[Decongestant nasal spray. Results of a rhinomanometric double-blind study]

Between november 1993 and july 1995 60 patients with a common cold underwent randomized and double-blind testing of 3 commercial nasal sprays-benzydamine, xylometazoline combined with the secretolytic S-carboxymethylcysteine, and phenylephrine combined with the antihistaminic dimethindene maleate. After prior active rhinomanometric measurement of the untreated nose, the test substance was applied. The change of nasal patency was registered after 3 and 10 minutes and then after 2, 4, 6 and 8 hours. At the end the patient gave a subjective evaluation of the used spray. There was no change in nasal obstruction following application of NaCl or benzydamine. Xylometazoline/S-carboxymethylcysteine (+87%) or phenylephrine/ dimethindene maleate (+113%) augmented nasal patency within minutes. Using phenylephrine/dimethindene maleate the effect lasted less than 2 hours, while after xylometazoline/S-carboxymethylcysteine decongestion lasted more than 6 hours. The patients also subjectively reported an increase in nasal patency after the use of benzydamine and placebo. But only phenylephrine/ dimethindene maleate or xylometazoline/S-carboxymethylcysteine were judged good. Using benzydamine or phenylephrine + dimethindene maleate, more side-effects (mainly dryness and burning) were mentioned. Considering the subjective assessment of side-effects and duration of action, as well as objective parameters, derivatives of imidazole (oxymetazoline and xylometazoline) are first choice in treatment of the common cold.