Naphazoline

Pronunciation

U.S. Brand Names

AK-Con™; Albalon®; Allersol®; Clear Eyes® ACR [OTC]; Clear Eyes® Extra Relief [OTC]; Naphcon® [OTC]; Privine® [OTC]; VasoClear® [OTC] [DSC]

Synonyms

Naphazoline Hydrochloride

Generic Available

Yes: Ophthalmic solution

Canadian Brand Names

Naphcon Forte®; Vasocon®

Use

Topical ocular vasoconstrictor; will temporarily relieve congestion, itching, and minor irritation, and to control hyperemia in patients with superficial corneal vascularity; treatment of nasal congestion; adjunct for sinusitis

Pregnancy Risk Factor

Contraindications

Hypersensitivity to naphazoline or any component of the formulation; narrow-angle glaucoma, prior to peripheral iridectomy (in patients susceptible to angle block)

Warnings/Precautions

Rebound congestion may occur with extended use; use with caution in the presence of hypertension, diabetes, hyperthyroidism, heart disease, coronary artery disease, cerebral arteriosclerosis, or long-standing bronchial asthma

Adverse Reactions

Frequency not defined.

Cardiovascular: Systemic cardiovascular stimulation

Central nervous system: Dizziness, headache, nervousness

Gastrointestinal: Nausea

Local: Transient stinging, nasal mucosa irritation, dryness, rebound congestion

Ocular: Mydriasis, increased intraocular pressure, blurred vision

Respiratory: Sneezing

Overdosage/Toxicology

Symptoms of overdose include CNS depression, hypothermia, bradycardia, cardiovascular collapse, apnea, coma

Following initiation of essential overdose management, toxic symptoms should be treated. The patient should be kept warm and monitored for alterations in vital functions. Seizures commonly respond to diazepam (5-10 mg I.V. bolus in adults every 15 minutes if needed up to a total of 30 mg; I.V. 0.25-0.4 mg/kg/dose up to a total of 10 mg for children) or to phenytoin or phenobarbital. Hypotension should be treated with fluids.

Drug Interactions

Anesthetics (discontinue mydriatic prior to use of anesthetics that sensitize the myocardium to sympathomimetics, ie, cyclopropane, halothane), MAO inhibitors, tricyclic antidepressants may cause hypertensive reactions.

Stability

Store in tight, light-resistant containers

Mechanism of Action

Stimulates alpha-adrenergic receptors in the arterioles of the conjunctiva and the nasal mucosa to produce vasoconstriction

Pharmacodynamics/Kinetics

Onset of action: Decongestant: Topical: ~10 minutes

Duration: 2-6 hours

Dosage

Nasal:

Children:

<6 years: Intranasal: Not recommended (especially infants) due to CNS depression

6-12 years: 1 spray of 0.05% into each nostril every 6 hours if necessary; therapy should not exceed 3-5 days

Children >12 years and Adults: 0.05%, instill 1-2 drops or sprays every 6 hours if needed; therapy should not exceed 3-5 days

Ophthalmic:

Children <6 years: Not recommended for use due to CNS depression (especially in infants)

Children >6 years and Adults: Instill 1-2 drops into conjunctival sac of affected eye(s) every 3-4 hours; therapy generally should not exceed 3-4 days

Patient Education

Do not use discolored solutions; discontinue eye drops if visual changes or ocular pain occur; notify prescriber of insomnia, tremor, or irregular heartbeat; stinging, burning, or drying of the nasal mucosa may occur; do not use beyond 72 hours

Nursing Implications

Rebound congestion can result with continued use

Dental Health: Effects on Dental Treatment

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions

Mental Health: Effects on Mental Status

May cause nervousness or dizziness

Mental Health: Effects on Psychiatric Treatment

TCAs and MAO inhibitors may potentiate the pressor response of decongestants; monitor for changes in response

Dosage Forms

[DSC] = Discontinued product

Solution, intranasal drops, as hydrochloride (Privine®): 0.05% (25 mL)

Solution, intranasal spray, as hydrochloride (Privine®): 0.05% (20 mL)

Solution, ophthalmic, as hydrochloride: 0.1% (15 mL)

AK-Con™, Albalon®, Allersol®: 0.1% (15 mL) [contains benzalkonium chloride]

Clear Eyes® Extra Relief: 0.012% (6 mL, 15 mL, 30 mL) [contains glycerin 0.2% and benzalkonium chloride]

Clear Eyes® ACR: 0.012% (15 mL, 30 mL) [contains glycerin 0.2%, zinc sulfate 0.25%, and benzalkonium chloride]

Naphcon®: 0.012% (15 mL) [contains benzalkonium chloride]

VasoClear®: 0.02% (15 mL) [contains benzalkonium chloride] [DSC]

International Brand Names

Afazol Grin® (MX); Albalon® (AU, BE, CH, HK, LU, NL, NZ); Albasol® (CL, CO); Alphadinal® (MX); Bactio-Rhin® (AR); Benil® (HR, SI, YU); Clarimir® (CL); Claroft® (BR); Clear Eyes® (AU); Clorhidrat de Nafazolina® (RO); Cloridrato de Nafazolina® (BR); Coldan® (AT); Colirio Alfa® (ES); Collirio Alfa® (IT); Danof® (CL); Dazolin® (AR); Deltarhinol® (BE, TR); Desamin Same® (IT); Disel® (AR); Enflucide® (TR); Gotinal® (AR); Idril® (DE); Imidazyl® (IT); Iridina due® (IT); Isoftal® (AT); Ixana® (AR); Minhavez® (BE); Miraclar® (ES); Mirafrin® (CO); Mirasan® (AR); Murine® (GB); Nafaborat® (HR); Nafa-Gal® (RO); Nafazolina® (AR); Nafazolin Jadran® (HR); Nafazolin® (RO, YU); Nafazol® (RO, YU); Naftazolina® (IT); Naphasal Drops® (IL); Naphazolin® (BG); Naphcon forte® (AU, BE); Naphcon Forte® (CA); Naphcon forte® (IL, LU, TH, ZA); Naphcon® (RO, ZA); Naphtears® (CL); Naphthyzin® (RU); Narix® (BR); Neusinol® (BE); Ocunasal® (IL); Ophaguttal® (AT); Optazine® (AU); Optrine® (ID); Priciasol® (BE); Privina® (AR, BR); Privin® (AT, DE); Proculin® (CZ, DE, HU, RO); Pupilla® (IT); Red Off® (CL); Rhinaf® (EC); Rhinal® (AR); Rhinazin® (PL); Rhinon® (AT); Rhinon - Nasentropfen® (AT); Rhinoperd® (AT); Rimidol® (SE); Rinalek® (YU); Rinazina® (IT); Rinofug® (RO); Rinogut® (RO); Rino naftazolina® (IT); Safyr Bleu® (ZA); Sanorin® (CZ, RU); Siozwo® (DE); Tele-Stulln® (DE); Vasacon® (ID); Vasocedine® (BE, LU); Vasocon® (CA); Vasoconstrictor Pensa® (ES); VasoNit® (DE); Vi-Claro® (CL); Video-mill® (IT); Virginiana gocce verdi® (IT)

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