Consists of Phenylephrine hydrochloride, shark-liver oil
What is Phenylephrine hydrochloride?
Phenylephrine hydrochloride (Phenylephrine hydrochloride) is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).
Phenylephrine hydrochloride is used to treat nasal and sinus congestion, or congestion of the tubes that drain fluid from your inner ears, called the eustachian (yoo-STAY-shun) tubes.
Phenylephrine hydrochloride may also be used for purposes not listed in this medication guide.
Phenylephrine hydrochloride indications
Phenylephrine hydrochloride Hydrochloride Ophthalmic Solution, USP 2.5% and 10%, is indicated to dilate the pupil.
How should I use Phenylephrine hydrochloride?
Use Phenylephrine hydrochloride as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Phenylephrine hydrochloride is for use in the eye only. Avoid contact with the nose or mouth.
- To use Phenylephrine hydrochloride, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.
- To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including your eye. Keep the container tightly closed.
- Do not wear contact lenses while you are using Phenylephrine hydrochloride. Sterilize contact lenses according to the manufacturer's directions and check with your doctor before using them.
- Do not use Phenylephrine hydrochloride if it is brown or contains particles.
- If you miss a dose of Phenylephrine hydrochloride, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Phenylephrine hydrochloride.
Uses of Phenylephrine hydrochloride in details
Use: Labeled Indications
Hypotension/shock: Treatment of hypotension, vascular failure in shock. Note: Not recommended for routine use in the treatment of septic shock; use should be limited until more evidence demonstrating positive clinical outcomes becomes available (Rhodes 2017).
Guideline recommendations:
Cardiogenic shock: The 2017 American Heart Association (AHA) scientific statement for the Contemporary Management of Cardiogenic Shock recommends Phenylephrine hydrochloride, if needed, be considered for initial vasoactive management of cardiogenic shock due to aortic stenosis, mitral stenosis, or dynamic left ventricular outflow tract (LVOT) obstruction (AHA [van Diepen 2017]).
Hypotension during anesthesia: As a vasoconstrictor in regional analgesia
Nasal congestion: As a decongestant [OTC]
Off Label Uses
Hypotension in patients with obstructive hypertrophic cardiomyopathy
Phenylephrine hydrochloride is a pure alpha1 agonist that will increase systemic vascular resistance without increasing heart rate or contractility. This is advantageous in patients with obstructive hypertrophic cardiomyopathy and hypotension since increases in both heart rate and contractility may cause the obstruction to worsen, leading to a decrease in cardiac output. Other vasopressors like dopamine, epinephrine, and norepinephrine may increase contractility and/or heart rate. Additional trials may be necessary to further define the role of Phenylephrine hydrochloride in this condition.
Based on the American Urological Association guidelines for the management of priapism, due to the low risk of cardiovascular side effects intracavernous injection of Phenylephrine hydrochloride is recommended for ischemic priapism that persists following aspiration/irrigation.
Phenylephrine hydrochloride description
Phenylephrine hydrochloride is a sympathomimetic amine that acts predominantly on α-adrenergic receptors. It is mainly used to treat nasal congestion, but may also be useful in treating hypotension and shock, hypotension during spinal anaesthesia, prolongation of spinal anaesthesia, paroxysmal supraventricular tachycardia, symptomatic relief of external or internal hemorrhoids, and to increase blood pressure as an aid in the diagnosis of heart murmurs.
Phenylephrine hydrochloride dosage
General Dosing Recommendations
In patients 1 year of age or greater, apply one drop of either Phenylephrine hydrochloride hydrochloride ophthalmic solution 2.5% or 10% every 3 to 5 minutes to the conjunctival fornix as required up to a maximum of 3 drops per eye per day.
In order to obtain a greater degree of mydriasis, Phenylephrine hydrochloride hydrochloride ophthalmic solution 10% may be needed.
Dosing in Pediatric Patients Less Than 1 Year of Age
In pediatric patients less than 1 year of age, one drop of Phenylephrine hydrochloride hydrochloride ophthalmic solution 2.5% should be instilled at 3 to 5 minute intervals up to a maximum of 3 drops per eye.
Phenylephrine hydrochloride interactions
See also:
What other drugs will affect Phenylephrine hydrochloride?
Atropine
Concurrent use may enhance the pressor effects and induce tachycardia, especially in infants.
Beta-blockers
Decrease Phenylephrine hydrochloride’s effect.
Digitalis glycosides, general anesthetics
Arrhythmias.
Furazolidone, MAOIs
May significantly increase pressor response resulting in hypertensive crisis and intracranial hemorrhage.
Guanethidine, methyldopa, reserpine
May increase pressor response of Phenylephrine hydrochloride; resulting in severe hypertension.
Halogenated hydrocarbon anesthetics
May sensitize myocardium to effects of catecholamines. Use extreme caution to avoid arrhythmias.
Oxytocic drugs
May cause severe persistent hypertension.
Tricyclic antidepressants
May decrease or increase response; use with caution.
Laboratory Test Interactions
Products with potassium guaiacolsulfonate may increase renal Cl for urate and thereby lower serum uric acid levels; may increase urinary 50 hydroxyindoleacetic acid; may falsely elevate VMA test for catecholis.
Phenylephrine hydrochloride side effects
See also:
What are the possible side effects of Phenylephrine hydrochloride?
The following serious adverse reactions are described below and elsewhere in the labeling:
- Cardiovascular Effects
- Elevation in Blood Pressure
The following adverse reactions have been identified following use of Phenylephrine hydrochloride hydrochloride ophthalmic solution. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Ocular Adverse Reactions
Eye pain and stinging on instillation, temporary blurred vision and photophobia, and conjunctival sensitization may occur.
Systemic Adverse Reactions
A marked increase in blood pressure has been reported particularly, but not limited to low weight premature neonates, infants and hypertensive patients.
Cardiovascular effects which have been seen primarily in hypertensive patients following topical ocular use of Phenylephrine hydrochloride hydrochloride ophthalmic solution 10% include marked increase in blood pressure, syncope, myocardial infarction, tachycardia, arrhythmia and subarachnoid hemorrhage.
Phenylephrine hydrochloride contraindications
See also:
What is the most important information I should know about Phenylephrine hydrochloride?
Cardiac and Endocrine Disease
Phenylephrine hydrochloride hydrochloride ophthalmic solution 10% is contraindicated in patients with hypertension or thyrotoxicosis. Phenylephrine hydrochloride hydrochloride ophthalmic solution 2.5% should be used in these patients.
Pediatric Patients Less Than 1 Year of Age
Phenylephrine hydrochloride hydrochloride ophthalmic solution 10% is contraindicated in pediatric patients less than 1 year of age due to the increased risk of systemic toxicity. Phenylephrine hydrochloride hydrochloride ophthalmic solution 2.5% should be used in these patients.
Shark-liver oil indications
infections
Active ingredient matches for Phenylephrine hydrochloride/shark-liver oil:
Phenylephrine hydrochloride/shark-liver oil
References
- PubChem. "phenylephrine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "phenylephrine". http://www.drugbank.ca/drugs/DB00388 (accessed September 17, 2018).
- MeSH. "Cardiotonic Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
