Child Poisonings From Eye Drops, Nose Sprays

Oct. 25, 2012 -- Over-the-counter eyedrops and nose sprays contain powerful drugs that are poisonous in surprisingly small amounts if swallowed, the FDA warns.

Unwary parents often leave these products within easy reach of curious children. From 1997 through 2009, eyedrops injured more than 4,500 children under the age of 5 and nasal sprays injured more than 1,100, according to the U.S. Consumer Product Safety Commission (CPSC).

Injury reports show that children can easily open the products, which do not come in child-resistant packages.

The drugs are surprisingly powerful. Swallowing less than a fifth of a teaspoon can seriously harm a child, the FDA says.

The eyedrops in question soothe redness by causing blood vessels in the eye to constrict. Visine is a popular brand; there are many generic versions. Nose drops work in a similar way, tightening blood vessels in the nose. Afrin, Dristan, and Mucinex are popular brands, and there are many generic versions.

The products contain the active ingredients tetrahydrozoline, naphazoline, or oxymetazoline.

All three drugs are in the class of drugs called imidazolines. When placed in the eye or nose as directed, the drugs only affect that part of the body. But if swallowed, they quickly have effects throughout the body.

"Generally, symptoms can occur in as little as one hour, peaking at eight hours, and resolving after 12-36 hours," a CPSC briefing paper notes. "Even though the symptoms resolve in a relatively short amount of time, ingestion of imidazolines can result in severe life-threatening consequences, such as decreased breathing, decreased heart rate, and loss of consciousness that require hospitalization to ensure recovery."

The CPSC has proposed a new rule requiring child-resistant packaging for these products. That rule has yet to be finalized. Even when it's final, the rule will give manufacturers at least a year to comply. Meanwhile, many homes have at least one of the products in medicine cabinets.

To avoid accidental poisonings, the FDA says parents and caregivers should:

• Store medicines in a safe location that is too high for young children to reach or see.
• Never leave medicines or vitamins out on a kitchen counter or a child's bedside.
• If a medicine bottle has a safety cap, relock it each time you use it.
• Remind babysitters, houseguests, and visitors to keep purses, bags, or coats that have medicines in them away and out of sight when they are in your home.
• Avoid taking medicines in front of young children because they like to mimic adults.

The FDA lists several specific products in its warning. Here's the list, which includes some but by no means all store and generic brands: