NAPHAZOLINE HYDROCHLORIDE

(naf-az'oh-leen)

Ak-Con, Albalon, Allerest, Clear Eyes, Comfort, Degest-2, Nafazair, Naphcon, Privine, VasoClear, Vasocon
Classifications: eye, ear, nose and throat (eent) preparation; vasoconstrictor; alpha-adrenergic agonist; decongestant;
Therapeutic: topical vasoconstrictor; decongestant
Pregnancy Category: C

Availability

0.012%, 0.02%, 0.03%, 0.1% ophthalmic solution; 0.05% nasal solution

Action

Direct-acting imidazoline derivative with marked alpha-adrenergic activity. Differs from other sympathomimetic amines in that systemic absorption may cause CNS depression rather than stimulation.

Therapeutic Effect

Produces rapid and prolonged vasoconstriction of arterioles, thereby decreasing fluid exudation and mucosal engorgement.

Uses

Nasal decongestant and ocular vasoconstrictor.

Contraindications

Narrow-angle glaucoma; concomitant use with MAO inhibitors or tricyclic antidepressants; pregnancy (category C), lactation. Safe use in children <6 y has not been established.

Cautious Use

Hypertension, cardiac irregularities, advanced arteriosclerosis; diabetes; hyperthyroidism; older adult patients.

Route & Dosage

Congestion
Adult: Intranasal 2 drops or sprays of 0.05% solution in each nostril q3–6h for no more than 3–5 d Ophthalmic See Appendix A
Child: Intranasal 1–2 drops or sprays of 0.025% solution q3–6h for no more than 3–5 d

Administration

Instillation

Instill nasal spray with patient in upright position. If administered in reclining position, a stream rather than a spray may be ejected, with possibility of systemic reaction.
Minimize amount of drug swallowed by taking care not to direct the flow toward nasopharynx and by positioning patient properly with the head tilted slightly downward.
Store at 15°–30° C (59°–86° F), protect from freezing.

Adverse Effects (≥1%)

Body as a Whole: Hypersensitivity reactions, headache, nausea, weakness, sweating, drowsiness, hypothermia, coma. CV: Hypertension, bradycardia, shock-like hypotension. Special Senses: Transient nasal stinging or burning, dryness of nasal mucosa, pupillary dilation, increased intraocular pressure, rebound redness of the eye.

Interactions

Drug: tricyclic antidepressants, maprotiline may potentiate pressor effects.

Pharmacokinetics

Onset: Within 10 min. Duration: 2–6 h.

Nursing Implications

Assessment & Drug Effects

Watch for rebound congestion and chemical rhinitis with frequent and continued use.
Monitor BP periodically for development or worsening of hypertension, especially with ophthalmic route.
Overdose: Bradycardia and hypotension can result. Report promptly.

Patient & Family Education

Do not exceed prescribed regimen. Systemic effects can result from swallowing excessive medication.
Discontinue medication and contact physician if nasal congestion is not relieved after 5 d.
Prevent contamination of eye solution by taking care not to touch eyelid or surrounding area with dropper tip.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

(140)