1564 Cough Suppressants Expectorants Mucolytics and Nasal Decongestants

Levmetamfetamine (USAN, rINN) ⊗ Mecysteine Hydrochloride (BANM, rINNM) CAS — 93-30-1 (methoxyphenamine); 5588-10-3 (meth- oxyphenamine hydrochloride). l-Deoxyephedrine; L-Desoxiefedrina; L-Desoxyephedrine; Le- Hidrocloruro de mecisteína; Mécystéine, Chlorhydrate de; ATC — R03CB02. soxyephedrine; Levmétamfétamine; Levmetamfetaminum; Lev- Mecysteini Hydrochloridum; Methyl Cysteine Hydrochloride; ATC Vet — QR03CB02. metanfetamina; Levometanfetamina; l-Methamphetamine; l- Methylcysteine Hydrochloride. Methyl L-2-amino-3-mercapto- Methylamphetamine. (R)-N,α-Dimethylbenzeneethanamine; (−)- propionate hydrochloride. (R)-N,α-Dimethylphenethylamine. Мецистеина Гидрохлорид H Левметамфетамин C H NO S,HCl = 171.6. N 4 9 2 CH C10H15N = 149.2. CAS — 2485-62-3 (mecysteine); 18598-63-5 (mecysteine 3 CAS — 33817-09-3. hydrochloride); 5714-80-7 (mecysteine hydrochloride). CH3 OCH3

H OO (methoxyphenamine) N H3C CH3 Profile SH H CH3 H N Methoxyphenamine is a sympathomimetic with effects similar 2 to those of ephedrine (p.1558), given orally as the hydrochloride. It has been used as a bronchodilator mainly in combination prep- Pharmacopoeias. In US. (mecysteine) arations for the relief of cough and nasal congestion. USP 31 (Levmetamfetamine). A clear, practically colourless, Preparations liquid. Store in airtight containers. Protect from light. Adverse Effects and Precautions Nausea and heartburn have occasionally been reported. Since Proprietary Preparations (details are given in Part 3) Profile mucolytics may disrupt the gastric mucosal barrier mecysteine Multi-ingredient: Chile: Cheracol; Hong Kong: Asmeton; Irl.: Casacol; Levmetamfetamine is the laevo isomer of metamfetamine hydrochloride should be used with caution in patients with a his- Thai.: Asmeton†; Venez.: Metoxifilin. (p.2158) and is used topically in the treatment of nasal conges- tory of peptic ulcer disease. tion (p.1548). Uses and Administration Abuse. Levmetamfetamine is a less potent central stimulant Mecysteine hydrochloride is used as a mucolytic in respiratory Methyl Dacisteine (rINNM) than metamfetamine, but it has been subject to occasional disorders associated with productive cough (p.1547). It is given abuse.1,2 In addition, as a stimulant its use is prohibited in sport Dacisteína de metilo; Dacistéine Méthyle; Dacisteinum Methylis; orally in a usual dose of 200 mg three times daily before meals during competition. However, it is classed by the World Anti- EL-1035 (dacisteine); Methyl Diacetylcysteinate. Methyl N,S- reduced to 200 mg twice daily after 6 weeks. A rapid clinical ef- Doping Agency as one of the specified substances particularly diacetyl-L-cysteinate. fect can be achieved by giving 200 mg four times daily for the susceptible to unintentional anti-doping rule violations because first 2 days. For children’s doses, see Administration in Children, Дацистеин Метил of general availability in medicinal products or which are less 3 below. Mecysteine has also been given by inhalation. C8H13NO4S = 219.3. likely to be successfully abused as doping agents. CAS — 18725-37-6 (dacisteine); 19547-88-7 (methyl da- 1. Halle AB, et al. Drug abuse with Vicks nasal inhaler. South Med Administration in children. The recommended oral dose of cisteine). J 1985; 78: 761–2. mecysteine hydrochloride in children aged 5 to 12 years is 2. Ferrando RL, et al. Bizarre behavior following the ingestion of 100 mg 3 times daily. levo-desoxyephedrine. Drug Intell Clin Pharm 1988; 22: 214–17. Respiratory disorders. Mecysteine hydrochloride given oral- H3C O 3. World Anti-Doping Agency. The World Anti-Doping Code: ly has reduced symptoms of cough in patients with chronic bron- 2007 Prohibited List International Standard (issued 16 Septem- chitis or other respiratory disorders, but its effect on sputum pro- HNH ber, 2006). Available at: http://www.wada-ama.org/rtecontent/ duction and pulmonary function has been variable.1,2 The use of document/2007_List_En.pdf (accessed 04/04/07) mucolytics in chronic obstructive pulmonary disease (p.1112) is H3CS OH Preparations controversial. Proprietary Preparations (details are given in Part 3) 1. Aylward M, et al. Clinical therapeutic evaluation of methyl- O O USA: Vicks Vapor Inhaler. cysteine hydrochloride in patients with chronic obstructive bron- chitis: a balanced double-blind trial with placebo control. Curr (dacisteine) Med Res Opin 1978; 5: 461–71. 2. Sahay JN, et al. The effect of methyl cysteine (Visclair) in respi- Marrubium ratory diseases: a pilot study. Clin Trials J 1982; 19: 137–43. Profile Like acetylcysteine (p.1548), methyl dacisteine has been used as Andornkraut; Herba Marrubii; Hurtanminttu; Jablečníková nat’; Preparations a mucolytic in respiratory disorders associated with productive Juanrubio; Kransborre; Malva de sapo; Malvarrubia; Marrube Proprietary Preparations (details are given in Part 3) cough (p.1547). It has been given orally in a usual dose of blanc, parties aériennes fleuries de; Marrubii herba; Marrubio; Irl.: Visclair; UK: Visclair. 600 mg daily, divided into 3 or 4 doses. Šantru˛ žole˙; White Horehound. Multi-ingredient: Ital.: Donatiol. Preparations Шандра Обыкновенная Proprietary Preparations (details are given in Part 3) Fr.: Mucothiol; Hung.: Mucothiol†; Ital.: Mucothiol. Menglytate (rINN) Menglitato; Menglytatum; Menthol Ethylglycolate. p-Menth-3-yl O ethoxyacetate. Methylephedrine Hydrochloride (BANM) ⊗ CH3 OH CH3 Менглитат dl-Methylephedrine Hydrochloride; dl-N-Methylephedrine Hy- C H O = 242.4. drochloride; Metilefedrina, hidrocloruro de. (1RS,2RS)-2- H 14 26 3 CAS — 579-94-2. Dimethylamino-1-phenylpropan-1-ol hydrochloride. Метилэфедрина Гидрохлорид H3C H O C11H17NO,HCl = 215.7. CH3 CAS — 552-79-4 ((−)-methylephedrine); 1201-56-5 ((±)- O methylephedrine); 38455-90-2 ((−)-methylephedrine hy- drochloride); 942-46-1 ((±)-methylephedrine hydrochlo- (marrubiin) ride); 18760-80-0 ((±)-methylephedrine hydrochloride). O Pharmacopoeias. In Eur. (see p.vii). Ph. Eur. 6.2 (White Horehound). The whole or fragmented H3C O CH3 OH CH3 dried flowering aerial parts of Marrubium vulgare. It contains a CH3 O N minimum 0.7% of marrubiin (C20H28O4 = 332.4), calculated as the dried drug. CH3 Profile CH Profile Menglytate is an ingredient of a number of preparations promot- 3 Marrubium is the flower or leaf of Marrubium vulgare (Labia- ed for the treatment of cough. tae). It has been used for its supposed expectorant properties in (methylephedrine) herbal preparations for the treatment of cough. It has also been Preparations used as a flavouring. Proprietary Preparations (details are given in Part 3) Pharmacopoeias. In Jpn. Preparations Multi-ingredient: Ital.: Coryfin C; Neo Borocillina Balsamica. Profile Proprietary Preparations (details are given in Part 3) Methylephedrine hydrochloride is a sympathomimetic with ef- Ger.: Angocin Bronchialtropfen. fects similar to those of ephedrine (p.1558). It has been used as a Multi-ingredient: Austral.: Broncafect; Verbascum Complex†; Austria: Methoxyphenamine Hydrochloride bronchodilator and is given orally in combination preparations Asthmatee EF-EM-ES; Gallen- und Lebertee St Severin; Canad.: Herbal for the relief of cough and nasal congestion. Throat†; Original Herb Cough Drops; Swiss Herb Cough Drops; Chile: (BANM, rINNM) ⊗ Fucus Compuesto†; Cz.: Original Schwedenbitter; Species Cholagogae Preparations Planta; The Salvat; Zlucnikova Cajova Smes; Ital.: Altuss; Broncosedina; Hidrocloruro de metoxifenamina; Methoxiphenadrin Hydro- Pol.: Amarosal; S.Afr.: Cough Elixir; Spain: Natusor Asmaten†; Natusor chloride; Méthoxyphénamine, Chlorhydrate de; Methoxyphen- Proprietary Preparations (details are given in Part 3) Broncopul†; Switz.: Hederix; UK: Allens Chesty Cough; Asthma & Catarrh amini Hydrochloridum; Mexyphamine Hydrochloride. 2-Meth- Multi-ingredient: Austria: Tussoretardin; Hong Kong: Codaewon; Jpn: Relief; Catarrh-eeze; Chest Mixture; Cough-eeze; Herb and Honey Cough Colgen Kowa IB Toumei; Sin Colgen Kowa Kaze; S.Afr.: Ilvico; Switz.: Elixir; Honey & Molasses; Horehound and Aniseed Cough Mixture; Mod- oxy-Nα-dimethylphenethylamine hydrochloride. Tossamine plus; Thai.: Coughmin†; Hustazol-C†; Methorcon; Venez.: Ilvi- ern Herbals Cough Mixture; Vegetable Cough Remover. Метоксифенамина Гидрохлорид co.

C11H17NO,HCl = 215.7. Levmetamfetamine/Naphazoline 1565

Metizoline Hydrochloride (BANM, USAN, rINNM) ⊗ Naphazoline Hydrochloride (BANM, rINNM) ⊗ Uses and Administration EX-10-781; Hidrocloruro de metizolina; Métizoline, Chlorhy- Hidrocloruro de nafazolina; Nafatsoliinihydrokloridi; Nafazolin Naphazoline is a sympathomimetic (p.1408) with drate de; Metizolini Hydrochloridum; Metyzoline Hydrochloride; Hidroklorür; Nafazolin-hidroklorid; Nafazolin-hydrochlorid; Na- marked alpha-adrenergic activity. It is a vasoconstric- RMI-10482A. 2-(2-Methylbenzo[b]thienylmethyl)-2-imidazoline fazolinhydroklorid; Nafazolino hidrochloridas; Naphazoline, chlo- tor with a rapid and prolonged action in reducing swell- hydrochloride. rhydrate de; Naphazolini hydrochloridum. ing and congestion when applied to mucous mem- Метизолина Гидрохлорид Нафазолина Гидрохлорид branes. C H N S,HCl = 266.8. 13 14 2 C14H14N2,HCl = 246.7. Naphazoline and its salts are used for the symptomatic CAS — 17692-22-7 (metizoline); 5090-37-9 (metizoline CAS — 550-99-2. hydrochloride). relief of nasal congestion (p.1548). Solutions contain- ATC — R01AA08; R01AB02; S01GA01. ing 0.05 to 0.1% of the hydrochloride or the nitrate ATC — R01AA10. ATC Vet — QR01AA08; QR01AB02; QS01GA01. ATC Vet — QR01AA10. may be applied topically as nasal drops or a spray usu- Pharmacopoeias. In Chin., Eur. (see p.vii), Jpn, and US. ally up to once every 6 hours. Children aged 7 years Ph. Eur. 6.2 (Naphazoline Hydrochloride). A white or almost white, crystalline powder. Freely soluble in water; soluble in al- and over have used a preparation containing 0.05%. S CH3 cohol. Protect from light. Solutions containing up to 0.1% of naphazoline hydro- N USP 31 (Naphazoline Hydrochloride). A white, odourless, crys- chloride have been instilled into the eye as a conjuncti- talline powder. Freely soluble in water and in alcohol; very slightly soluble in chloroform; practically insoluble in ether. pH val decongestant (see Conjunctivitis, p.564). N of a 1% solution in water is between 5.0 and 6.6. Store in airtight H Naphazoline has been used as a vasoconstrictor with containers. Protect from light. local anaesthetics. (metizoline) Naphazoline Nitrate (BANM, rINNM) ⊗ Naphazoline acetate has also been used in nasal prepa- rations. NOTE. The name benazoline has been used as a synonym for meti- Nafatsoliininitraatti; Nafazolin Nitrat; Nafazolinnitrat; Nafazolin- zoline. Care should be taken to distinguish it from benazolin (4- nitrát; Nafazolino nitratas; Nafazoliny azotan; Naphazoline, ni- Preparations chloro-2,3-dihydro-2-oxo-1,3-benzothiazol-3-ylacetic acid, trate de; Naphazolini nitras; Naphazolinium Nitricum; Naph- C9H6ClNO3S = 243.7), which is a herbicide. Also do not confuse thizinum; Nitrato de nafazolina. USP 31: Naphazoline Hydrochloride and Pheniramine Maleate Ophthal- with benzazoline (see Tolazoline, p.1415), which is a vasodilator. mic Solution; Naphazoline Hydrochloride Nasal Solution; Naphazoline Hy- Нафазолина Нитрат Profile drochloride Ophthalmic Solution. Metizoline hydrochloride is a sympathomimetic with effects C14H14N2,HNO3 = 273.3. Proprietary Preparations (details are given in Part 3) similar to those of naphazoline (p.1565) that has been used for its CAS — 5144-52-5. Arg.: Actifedrin Nasal; Bactio Rhin; Bano Ocular Agrand; Dazolin; Disel; vasoconstrictor activity in the treatment of nasal congestion. ATC — R01AA08; R01AB02; S01GA01. Gotabiotic D; Gotinal; Let-Nasal; Mirasan; Mirus-S; Nafazolex; Nasalex; ATC Vet — QR01AA08; QR01AB02; QS01GA01. Privina; Rhinal; Austral.: Albalon; Clear Eyes†; Naphcon; Optazine†; Aus- tria: Aconex; Coldan; Isoftal; Mertan; Privin; Rhinon; Rhinoperd; Belg.: Al- Pharmacopoeias. In Eur. (see p.vii), Jpn, and Viet. balon†; Deltarhinol-Mono; Naphcon; Neusinol; Priciasol; Vasocedine; Ph. Eur. 6.2 (Naphazoline Nitrate). A white or almost white, Braz.: Clarivit†; Claroft; Multisoro; Narial†; Narix; Nazicol; Neosoro; Privi- Morclofone (rINN) na; Rino Resfenol†; Rinos-A; Canad.: Ak-Con; Albalon; Allergy Drops; crystalline powder. Sparingly soluble in water; soluble in alco- Clear Eyes; Diopticon; Naphcon Forte; Red Away†; Vasocon†; Chile: Al- Dimeclofenone; Morclofona; Morclofonum; Morclophon. 4′- hol. A 1% solution in water has a pH of 5.0 to 6.5. Protect from basol†; Clarimir; Red Off; Vi-Claro†; Cz.: Proculin†; Sanorin; Ger.: Idril N Chloro-3,5-dimethoxy-4-(2-morpholinoethoxy)benzophenone. light. sine†; Piniol Nasenspray†; Privin; Proculin; Rhinex mit Naphazolin; Tele- Stulln; Gr.: Coldan; Naphcon; Hong Kong: Albalon; All Clear; Hung.: Морклофон Naphcon†; Proculin†; India: Clearine; Ocustress; Indon.: Optrine; Israel: C H ClNO = 405.9. Adverse Effects, Treatment, and Precau- Naphasal; Naphcon Forte; Ital.: Collirio Alfa; Desamin Same; Imidazyl; Iridi- 21 24 5 na Due; Naftazolina; Pupilla; Rinazina; Rino Naftazolina; Video-Mill; Virgin- CAS — 31848-01-8 (morclofone); 31848-02-9 (mor- tions iana Gocce Verdi†; Malaysia: Albalon; Mex.: Afazol; Alphadinal; Celunaf; clofone hydrochloride). As for Sympathomimetics, p.1407; naphazoline has Fazolin; Gotinal; Nazil; Neth.: Albalon; NZ: Albalon†; Clear Eyes; Naphcon; ATC — R05DB25. mainly alpha-agonist effects. After local use, transient Philipp.: Cosooth; Pol.: Rhinazin; Rus.: Naphthyzin (Нафтизина)†; Sa- ATC Vet — QR05DB25. norin (Санорин); S.Afr.: Murine Clear Eyes†; Safyr Bleu; Spain: Alfa; Eub- irritation may occur. Rebound congestion may occur oral; Miraclar; Vasoconstrictor Pensa; Swed.: Rimidol†; Switz.: Albalon; Minha†; Thai.: Albalon; Naphcon; Turk.: Deltarhinol; Enflucide; UK: after frequent or prolonged use. Systemic effects, in- Murine; USA: Ak-Con; Albalon; All Clear; Allerest†; Allergy Drops†; Clear H C cluding nausea, headache, and dizziness have occurred Eyes; Clear Eyes Plus Redness Relief; Comfort Eye Drops†; Degest†; Na- 3 after topical use. Overdosage or accidental dosage by fazair†; Napha Forte; Naphcon; Privine; Vasocon†; Venez.: Clarasol; Clear- O ize; Fanasal†; Fazolan; Fazonil†; Gotinal; Nafin†; Naphcon; Nas; Niazol; Nina- mouth may cause CNS depression with marked reduc- zo. O tion of body temperature and bradycardia, sweating, Multi-ingredient: Arg.: Alercortil†; Alvo Nasal†; Antibiocort†; Bactio O drowsiness, and coma, particularly in children; it Rhin Prednisolona; Bideon; Biotaer Nasal; Dexafurazon†; Dexalergin; Disel Hidrocortisona; Drynisan; Factioneye; Fadanasal; Gramicortil†; Hyalcrom; should be used with great caution, if at all, in infants Mira Klonal; Mirus; Nasojol†; Nasomicina; Neo-Currino; Neodexa Plus; and young children. Use of naphazoline in the eye may Neoefodil†; Neosona; Nexadron Compuesto; Nexadron Plus; Panoptic; O N Provacsin Nasal; Refenax Colirio; Refenax Gotas Nasales; Rinofilax AG M; liberate pigment granules from the iris, especially Rinogel; Suavithiol; Vistacloran†; Austral.: Albalon-A; Antistine-Privine; In A H3C when given in high doses to elderly patients. Hyperten- Wink†; Naphcon-A; Optrex; Visine Allergy with Antihistamine; Austria: Coldistan; Coldophthal; Histophtal; Luuf-Nasenspray; Ophtaguttal; Rhino- Cl O sion may be followed by rebound hypotension. Treat- drin; Rhinon; Rhinoperd comp; Belg.: Diphenhydramine Constrictor†; Min- ment of adverse effects is symptomatic. havez; Naphcon-A; Neofenox; Sofraline; Sofrasolone; Zincfrin Antihistamin- Profile icum†; Braz.: Alergotox Nasal†; Claril; Colirio Legrand; Colirio Moura Effects on the eyes. For mention of conjunctivitis induced by Brasil; Colirio Teuto; Conidrin; Fluo-Vaso; Hemodotti; Hidrocin; Inhadrina†; Morclofone is a centrally acting cough suppressant used for non- Lerin; Maxibell; Mentodrin†; Naridrin; Nariflux; Naso-Josp†; Nazobel†; Na- productive cough (p.1547); it is given orally in usual doses of ophthalmic decongestant preparations containing naphazoline, zobio†; Neo Quimica Colirio; Nitrileno; Novo Rino; Rhinosept; Rinisone; 150 mg four or five times daily. It has also been given as the hy- see under Phenylephrine, p.1568. Rinosite†; Sinustrat Vasoconstritor; Sorine Adulto; Stilux; Visazul; Visiplex; drochloride. Visolon; Visual†; Zincolok; Canad.: Albalon-A; Clear Eyes Allergy; Collyre Intraoperative use. A report1 of 2 cases of toxicity associated Bleu†; Diopticon A; Naphcon-A; Onrectal; Opcon-A; Vasocon-A†; Visine Preparations with intraoperative use of a naphazoline-soaked sponge to con- Advance Allergy; Zincfrin-A; Chile: Albasol A†; Clarimir F; Dessolets; Miral; trol excessive bleeding after adenoidectomy. Both patients expe- Mirus†; Naphcon-A; Naphtears; Nico Drops; Novo-Tears; Oculosan; Ofta- Proprietary Preparations (details are given in Part 3) rienced hypertension and reflex bradycardia, which evolved in lirio; Red Off Aqua; Red Off Plus; Cz.: Sanorin-Analergin; Denm.: Ansal; Ital.: Plausitin; Switz.: Nitux. Antistina-Privin; Sesal; Fin.: Antistin-Privin†; Zincfrin-A†; Fr.: Collyre Bleu; one case into marked hypotension. There was evidence of CNS Derinox; Ger.: Antistin-Privin; Diabenyl-Rhinex†; duraultra; Konjunktival depression with a reduced respiration rate and prolonged recov- Thilo†; Oculosan N; Rhinoguttae Dexamethasoni cum Naphazolino†; Rhi- ery from anaesthesia. nosovil†; Siozwo; Stipo†; Gr.: Neo-Priphen; Oculosan; Septobore; Za- bysept; Hong Kong: Clear Blue; Frazoline; Konjunktival†; Naphcon-A; Na- (BAN, rINN) 1. Wenzel S, et al. Course and therapy of intoxication with imida- zin; Oculosan; Opcon-A; Hung.: Coldistan†; India: Andre; Andre-I-Kul; Naphazoline ⊗ zoline derivate naphazoline. Int J Pediatr Otorhinolaryngol Betnesol-N Nasal; Efcorlin; Fenox; Ocurest; Ocurest-AH; Ocurest-Z; Pro- 2004; 68: 979–83. to-Boric; Indon.: Flamergi; Indofrin-A; Isotic Azora; Naphcon-A; Oculosan; Nafatsoliini; Nafazolin; Nafazolina; Naphazolinum. 2-(1-Naph- Zincopto; Israel: Alnase; Antistin-Privin†; Nodryl†; Optryl; Phenyphrine- thylmethyl)-2-imidazoline. Interactions Azol†; Proaf; Ital.: Alfaflor; Antisettico Astringente Sedativo; Antistin-Privi- Нафазолин na; Collirio Alfa Antistaminico; Corizzina†; Deltarinolo; Fotofil; Genalfa; Id- Since naphazoline is absorbed through the nasal muco- roneomicil†; Imidazyl Antistaminico; Indaco; Iristamina; Nafcon A†; Oftalmil; C14H14N2 = 210.3. Pupilla Antistaminico; Rinocidina; Rinofomentil†; Zinc-Imizol; Malaysia: sa interactions may follow topical application. The Alergoftal; Napha A; Naphcon-A; Oculosan†; Mex.: Afazol Z; Biofrin; Bio- CAS — 835-31-4. BNF considers that all sympathomimetic nasal decon- tarson O; Eyrasil; Istasol; Midazol Ofteno; Mirus; Naphacel; Naphtears; ATC — R01AA08; R01AB02; S01GA01. Oftalirio†; Opcon-A; Soltrictor con Lagrifilm; Solutina; Sulvi; Zincfrin-A; NZ: gestants may cause a hypertensive crisis if used during Albalon-A†; Betnesol Aqueous; Clear Eyes ACR†; Degest 2†; Naphcon-A; ATC Vet — QR01AA08; QR01AB02; QS01GA01. treatment with an MAOI. For the interactions of sym- Optrex Red-Eye Relief; Visine Allergy; Philipp.: Decocon A; Moisturizing All Clear; Naphcon-A; Oculosan; Optaphen; Pol.: Betadrin; Cincol; Der- pathomimetics in general, see p.1407. mophenazol; Mibalin; Oculosan; Oftophenazol; Rhinophenazol; Sulfarinol; Port.: Alergiftalmina; Colircusi Anestesico; Naso-Prieulina†; Rus.: Betadrin N (Бетадрин); Polynadim (Полинадим); Sanorin (Санорин); Sanorin-Anal- Pharmacokinetics ergin (Санорин-аналергин); S.Afr.: Albalon-A†; Antistin-Privin; Covomy- Systemic absorption has been reported after topical use cin; Covosan; ENT; Nasdro; Oculosan; Universal Nasal Drops; Zincfrin-A; N Singapore: Antistin-Privin; Flucur†; Naphcon-A; Spain: Alergoftal; Cen- H of solutions of naphazoline. It is not given systemical- tilux; Cloram Zinc; Coliriocilina Adren Astr; Epistaxol; Kanafosal; Kanafosal ly, but it is readily absorbed from the gastrointestinal Predni; Oftalmol Ocular; Ojosbel; Rinovel; Zolina; Swed.: Antasten-Privin; Switz.: Antistin-Privin; Collyre Alpha†; Collyre Bleu Laiter; Gouttes nasales tract. Naphazoline instilled into the eye causes con- N†; Oculosan; Spray nasal comp pour adultes; Thai.: Levoptin; Naphcon- junctival vasoconstriction within 10 minutes and ef- A; Oculosan; Turk.: Alergoftal; Sulfarhin; UK: Eye Dew; Optrex Red Eyes; USA: 4-Way Fast Acting; Antazoline-V; Clear Eyes Seasonal Relief; Maxi- fects can last for up to 6 hours. mum Strength Allergy Drops; Nafazair A†; Naphazoline Plus; Naphcon-A; The symbol † denotes a preparation no longer actively marketed The symbol ⊗ denotes a substance whose use may be restricted in certain sports (see p.vii)