title":"Does pseudoephedrine increase blood pressure in patients with controlled hypertension?","volume":"40","author":"Coates ML","year":"1995","unstructured":"Coates ML, Rembold CM, Farr BM. 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Misuse of topical nasal decongestants: a review. Ther Adv Drug Saf 2013; 4(3): 143\u2013154.","journal-title":"Ther Adv Drug Saf"},{"key":"e_1_3_4_15_2","first-page":"314","article-title":"Long-term use of nasal decongestants and rebound congestion","volume":"16","author":"Stj\u00e4rne P","year":"1991","unstructured":"Stj\u00e4rne P, Br\u00f6ms K, Nordlander B. Long-term use of nasal decongestants and rebound congestion. Clin Otolaryngol 1991; 16: 314\u2013317.","journal-title":"Clin Otolaryngol"},{"key":"e_1_3_4_16_2","first-page":"278","article-title":"Prevalence of nasal obstruction and decongestant use in rhinitis","volume":"56","author":"Klossek JM","year":"2001","unstructured":"Klossek JM, Mesbah K, Bousquet J. Prevalence of nasal obstruction and decongestant use in rhinitis. 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