Oxymetazoline Metered Dose Spray: Factors Affecting Delivery Volume

Area of Science:

• Anesthesiology
• Pharmacology
• Medical Devices

Background:

• Oxymetazoline is commonly used in perioperative settings.
• Accurate medication dosing is critical to prevent adverse events.
• Metered-dose bottles may have variable delivery depending on usage.

Purpose of the Study:

• To compare the volume of oxymetazoline delivered from metered-dose bottles held upright versus inverted.
• To assess the impact of bottle volume (full vs. half-full) on drug delivery.
• To evaluate variations in delivery among different anesthesia providers.

Main Methods:

• An analytical balance was used to measure the precise volume of oxymetazoline dispensed.
• The study compared delivery volumes from full and half-full bottles.
• Bottle position (upright vs. inverted) and provider type (staff vs. trainee) were key variables.

Main Results:

• Inverting the bottle significantly increased oxymetazoline delivery compared to holding it upright for both full and half-full bottles.
• Delivery volume increased nearly 10-fold when a full bottle was inverted (62 ± 80 μL to 606 ± 366 μL).
• Significant inter-provider variability in delivered amounts was observed across all tested conditions.

Conclusions:

• Bottle position and volume influence the amount of oxymetazoline delivered from metered-dose bottles.
• The significant variability and potential for overdose highlight risks associated with current delivery methods.
• Alternative drug delivery systems are recommended for safer perioperative oxymetazoline administration.