Four synthetic adrenergic angonist phenylephrine, naphazoline, oxymetazoline and tetrahydrozoline are currently available as ocular decongestants


Mechanism of Action

Phenylephrine is a synthetic adrenergic agonist. Phenylephrine causes vasoconstriction by direct stimulation of receptors on conjunctival vasculature. The resultant clinical effect is usually a decrease in conjunctival hyperemia and edema. At the 0.12% concentration used for ocular decongestion, phenylephrine can occasionally dilate the pupil. Naphazoline, oxymetazoline and tetrahydrozoline differ structurally from other adrenergic agonists by replacement of the benzene ring with an unsaturated ring. In general, these agents exhibit greater a-than b-adrenergic receptor activity. After topical application to the eye, they induce a marked vasoconstriction



Conjunctival hyperemia and edema



Adults: 1 drop 2-4 times daily. Preferably be infrequent


Children: Can be used



Cardiovascular disease, hyperthyroidism, diabetes, angle-closure glaucoma, potentially occludable angles and traumatized cornea


Special Precautions

Rebound congestion can occur with extended use. Infrequent use is preferred


Adverse Drug Reactions

Transient stinging can occur with all decongestant preparations after instillation. Dosage frequency is generally 2 to 4 times daily but should be as infrequent as possible to minimize possible ocular side effects. Pupillary dilation, blurred vision, epithelial erosions and rebound congestion can occur with extended use. Upper lid retraction has been associated. Systemic absorption can cause central nervous system (CNS) and respiratory depression, including bradycardia and hypotension. Long-term use of phenylephrine can cause a rebound conjunctival congestion and result in conjunctivitis medicamentosa. Imidazole derivatives


Status in

1. Pregnancy : Use with caution

2. Lactation : Use with caution

3. Old age : Can be used

4. Children : Can be used in reduce frequency



Brands available and preparations of DECONGESTANTS


Pharmaceutical Company

Brand Name


ANDRE EYE DROPS  (Boric Acid 1.25% sodium chloride 0.05%, Chlorobutanol 0.035%, naphazoline hcl. 0.056%, zinc sulp. 0.012%, chlorpheniramine maleate 0.01%, all w/v)

10ml Dps 




(Naphazoline HCI, boric acid, borex, glycerol, Benzalkonium chloride)

10ml Dps    


Klan Sehen

DECOMIC DPS.             

(Phenylephire HCI 0.12%, Chlorphenirine maleate 0.2%, boric acid 1.25%, hydroxypropyl methyl cellulose 0.5%, Phenylethyl alcohol USP 0.5%, all v/v)

10ml Dps   


Syntho Pharma

MEZOL  (Naphazoline hydrocloride 0.1%, Benzalkonium chloride 0.02%, Chlorpheniramine meleate 0.01%, Methyl cellulose 0.2%)

10ml Dps   



MIL (Boric acid 1.25%, Naphazoline hcl 0.056%, Chlorpheniramine maleate 0.01%, Zinc sulph. 0.12%)

10ml Dps   



OCUCEL EYE DROPS   (Naphazoline)

5ml Dps       0.01% w/v   


East India

ZOAMET EYE DPS.  (Oxymetazoline HCl 0.025%)

5ml Dps