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

Authors

  • João Pedro Martins Napi Correa Author
  • Wesley Cássio de Souza Silva Author
  • André Gustavo Sampaio Costa Author
  • Wendel Marcelo Quaresma Ribeiro Author
  • Hyury Cesar Barros de Oliveira Author
  • Neuci Alves dos Santos Prata Author
  • Lígia Brambilla Costa Author
  • Nathalia Leite Lara Nunes Author
  • Angelo Coutinho Mazolini Author
  • Heloisa Maffioletti Ferrari Author
  • Marcos Antônio Forte Júnior Author
  • José Iracy Macário Barros Júnior Author
  • Ana Clara Cavalaro Zamboni Author
  • Adrieli Tavares Polate Author
  • Raynara Brito Silva Author
  • Dayana Assunção Nascimento Author
  • Pedro Costa Lima Author
  • Rafaella Abrantes e Silva Author
  • Carlos Arthur Marinho da Silva Beltrão Author
  • Luma Moreira Soares de Andrade Author
  • Adriane Brasileiro Mazocoli Silva Author
  • André Junior Lopez Lima Author
  • Hanna Fauzi Abdul Rahim Author
  • Marcos Phellype de Souza Kussler Author
  • Lucas Cardeal Simão Ribeiro Author

DOI:

https://doi.org/10.56238/levv16n55-074

Keywords:

Cardiovascular Toxicity, Integrative Review, Naphazoline, Nasal Decongestants, Self-Medication

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.

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References

BOTELHO, L. L. R.; CUNHA, C. C. A.; MACEDO, M. O método da revisão integrativa nos estudos organizacionais. Gestão e Sociedade, v. 5, n. 11, p. 121–136, 2011. DOI: 10.21171/ges.v5i11.1220.

BRASIL. Conselho Nacional de Saúde. Resolução nº 510, de 7 de abril de 2016. Dispõe sobre as normas aplicáveis a pesquisas em Ciências Humanas e Sociais. Diário Oficial da União, Brasília, DF, 24 maio 2016.

BRASIL. Ministério da Saúde. Política Nacional de Práticas Integrativas e Complementares no SUS. Brasília: Ministério da Saúde, 2018.

CASP – Critical Appraisal Skills Programme. CASP Checklist for Qualitative Studies. Oxford: CASP, 2018. Disponível em: https://casp-uk.net/casp-tools-checklists/. Acesso em: 10 dez. 2025.

DA SILVA, A. P.; NASCIMENTO, R. F.; OLIVEIRA, J. L. Riscos cardiovasculares associados ao uso prolongado de descongestionantes nasais: revisão de literatura. Scientific Electronic Archives, v. 17, n. 5, p. 114–123, 2024.

DRUGBANK DATABASE. Naphazoline: pharmacology and safety profile. DrugBank Online, 2024. Disponível em: https://go.drugbank.com/drugs/DB06725. Acesso em: 8 dez. 2025.

GALASSO, G. Ventricular dysfunction and nasal decongestant exposure: a clinical alert. European Heart Journal Supplements, v. 26, n. 1, p. A42–A46, 2024. DOI: 10.1093/eurheartjsupp/suad018.

GALASSO, G. et al. Myocardial infarction with nonobstructive coronary arteries (MINOCA) after chronic nasal decongestant abuse. Journal of Cardiovascular Medicine, v. 25, n. 4, p. 310–314, 2024. DOI: 10.2459/JCM.0000000000001502.

IVANOV, V. A. et al. In silico modeling of alpha-adrenergic stimulation and cardiac effects of vasoconstrictive agents. Bulletin of the Russian Military Medical Academy, v. 32, n. 3, p. 112–118, 2020. Disponível em: https://elibrary.ru/item.asp?id=44051278.

JCA – JOURNAL OF CARDIAC ARRHYTHMIAS. Bradycardia and hypertension secondary to naphazoline intoxication: case report. Journal of Cardiac Arrhythmias, v. 28, n. 2, p. 201–204, 2024. DOI: 10.1016/j.jca.2024.03.002.

MAMOSHINA, P.; RODRÍGUEZ, B.; BUENO-OROVIO, A. Computational modeling of drug-induced cardiotoxicity: insights from alpha-adrenergic agonists. Cell Reports Medicine, v. 2, n. 12, p. 100465, 2021. DOI: 10.1016/j.xcrm.2021.100465.

MAYO CLINIC. Naphazoline (nasal route): precautions and adverse effects. Mayo Clinic Monographs, 2024. Disponível em: https://www.mayoclinic.org/drugs-supplements/naphazoline-nasal-route. Acesso em: 8 dez. 2025.

MIHALCEA, D. et al. Cardiotoxicity of vasoconstrictive agents: a systematic review. Life (MDPI), v. 13, n. 2, p. 185, 2023. DOI: 10.3390/life13020185.

MINAYO, M. C. S. O desafio do conhecimento: pesquisa qualitativa em saúde. 15. ed. São Paulo: Hucitec, 2023.

PAGE, M. J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, v. 372, p. n71, 2021. DOI: 10.1136/bmj.n71.

REPOSITÓRIO IMEPAC. Uso irracional de descongestionantes e repercussões sistêmicas. Revista Master IMEPAC, v. 9, n. 3, p. 48–55, 2022. Disponível em: https://revista.imepac.edu.br.

SCIENTIFIC ELECTRONIC ARCHIVES (SEA). Descongestionantes nasais e riscos cardiovasculares associados ao uso abusivo. SEA Journal, v. 13, n. 8, p. 90–98, 2020. Disponível em: https://sea.ufr.edu.br.

SOUZA, M. T.; SILVA, M. D.; CARVALHO, R. Revisão integrativa: o que é e como fazer. Einstein (São Paulo), v. 8, n. 1, p. 102–106, 2010. DOI: 10.1590/S1679-45082010RW1134.

UFAL – UNIVERSIDADE FEDERAL DE ALAGOAS. Revisão narrativa sobre o uso de descongestionantes nasais e eventos cardiovasculares. Repositório Institucional UFAL, 2021. Disponível em: https://repositorio.ufal.br.

WHITTEMORE, R.; KNAFL, K. The integrative review: updated methodology. Journal of Advanced Nursing, v. 52, n. 5, p. 546–553, 2005. DOI: 10.1111/j.1365-2648.2005.03621.x.

WORLD HEALTH ORGANIZATION (WHO). The importance of pharmacovigilance: safety monitoring of medicinal products. Geneva: WHO, 2020.

Published

2025-12-13

How to Cite

CORREA, João Pedro Martins Napi et al. CARDIOVASCULAR RISKS ASSOCIATED WITH THE SYSTEMIC USE OF NAPHAZOLINE: AN INTEGRATIVE REVIEW. LUMEN ET VIRTUS, [S. l.], v. 16, n. 55, p. e11053, 2025. DOI: 10.56238/levv16n55-074. Disponível em: https://periodicos.newsciencepubl.com/LEV/article/view/11053. Acesso em: 17 feb. 2026.