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Naphazoline (ophthalmic [nasal decongestant preparation is not available in United States]): Drug information

Naphazoline (ophthalmic [nasal decongestant preparation is not available in United States]): Drug information
(For additional information see "Naphazoline (ophthalmic [nasal decongestant preparation is not available in United States]): Patient drug information" and see "Naphazoline (ophthalmic [nasal decongestant preparation is not available in United States]): Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Clear Eyes Redness Relief [OTC] [DSC]
Pharmacologic Category
  • Alpha1 Agonist;
  • Imidazoline Derivative;
  • Ophthalmic Agent, Vasoconstrictor
Dosing: Adult
Decrease in eye redness

Decrease in eye redness (vasoconstrictor): Ophthalmic: 1 to 2 drops into affected eye(s) up to 4 times daily.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Naphazoline (ophthalmic [nasal decongestant preparation is not available in United States]): Pediatric drug information")

Ocular redness, irritation

Ocular redness, irritation: Limited data available: Children ≥6 years and Adolescents: Ophthalmic solution 0.012% to 0.03% (OTC products): Instill 1 to 2 drops in affected eye up to four times daily (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions

There are no adverse reactions listed in the manufacturer's labeling.

Warnings/Precautions

Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with cardiovascular abnormalities or hypertension.

• Diabetes: Use with caution in patients with diabetes mellitus.

• Hyperthyroidism: Use with caution in patients with hyperthyroidism.

• Infection/injury: Use with caution in patients with ophthalmic infection or injury.

Dosage form specific issues:

• Benzalkonium chloride: May contain benzalkonium chloride which may be absorbed by soft contact lenses.

Other warnings/precautions:

• Accidental ingestion: Accidental ingestion by children of nonprescription (OTC) imidazoline-derivative eye drops and nasal sprays may result in serious harm. Serious adverse reactions (eg, coma, bradycardia, respiratory depression, sedation) requiring hospitalization have been reported in children ≤5 years of age who had ingested even small amounts (eg, 1 to 2 mL). Contact a poison control center and seek emergency medical care immediately for accidental ingestion (FDA Drug Safety Communication, 2012).

• Self-medication (OTC use): For topical ophthalmic use only. Do not touch tip of container to any surface, the eyelids, or the surrounding area. Discontinue use and notify health care provider if symptoms worsen or persist >72 hours or if symptoms of systemic absorption occur (ie, dizziness, headache, nausea, decrease in body temperature, drowsiness). Overuse may produce increased redness of the eye; pupils may become enlarged temporarily. Discontinue use and contact health care provider if eye pain or changes in vision occur.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Ophthalmic, as hydrochloride:

Clear Eyes Redness Relief: Naphazoline 0.0125% and glycerin 0.2% (6 mL [DSC]) [contains benzalkonium chloride]

Generic Equivalent Available: US

No

Pricing: US

Solution (Clear Eyes Redness Relief Ophthalmic)

0.012-0.2% (per mL): $0.20

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

For topical ophthalmic use only. Remove contact lenses prior to administration. Do not touch tip of container to any surface, the eyelids, or the surrounding area. Do not use if solution changes color or becomes cloudy.

Administration: Pediatric

For ophthalmic use only: Instill drop(s) into conjunctival sac of affected eye(s); finger pressure should be applied to lacrimal sac during and for 1 to 2 minutes after instillation to decrease risk of absorption and systemic reactions; avoid contact of bottle tip with skin or eye

Use: Labeled Indications

Decrease in eye redness (vasoconstrictor):

Relief of redness of the eye due to minor irritation; temporary relief of burning and irritation due to dry eyes; as a protectant against further irritation or dryness of the eye.

Medication Safety Issues
Other safety concerns:

Accidental ingestion: Serious adverse reactions (eg, coma, bradycardia, respiratory depression, sedation) requiring hospitalization have been reported in children ≤5 years of age who have accidentally ingested even small amounts (eg, 1-2 mL) of imidazoline-derivative (ie, tetrahydrozoline, oxymetazoline, or naphazoline) eye drops or nasal sprays. Store these products out of reach of children at all times. Contact poison control or seek medical attention if accidental ingestion occurs.

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1-Agonists may antagonize Alpha1-Blocker vasodilation. Risk C: Monitor therapy

Atomoxetine: May enhance the hypertensive effect of Sympathomimetics. Atomoxetine may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy

Atropine (Systemic): May enhance the hypertensive effect of Alpha1-Agonists. Risk C: Monitor therapy

Bromocriptine: May enhance the hypertensive effect of Alpha1-Agonists. Management: Consider alternatives to this combination when possible. If combined, monitor for hypertension and tachycardia, and do not coadminister these agents for more than 10 days. Risk D: Consider therapy modification

Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy

Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Risk D: Consider therapy modification

Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Risk C: Monitor therapy

Ergot Derivatives (Vasoconstrictive CYP3A4 Substrates): May enhance the vasoconstricting effect of Alpha1-Agonists. Risk X: Avoid combination

Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Risk C: Monitor therapy

Iobenguane Radiopharmaceutical Products: Alpha1-Agonists may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Risk X: Avoid combination

Kratom: May enhance the adverse/toxic effect of Sympathomimetics. Risk X: Avoid combination

Levothyroxine: May enhance the adverse/toxic effect of Sympathomimetics. Specifically, the risk of coronary insufficiency may be increased in patients with coronary artery disease. Levothyroxine may enhance the therapeutic effect of Sympathomimetics. Sympathomimetics may enhance the therapeutic effect of Levothyroxine. Risk C: Monitor therapy

Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Consider initial dose reductions of sympathomimetic agents, and closely monitor for enhanced blood pressure elevations, in patients receiving linezolid. Risk D: Consider therapy modification

Lisuride: May enhance the hypertensive effect of Alpha1-Agonists. Risk X: Avoid combination

Monoamine Oxidase Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Risk X: Avoid combination

Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Risk C: Monitor therapy

Pergolide: May enhance the hypertensive effect of Alpha1-Agonists. Risk C: Monitor therapy

Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Risk C: Monitor therapy

Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Risk C: Monitor therapy

Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy

Tricyclic Antidepressants: May enhance the therapeutic effect of Alpha1-Agonists. Tricyclic Antidepressants may diminish the therapeutic effect of Alpha1-Agonists. Risk C: Monitor therapy

Mechanism of Action

Stimulates alpha-adrenergic receptors in the arterioles of the conjunctiva and the nasal mucosa to produce vasoconstriction

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AU) Australia: Albalon Liquifilm;
  • (DE) Germany: Proculin | Sednesa | Tele stulln N | Tele stulln UD Mono | Televis Stulln UD;
  • (ID) Indonesia: Optrine | Vasacon;
  • (IT) Italy: Collirio alfa | Imidazyl | Iridina due;
  • (MX) Mexico: Nazil ofteno;
  • (PE) Peru: Floril;
  • (QA) Qatar: Oculosan | Riazolin;
  • (RU) Russian Federation: Sigida crystall
  1. Clear Eyes Maximum Redness Relief (naphazoline) [prescribing information]. Irvington, NY: Prestige Consumer Healthcare Inc; received August 2021.
  2. Food and Drug Administration. FDA Drug Safety Communication: Serious adverse events from accidental ingestion by children of over-the-counter eye drops and nasal sprays. U.S. Food and Drug Administration. October 25, 2012. Available at http://www.fda.gov/Drugs/DrugSafety/ucm325257.htm. Accessed September 5, 2013.
  3. Goodsense Redness Relief Plus (naphazoline) [prescribing information]. Peachtree City, GA: Perrigo Company; received August 2021.
  4. Kliegman RM, Stanton BMD, St. Geme J, Schor NF, eds. Nelson' s Textbook of Pediatrics. 20th ed. Philadelphia, PA: Saunders Elsevier; 2016.
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