A case of naphazoline intoxication after the ingestion of a topical antiseptic solution

Senepul™ solution is frequently used as a topical antiseptic solution in Korea in cases with abrasion, laceration and impetigo. 100 ml of this solution contains a mixture of 100 mg naphazoline hydrochloride, 100 mg dibucaine hydrochloride, 200 mg chlorpheniramine maleate, and 100 mg benzethonium chloride. Naphazoline is an alpha sympathomimetic and an imidazoline derivative. In excessive dosage or ingested by accident, naphazoline may cause not only local but also systemic side effects like hypertension, bradycardia with arrhythmia, hypotension, respiratory depression, excitation or severe central nervous system depression. We report a case of a patient with prolonged bradycardia, hypotension, central nervous system depression that occurred after ingestion of a small amount of this topical antiseptic solution.