Generic Name

Naphazoline Hydrochloride and Pheniramine Maleate

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Classification

FDA Approved Indications

• Relief of ocular redness due to minor irritations of the eye or allergies

Mechanism of Action

Naphazoline stimulates alpha-adrenergic receptors causing vasoconstriction; Pheniramine blocks H1 histamine receptors reducing allergic symptoms.

Dosage and Administration

Adult: 1-2 drops in affected eye(s) up to 4 times daily as needed

Pediatric: Use only under guidance of a healthcare professional; generally not recommended for children without medical advice

Geriatric: Use with caution; monitor for systemic effects due to vasoconstriction and antihistamine activity

Renal Impairment: Adjustments not specifically defined; use with caution due to systemic absorption

Hepatic Impairment: Use with caution; no specific dosing guidelines available

Pharmacokinetics

Absorption: Minimal systemic absorption when used topically

Distribution: Primarily localized in ocular tissues

Metabolism: Metabolized in the liver; specific pathways not well defined

Excretion: Renal excretion of metabolites

Half Life: Not precisely established; systemic activity is limited with topical use

Contraindications

• Hypersensitivity to naphazoline, pheniramine, or other sympathomimetics or antihistamines
• Acute narrow-angle glaucoma

Precautions

• Use with caution in patients with cardiovascular disease, hypertension, or thyroid disease; avoid prolonged use to prevent rebound conjunctivitis or other effects

Adverse Reactions - Common

• Transient ocular irritation or burning (Common)
• Blurred vision or discomfort (Common)

Adverse Reactions - Serious

• Increased intraocular pressure, allergic reactions, systemic effects such as hypertension or tachycardia, especially with overuse (Rare)

Drug-Drug Interactions

• Other adrenergic or sympathomimetic drugs, which may enhance vasoconstrictive effects; CNS depressants may enhance sedation from pheniramine

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Use as directed, do not exceed recommended dose or duration
• Avoid touching the tip of the bottle to prevent contamination
• Report any adverse reactions or persistent symptoms

Special Considerations

Black Box Warnings:

• Potential for systemic absorption leading to increased blood pressure and effects of sympathomimetics
• Rebound congestion if overused

Genetic Factors: None specific to this combination

Lab Test Interference: Rare; may interfere with intraocular pressure measurements

Overdose Management

Signs/Symptoms: Severe hypertension, CNS disturbances, tachycardia, restlessness

Treatment: Discontinue use, provide symptomatic treatment, and support as needed; specific antidotes are not available

Storage and Handling

Storage: Store at room temperature, away from light and moisture

Stability: Stable when stored properly; discard expired medication