Over-the-Counter Ocular Decongestants in the United States - Mechanisms of Action and Clinical Utility for Management of Ocular Redness.

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Hosten LO, Snyder C

Over-the-Counter Ocular Decongestants in the United States - Mechanisms of Action and Clinical Utility for Management of Ocular Redness.

Clin Optom (Auckl). 2020 Jul 23;12:95-105. doi: 10.2147/OPTO.S259398. eCollection 2020.

PubMed ID

32801982 [ View in PubMed

]

Abstract

To manage ocular redness effectively, health-care practitioners require an understanding of the pathophysiology, clinical features and differential diagnosis of ocular redness, as well as comprehensive knowledge of medical therapies available and their pharmacologic properties. This review aims to provide a clinically relevant summary of the current literature on the mechanism of action, efficacy, and safety of current over-the-counter (OTC) decongestants available for reduction of ocular redness due to minor irritations. Currently marketed OTC products indicated for such use in the United States include topical solutions of tetrahydrozoline 0.05%, naphazoline 0.012% to 0.03%, and brimonidine 0.025%. All 3 agents are adrenergic receptor agonists but vary in their receptor-binding profiles: tetrahydrozoline is a selective alpha1 receptor agonist; naphazoline is a mixed alpha1/alpha2 receptor agonist; and brimonidine is a selective alpha2 receptor agonist. These OTC decongestants produce vasoconstriction of conjunctival blood vessels, which results in a rapid reduction in ocular redness. In general, ocular adverse events reported in published studies of these OTC decongestants were minimal, mild, and transient, with no significant adverse systemic effects. However, ocular decongestants with alpha1-adrenergic receptor agonist activity can be associated with loss of effectiveness with continued use (ie, tachyphylaxis) and rebound redness upon treatment discontinuation. In clinical trials of the selective alpha2-adrenergic receptor agonist brimonidine 0.025%, tachyphylaxis was not observed, and rebound redness was rarely reported.

DrugBank Data that Cites this Article

Drugs

Tetryzoline

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Tetryzoline	Alpha-1 adrenergic receptors (Protein Group)	Protein group	Humans	Yes	Agonist	Details