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phenylephrine

C05AX06

Forms & Strengths

Ophthalmic Solution: 2.5%, 10%
Nasal Spray: 0.125%, 0.25%, 0.5%, 1%
Injection: 10 mg/mL
Oral Solution: 5 mg/5 mL

Adult Dosing

Vasoconstriction (Hypotension): IV bolus 50-250 mcg every 1-2 minutes as needed; IV infusion 0.1-0.5 mcg/kg/min titrated to effect
Nasal Congestion: 2-3 sprays of 0.25%-0.5% solution into each nostril every 4 hours as needed
Mydriasis: 1 drop of 2.5% or 10% ophthalmic solution

Pediatric Dosing

Nasal Congestion (Children >= 12 years): 2-3 sprays of 0.25% solution every 4 hours
Nasal Congestion (Children 6-12 years): 2-3 sprays of 0.125% or 0.25% solution every 4 hours
Ophthalmic Mydriasis (Children >= 1 year): 1 drop of 2.5% solution

Indications

Treatment of hypotension, particularly during anesthesia
Temporary relief of nasal congestion associated with rhinitis and sinusitis
Induction of mydriasis for ophthalmic procedures and examinations

Mechanism of Action

Direct-acting alpha-1 adrenergic receptor agonist causing vasoconstriction of arterioles, raising systolic and diastolic blood pressure, and producingmydriasis and nasal decongestion

Contraindications

Hypersensitivity to phenylephrine or formulation components
Severe hypertension
Ventricular tachycardia (for parenteral use)
Narrow-angle glaucoma (for ophthalmic use)

Adverse Reactions

Hypertension
Reflex bradycardia
Headache
Nausea
Rebound nasal congestion (rhinitis medicamentosa with prolonged topical use)
Stinging or blurred vision (ophthalmic use)

Drug Interactions

Monoamine Oxidase Inhibitors (MAOIs): May cause severe hypertensive crisis
Oxytocic drugs: May cause severe persistent hypertension or stroke
Beta-blockers: May antagonize cardiac effects and lead to severe peripheral vasoconstriction
Tricyclic antidepressants: May potentiate pressor response

Curated Content: Needs Vetting Before Put to Clinical Use