Home Drug Guide Naphazoline Hydrochloride and Pheniramine Maleate

Drug Guide

Generic Name

Naphazoline Hydrochloride and Pheniramine Maleate

Brand Names Opcon-A, Naphcon-A, Visine-NAPH, Naphazoline Hydrochloride and Pheniramine Maleate

Classification

Therapeutic: Decongestant, Antihistamine combination

Pharmacological: Naphazoline: Alpha-adrenergic agonist; Pheniramine: Antihistamine (H1 antagonist)

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

Assessment: Assess for hypersensitivity, contraindications, and ocular condition

Diagnoses:

  • Risk for adverse reactions related to vasoconstriction and antihistamine effects
  • Impaired visual comfort

Implementation: Instill proper drops, instruct patient on avoiding rubbing eyes, monitor for side effects

Evaluation: Relief of redness and allergic symptoms without adverse effects

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

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.