Naphcon-A®
naphazoline 0.025% / pheniramine 0.3% · ophthalmic solution
Allergy
Same formulation, different label. Identical to Opcon-A® and Visine-A®. Choose on price and availability, not on the drug.
Approved uses
Allergic conjunctivitis, itching and redness
1 or 2 drops in the affected eye(s) up to 4 times daily, age 6 years and over
Cuts redness more than either component alone, and beats olopatadine 0.1% at 12 and 20 minutes post-challenge.
Contraindications
Sensitivity to naphazoline, pheniramine, or any component of the product.
Available FormsOphthalmic solution, 15 mL (0.5 fl oz) dropper bottle, 15 mL twin pack
Mechanism of ActionMixed alpha-1/alpha-2 adrenergic agonist (naphazoline) that constricts conjunctival vessels, combined with a first generation H1 antagonist (pheniramine) that blocks histamine-mediated itch. Decongestants with alpha-1 activity are associated with tachyphylaxis and rebound redness on repeated use, unlike the alpha-2 selective agonist brimonidine 0.025%.
Warnings & Precautions
- Rebound hyperemia: Chronic use can produce conjunctivitis medicamentosa; in a 70 patient case series of naphazoline, tetrahydrozoline or phenylephrine users, patterns were conjunctival hyperemia (50 cases), follicular conjunctivitis (17), and eczematoid blepharoconjunctivitis (3), with a median 4 weeks to resolution after discontinuation.
- Narrow angle glaucoma: Label-listed precaution; the product transiently enlarges the pupil.
- Cardiovascular and prostatic disease: Caution in cardiac disease, hypertension, and benign prostatic hyperplasia with urinary difficulty.
- Oral ingestion in children: Accidental oral ingestion in infants and children may lead to coma and marked reduction in body temperature.
- Persistent symptoms: Eye pain, vision change, or redness or irritation that worsens or lasts more than 72 hours warrants examination rather than continued use.
Common Side Effects
- Ocular: Temporary pupil enlargement, brief tingling on instillation, and increased redness with overuse; no frequencies given.
- Systemic: Not characterized in this OTC label.
Pregnancy & LactationNo adequate and well-controlled studies in pregnant women. It is not known whether this drug is excreted in human milk
Pediatric UseLabeled for age 6 years and over; under 6, the label directs consultation.