naphazoline hydrochloride + witch hazel, distilled: clinical use

Prescribing considerations

• Confirm that redness is consistent with minor irritation rather than infection, injury, acute glaucoma or another serious ocular disorder.
• Seek medical review for persistent or worsening redness, eye pain or visual change.
• Use caution in hypertension, depression, cardiovascular disease, arteriosclerosis, diabetes, hyperthyroidism, dry eye or a compromised corneal surface.
• Avoid prolonged or indiscriminate use because rebound hyperaemia and ocular surface effects can occur.

Contraindications and cautions

• Hypersensitivity to naphazoline, hamamelis water or an excipient.
• Closed-angle glaucoma.
• Serious eye disease or previous eye surgery.
• Current or recent monoamine oxidase inhibitor treatment.
• Children younger than 12 years.
• Administration while soft contact lenses are worn.

Monitoring

• Review ongoing redness, irritation, pain, dry-eye symptoms or visual change.
• Consider systemic sympathomimetic effects in susceptible patients because ocular naphazoline can be absorbed.
• Monitor the corneal surface if use is prolonged, particularly where dry eye or corneal compromise is present.

Clinical pharmacology

Naphazoline is an alpha-adrenergic sympathomimetic that produces ocular vasoconstriction. Distilled witch hazel provides an astringent action; some systemic absorption of naphazoline may follow topical application.

Formulation and product differences

• The selected product is a multidose ocular solution containing naphazoline hydrochloride 0.01% w/v and distilled witch hazel 12.5% v/v.
• It contains benzalkonium chloride, which can irritate dry or compromised eyes and can be absorbed by soft contact lenses.