A fixed-dose ophthalmic combination of Naphazoline, a sympathomimetic alpha-adrenergic agonist, and Chlorpheniramine Maleate, a first-generation alkylamine H1-antihistamine. It is primarily used for the symptomatic relief of allergic conjunctivitis. Naphazoline provides rapid vasoconstriction, reducing conjunctival redness and edema, while Chlorpheniramine competitively antagonizes histamine at H1 receptors, alleviating itching, tearing, and other allergic symptoms. This combination offers both immediate decongestant and sustained antihistaminic effects, making it a popular choice for acute allergic eye conditions in the Indian market.
Adult: One to two drops instilled into the affected eye(s). Usually used up to 3-4 times daily, or as directed by the physician. Do not exceed 4 instillations in 24 hours.
Note: 1. Wash hands before use. 2. Tilt head back. 3. Gently pull lower eyelid down to form a pouch. 4. Instill the prescribed number of drops without touching the dropper tip to eye, eyelid, or any surface. 5. Close eyes gently and apply gentle pressure to the inner corner of the eye (nasolacrimal occlusion) for 1-2 minutes to minimize systemic absorption. 6. Wait at least 5 minutes before instilling any other eye medication.
The combination works via two distinct pathways. Naphazoline acts as a direct-acting sympathomimetic on alpha-1 adrenergic receptors on conjunctival vasculature, causing vasoconstriction. This reduces blood flow, capillary permeability, and edema, leading to decreased redness and swelling. Chlorpheniramine Maleate is a competitive reversible antagonist of histamine at H1 receptors. By blocking histamine binding, it inhibits the allergic response in conjunctival mast cells, preventing capillary dilation, permeability, and sensory nerve stimulation, thereby relieving itching, tearing, and redness.
Pregnancy: Category C (US FDA). Animal reproduction studies not conducted. Use only if potential benefit justifies potential risk to the fetus. Systemic absorption can occur. Avoid in first trimester unless absolutely necessary.
Driving: May cause blurred vision, drowsiness, and dizziness. Patients should not drive or operate machinery until they know how the medication affects them, especially after the first dose.
| Monoamine Oxidase Inhibitors (MAOIs) - e.g., Phenelzine, Tranylcypromine | Potentiation of pressor effects of Naphazoline, risk of hypertensive crisis. | Major |
| Tricyclic Antidepressants (TCAs) - e.g., Amitriptyline | Increased anticholinergic effects (dry eyes, urinary retention) and potentiation of pressor effects. | Moderate |
| Beta-blockers (Ophthalmic - e.g., Timolol) | Potential additive effect on intraocular pressure; may antagonize effects in glaucoma. | Moderate |
| Other CNS Depressants (Alcohol, Benzodiazepines, Opioids) | Increased sedation and impaired alertness from Chlorpheniramine. | Moderate |
| Antihypertensives | Naphazoline may counteract hypotensive effect. | Moderate |
Same composition (Naphazoline (NA) + Chlorpheniramine Maleate (NA)), different brands: