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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.