Two medicines, side by side
Oxymetazoline vs phenylephrine
Oxymetazoline and phenylephrine are both labeled for allergies and cough and cold. Drugs@FDA records approvals of oxymetazoline since 1986 and of phenylephrine since 2012. Pharmacies paid $0.111 per mL (Nasal decongestant 0.05% spray) and $5.24 per mL (Phenylephrine 10% eye drop) (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Oxymetazoline's other strengths are brand-only: $23.47 per gram (Rhofade 1% cream). In FDA's classes, oxymetazoline is a vasoconstrictor and phenylephrine an alpha-1 adrenergic agonist.
Check it at the source: the oxymetazoline FDA label on DailyMed (effective July 13, 2026); the phenylephrine FDA label on DailyMed (effective August 19, 2026).
Highlights of the oxymetazoline record
Oxymetazoline (Upneeq) · label of July 13, 2026
Used for
From the label: indicationsOxymetazoline Hydrochloride Cream, 1% is indicated for the topical treatment of persistent facial erythema associated with rosacea in adults. Oxymetazoline Hydrochloride Cream is an alpha 1A adrenoceptor agonist indicated for the topical treatment of persistent facial erythema associated with rosacea in adults.
On the market
- Earliest approval on file
- May 30, 1986
- Generic labelers
- 1 labeler
- Pharmacy cost
- $0.111 per mL
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Highlights of the phenylephrine record
Phenylephrine (Biorphen) · label of August 19, 2026
Used for
From the label: indicationsIMMPHENTIV injection 100 mcg/mL is indicated for increasing blood pressure in adults with clinically important hypotension resulting primarily from vasodilation in the setting of anesthesia. Phenylephrine Hydrochloride Injection 10 mg/mL is indicated for increasing blood pressure in adults with clinically important hypotension resulting primarily from vasodilation in the settings of anesthesia and septic shock. […]
On the market
- Earliest approval on file
- December 20, 2012
- Generic labelers
- 33 labelers
- Pharmacy cost
- $5.24 per mL
Supply and safety
- Shortage
- No current entry
- Recalls
- 90
Source: FDA drug labels via openFDA (Oxymetazoline label of July 13, 2026, Phenylephrine label of August 19, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do oxymetazoline and phenylephrine differ on the record?
In FDA's classes, oxymetazoline is a vasoconstrictor and phenylephrine an alpha-1 adrenergic agonist.
How each works, in its label's words: Oxymetazoline, “Oxymetazoline is an alpha 1A adrenoceptor agonist.”; Phenylephrine, “Phenylephrine hydrochloride is an α-1 adrenergic receptor agonist.”
Generics: oxymetazoline since 2021; phenylephrine since 2018 (Drugs@FDA).
| Oxymetazoline | Phenylephrine | |
|---|---|---|
| Labeled for | Cough and cold, Allergies | Cough and cold, Allergies |
| Pharmacologic class | Vasoconstrictor | alpha-1 Adrenergic Agonist |
| How it works (label) | Oxymetazoline is an alpha 1A adrenoceptor agonist. Oxymetazoline acts as a vasoconstrictor. | Phenylephrine hydrochloride is an α-1 adrenergic receptor agonist. |
| Half-life (label) | n/a | 12.3 Pharmacokinetics Following an intravenous infusion of phenylephrine hydrochloride, the effective half-life was approximately 5 minutes. |
| Earliest approval on file (Drugs@FDA) | May 30, 1986 | December 20, 2012 |
| First generic approved | October 4, 2021 | April 27, 2018 |
| Generic labelers (NDC) | 1 labeler | 33 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.111 per mL (Nasal decongestant 0.05% spray) | $5.24 per mL (Phenylephrine 10% eye drop) |
| 12-month price change | -0.8% | n/a |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 0 | 90 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 6,779 | 3,736 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to oxymetazoline
- every medicine labeled for the same conditions