Not Just a Drop in the Bucket—Inversion of Oxymetazoline Nasal Decongestant Container Increases Potential for Severe Pediatric Poisoning

Oxymetazoline is an over-the-counter nasal decongestant with potent alpha agonist properties. In overdoses as small as 1-2 mL, toxicity can be seen including bradycardia and respiratory depression. We demonstrated that inverting the container increased the volume delivered 20- to 30-fold compared with holding it upright in an in vitro model.