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Otrivine adult nasal spray contains the active ingredient xylometazoline, which is a type of medicine called a decongestant.? When this medicine is sprayed into the nose, the xylometazoline works by acting on alpha receptors that are found in the walls of blood vessels in the linings of the nasal passages and sinuses. It causes these blood vessels to contract and narrow, thereby decreasing blood flow into the linings of the nose and sinuses. This reduces swelling and the feeling of congestion. It also reduces the production of mucus, helping to relieve a blocked nose. The nasal spray helps relieve congestion in a few minutes and the effect of the medicine lasts for up to 10 hours. As the medicine causes the blood vessels in the nose to contract, it minimises the amount of medicine that is absorbed into the bloodstream from the nose. This means that the nasal spray has a relatively local effect in the nose and is unlikely to have side effects on other parts of the body.