Chemistry:Naphazoline

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Short description: Chemical compound
Naphazoline
Naphazoline.svg
Naphazoline.png
Clinical data
Trade namesClear Eyes, Cleari, Naphcon-A, Rohto
AHFS/Drugs.comMonograph
Routes of
administration
Ophthalmic drug administration, nasal administration
ATC code
Legal status
Legal status
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
Chemical and physical data
FormulaC14H14N2
Molar mass210.274 g·mol−1
3D model (JSmol)
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Naphazoline is a medicine used as a decongestant, and a vasoconstrictor added to eye drops to relieve red eye. It has a rapid action in reducing swelling when applied to mucous membranes. It is a sympathomimetic agent with marked alpha adrenergic activity that acts on alpha-receptors in the arterioles of the conjunctiva to produce constriction, resulting in decreased congestion.

It was patented in 1934 and came into medical use in 1942.[1]

Medical uses

Red eyes can be treated with naphazoline.

Nasal administration

Nasal decongestant.[2]

Ophthalmic drug administration

Eye drops (brand names Clear Eyes, and Cleari) narrowing swollen blood vessels (ophthalmic arteries, and ophthalmic veins) to relieve red eye.[2]

Temporary red eye can safely be treated when the cause of the redness is established (eg cannabis induces corneal vasodilation[3])[Insufficient Bibliography]. However, continuous use is not recommended without knowing an underlying condition.

Side effects

A few warnings and contraindications that apply to all naphazoline-containing substances intended for medicinal use are:

  • Hypersensitivity to naphazoline
  • Use in infants and children can result in central nervous system depression, leading to coma and marked reduction in body temperature
  • Should be used with caution in patients with severe cardiovascular disease including cardiac arrhythmia and in patients with diabetes, especially those with a tendency toward diabetic ketoacidosis
  • A possible association with stroke has been suggested.[4]

Nasal administration

  • Extended use may cause rhinitis medicamentosa, a condition of rebound nasal congestion.

Ophthalmic drug administration

Known side-effect:[5][6]

Contraindications

  • Patients taking MAO inhibitors can experience a severe hypertensive crisis if given a sympathomimetic drug such as naphazoline HCl
  • Drug interactions can occur with anaesthetics that sensitize the myocardium to sympathomimetics (e.g. cyclopropane or halothane cautiously)
  • Exercise caution when applying prior to use of phenylephrine.

Pharmacology

Naphazoline is a mixed α1- and α2-adrenergic receptor agonist.[2]

Chemistry

The non-hydrochloride form of Naphazoline has the molecular formula C14H14N2 and a molar mass of 210.28 g/mol. The HCl salt form has a molar mass of 246.73 g/mol.

Society and culture

It is an active ingredient in several over-the-counter eye drop formulations including Clear Eyes, Rohto, Eucool, and Naphcon-A.[7]

Illicit use

The nasal or ophthalmic form of naphazoline has been abused by heroine or cocaine drug addicts.[8][9] It's used as CNS stimulant and vasoconstrictor to enhance primary drug effects.[9]

References

  1. (in en) Analogue-based Drug Discovery. John Wiley & Sons. 2006. p. 552. ISBN 9783527607495. https://books.google.com/books?id=FjKfqkaKkAAC&pg=PA552. 
  2. 2.0 2.1 2.2 "Over-the-Counter Ocular Decongestants in the United States - Mechanisms of Action and Clinical Utility for Management of Ocular Redness". Clinical Optometry 12: 95–105. 2020. doi:10.2147/OPTO.S259398. PMID 32801982. 
  3. "Endocannabinoids in the retina: from marijuana to neuroprotection". Progress in Retinal and Eye Research 27 (5): 501–526. September 2008. doi:10.1016/j.preteyeres.2008.07.002. PMID 18725316. 
  4. "Hemorrhagic stroke after naphazoline exposition: case report". Arquivos de Neuro-Psiquiatria 62 (3B): 889–891. September 2004. doi:10.1590/S0004-282X2004000500030. PMID 15476091. 
  5. "Naphazoline - FDA prescribing information, side effects and uses" (in en). https://www.drugs.com/pro/naphazoline.html. 
  6. "naphazoline ophthalmic (eye): Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD" (in en). https://www.webmd.com/drugs/2/drug-5611/naphazoline-ophthalmic-eye/details. 
  7. "Ophthalmology: Naphazoline". Tarascon Pocket Pharmacopoeia 2009. Jones and Bartlett. 2008. ISBN 978-0-7637-6572-9. 
  8. "Intravenous naphazoline intoxication". Acta Medica Scandinavica 209 (5): 429–430. 1981. doi:10.1111/j.0954-6820.1981.tb11622.x. PMID 7246278. 
  9. 9.0 9.1 "Naphazoline abuse" (in en). Reactions Weekly 1815 (1): 251. 2020-08-01. doi:10.1007/s40278-020-81577-1. ISSN 1179-2051. https://doi.org/10.1007/s40278-020-81577-1.