CARDIOVASCULAR RISKS ASSOCIATED WITH THE SYSTEMIC USE OF NAPHAZOLINE: AN INTEGRATIVE REVIEW

Abstract

Naphazoline, an alpha-adrenergic sympathomimetic amine widely used in nasal decongestants and ophthalmic solutions, has systemic absorption potential that may lead to adverse cardiovascular effects. This integrative review aimed to critically analyze scientific evidence published between 2015 and 2025 regarding the cardiovascular risks associated with the systemic or abusive use of naphazoline. The search was conducted between November and December 2025 in the PubMed/MEDLINE, SciELO, and Scopus databases using controlled descriptors (DeCS/MeSH) related to naphazoline and its cardiovascular effects. Clinical studies, reviews, and case reports published in Portuguese, English, or Spanish addressing systemic effects or cardiovascular events were included, totaling 14 articles that met the inclusion criteria. The findings indicate a consistent association between systemic absorption of naphazoline and events such as hypertension, reflex bradycardia, arrhythmias, and myocardial ischemia. The main pathophysiological mechanism involves hyperstimulation of alpha-adrenergic receptors, resulting in intense vasoconstriction, increased peripheral vascular resistance, and reduced coronary blood flow. A recurrent pattern of self-medication and prolonged use was also observed, favored by over-the-counter availability and the mistaken perception of safety. It is concluded that naphazoline, although effective as a topical vasoconstrictor, presents clinically relevant cardiovascular toxicity potential when systemically absorbed. This review contributes to strengthening pharmacovigilance and highlights the need for regulatory measures and health education aimed at promoting the rational use of nasal decongestants.

DOI: https://doi.org/10.56238/sevened2025.037-041