Phenylephrine

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Thalia, Visadron; Belgium: Phenylephrine; Bulgaria: Mydfrin; Cyprus: Mydfrin, Prefrin; Denmark: Metaoxedrin; Finland: Oftan-Metaoksedrin; France: Auristan, Iriclair, Neosynephrine, Nycto; Germany: Neo-Synephrine; Ireland: Minims Phenylephrine; Italy: Optistin; Netherlands: Phenylephrine; Poland: Analux, Neo-Synephrine; Portugal: Anti Gripe Asclepius; Spain: Ada Spray Nasal, Colicursi Fenilefrina, Disneumón, Mirazul, Visadrón, Vistafrín; Sweden: Lepheton; UK: Minims Phenylephrine.

North America

Canada: Dionephrine, Mydfrin, Neo-Synephrine; USA: Ah-Chew, AK-Dilate, Altafrin, Anu-Med, Dimetapp Toddler’s, Formulation R, Little Noses Decongestant, LuSonal, Medi-Phenyl, Mydfrin, NāSop, Neofrin, Neo-Synephrine Mild, OcuNefrin, Preparation H, Rectacaine, Rhinall, Tronolane, Tur-bi-kal.

Latin America

Argentina: Efrina, Fadalefrina, Prefrín Liquifilm, Qura Nasal; Brazil: Fenilefrin, Fenilefrina; Mexico: Actifed Advance, Lefrine, Nefrín Ofteno, Rinolán.

Asia

Japan: Neosynesin.

Drug combinations

Phenylephrine and Acetaminophen

Phenylephrine and Caffeine

Phenylephrine and Carbetapentane

Phenylephrine and Cetrimonium

Phenylephrine and Chlorpheniramine

Phenylephrine and Cyclopentolate

Phenylephrine and Dimetindene

Phenylephrine and Diphenhydramine

Phenylephrine and Diphenylpyraline

Phenylephrine and Guaifenesin

Phenylephrine and Ibuprofen

Phenylephrine and Isoproterenol

Phenylephrine and Prednisolone

Phenylephrine and Promethazine

Phenylephrine and Pyrilamine

Phenylephrine and Scopolamine

Phenylephrine and Tropicamide

Phenylephrine and Zinc Sulfate

Phenylephrine, Acetaminophen, and Ascorbic Acid (Vitamin C)

Phenylephrine, Acetaminophen, and Caffeine

Phenylephrine, Acetaminophen, and Dextromethorphan

Phenylephrine, Acetaminophen, and Diphenhydramine

Phenylephrine, Acetaminophen, and Guaifenesin

Phenylephrine, Amantadine, and Acetaminophen

Phenylephrine, Aspirin, and Chlorpheniramine

Phenylephrine, Carbetapentane, and Chlorpheniramine

Phenylephrine, Carbetapentane, and Guaifenesin

Phenylephrine, Carbetapentane, and Pyrilamine

Phenylephrine, Chloramphenicol, and Dexamethasone

Phenylephrine, Chloramphenicol, and Neomycin

Phenylephrine, Chlorpheniramine, and Dextromethorphan

Phenylephrine, Chlorpheniramine, and Dihydrocodeine

Phenylephrine, Chlorpheniramine, and Guaifenesin

Phenylephrine, Chlorpheniramine, and Hydrocodone

Phenylephrine, Chlorpheniramine, and Methscopolamine

Phenylephrine, Chlorpheniramine, and Phenyltoloxamine

Phenylephrine, Chlorpheniramine, and Pyrilamine

Phenylephrine, Codeine, and Promethazine

Phenylephrine, Dextromethorphan, and Guaifenesin

Phenylephrine, Dextromethorphan, and Paracetamol

Phenylephrine, Dextromethorphan, and Pyrilamine

Phenylephrine, Diphenhydramine, and Hydrocodone

Phenylephrine, Guaifenesin, and Hydrocodone

Phenylephrine, Guaifenesin, and Pyrilamine

Phenylephrine, Neomycin, and Polymyxin B

Phenylephrine, Acetaminophen, Ascorbic Acid (Vitamin C), and Guaifenesin

Phenylephrine, Acetaminophen, Ascorbic Acid (Vitamin C), and Pheniramine

Phenylephrine, Acetaminophen, Ascorbic Acid (Vitamin C), and Salicylamide

Phenylephrine, Acetaminophen, Butetamate, and Caffeine

Phenylephrine, Acetaminophen, Chlorpheniramine, and Guaifenesin

Phenylephrine, Carbetapentane, Chlorpheniramine, and Ephedrine

Phenylephrine, Chlorpheniramine, Codeine, and Potassium Iodide

Phenylephrine, Chlorpheniramine, Dextromethorphan, and Guaifenesin

Phenylephrine, Chlorpheniramine, Gramicidin, and Neomycin

Phenylephrine, Dextromethorphan, Guaifenesin, and Mepyramine

Phenylephrine, Hydrocortisone, Lidocaine, and Tetracaine

Phenylephrine, Acetaminophen, Ascorbic Acid (Vitamin C), Aspartame, and Citric Acid

Phenylephrine, Acetaminophen, Bromhexine, Chlorpheniramine, and Dextromethorphan

Phenylephrine, Acetaminophen, Ascorbic Acid (Vitamin C), Caffeine, Codeine, and Diphenhydramine

Chemistry

Phenylephrine Bitartrate: C~9~H~13~NO~2~ C~4~H~6~O~6~. Mw: 317.29. (1) R-2-(Methylamino)-1-(3-hydroxyphenyl)ethanol-, (2R,3R)-2,3-dihydroxybutanedioate (1:1); (2)(-)-1-(3-Hydroxyphenyl)-2-methylaminoethanol, hydrogen tartrate; (3)(-)-3 Hydroxy-α-[(methylamino)methyl]benzenemethanol, hydrogen tartrate; (4) 1-m-Hydroxy-α-[(methylamino)methyl]benzyl alcohol, hydrogen tartrate. CAS-17162-39-9.

Phenylephrine Hydrochloride: C~9~H~13~NO~2~ HCl. Mw: 203.67. Benzenemethanol, 3-hydroxy- α-[(methylamino)methyl]-, hydrochloride (R)-. CAS-61-76-7; CAS-59-42-7 (phenylephrine).

Pharmacologic Category

Sympathomimetic (Adrenergic) Agents; α-Adrenergic Agonists. EENT Preparations; Vasoconstrictors. EENT Preparations; Mydriatics. Antiglaucoma Ophthalmic Agent. (ATC-Code: C01CA06; R01AA04; R01AB01; R01BA03; S01FB01; S01GA05).

Mechanism of action

Causes vasoconstriction of arterioles of nasal mucosa and conjunctiva. Activates dilator muscle of pupil to cause contraction. Produces vasoconstriction of arterioles in body. Produces systemic arterial vasoconstriction.

Therapeutic use

Treatment of hypotension, vascular failure in shock. As vasoconstrictor in regional analgesia. As mydriatic in ophthalmic procedures and treatment of wide-angle glaucoma. Supraventricular tachycardia. Symptomatic relief of nasal and nasopharyngeal mucosal congestion, treatment of hemorrhoids, relief of redness of eye due to irritation.

Pregnancy and lactiation implications

Reproduction studies not conducted. Excretion in breast milk unknown.

Unlabeled use

Contraindications

Hypersensitivity to phenylephrine or any component of the formulation. Hypertension. Ventricular tachycardia. Use with or within 14 days of MAOI therapy. Narrow-angle glaucoma.

Warnings and precautions

Use with extreme caution in patients taking MAOIs (hypertension may result from concurrent use). Intravenous: Use with caution in the elderly, patients with hyperthyroidism, bradycardia, partial heart block, myocardial disease, or severe coronary artery disease. Avoid hypertension. Avoid extravasation. Avoid infusion into leg veins. Nasal: Use with caution in hyperthyroidism, diabetes mellitus, cardiovascular disease, ischemic heart disease, increased intraocular pressure, prostatic hyperplasia or in the elderly. Rebound congestion may occur when nasal products discontinued after chronic use. Oral: Use with caution in asthma, bowel obstruction/narrowing, hyperthyroidism, diabetes mellitus, cardiovascular disease, ischemic heart disease, increased intraocular pressure, prostatic hyperplasia, or in the elderly. Rectal: Use with caution in hyperthyroidism, diabetes mellitus, cardiovascular disease, ischemic heart disease, increased intraocular pressure, prostatic hyperplasia or in the elderly. Some products contain sulfites (may cause allergic reactions in susceptible individuals).

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