Dosing & Uses
Dosage Forms & Strengths
ophthalmic solution
- 0.12% (OTC; Refresh Redness Relief)
- 2.5% (Rx; Altafrin, Neofrin)
- 10% (Rx; Altafrin, Neofrin)
Mydriasis Production
Ophthalmoscopy: 1-2 gtt 2.5% solution or 10% solution, may repeat in 10-60 min, mydriasis persists >3 hr, no cycloplegia
Ocular Surgery: 1-2 gtt 2.5% or 10% solution administered 30-60 min preop
Irrigation: 1-2 gtt 0.12% solution into affected eye up to four times daily; not to exceed 72 hr of therapy
Posterior Synechiae Prevention
Anterior Uveitis: 1 gtt of 10% solution three times daily or more (with atropine);
Post-iridectomy: 1 gtt of 10% solution qDay or twice daily
Eye Redness
OTC strength (0.12%) may be used to decrease appearance of eye redness (bloodshot eyes)
Instill 1-2 gtt in affected eye(s) BID/TID
Dosage Forms & Strengths
ophthalmic solution
- 2.5% (Rx; Altafrin, Neofrin)
- 10% (Rx; Altafrin, Neofrin)
Ocular Procedures
Indicated to provide mydriasis (pupil dilation) needed for ophthalmic procedures
<1 year: 1 gtt of 2.5% solution 15-20 min before procedure
≥1 yr
- Ophthalmoscopy: 1-2 gtt 2.5% solution or 10% solution, may repeat in 10-60 min, mydriasis persists >3 hr, no cycloplegia
- Ocular Surgery: 1-2 gtt 2.5% or 10% solution administered 30-60 min pre-op
- Irrigation: 1-2 gtt 0.12% solution into affected eye up to four times daily; not to exceed 72 hr of therapy
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (17)
- amitriptyline
amitriptyline, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- amoxapine
amoxapine, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- clomipramine
clomipramine, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- desipramine
desipramine, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- doxepin
doxepin, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- imipramine
imipramine, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- isocarboxazid
isocarboxazid increases effects of phenylephrine ophthalmic by pharmacodynamic synergism. Use Caution/Monitor. Some systemic absorption of ophthalmic phenylephrine; reduce dose within 21 days of MAO inhibitors.
- linezolid
linezolid increases effects of phenylephrine ophthalmic by pharmacodynamic synergism. Use Caution/Monitor. Some systemic absorption of ophthalmic phenylephrine; reduce dose within 21 days of MAO inhibitors.
- lofepramine
lofepramine, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- maprotiline
maprotiline, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- nortriptyline
nortriptyline, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- phenelzine
phenelzine increases effects of phenylephrine ophthalmic by pharmacodynamic synergism. Use Caution/Monitor. Some systemic absorption of ophthalmic phenylephrine; reduce dose within 21 days of MAO inhibitors.
- procarbazine
procarbazine increases effects of phenylephrine ophthalmic by pharmacodynamic synergism. Use Caution/Monitor. Some systemic absorption of ophthalmic phenylephrine; reduce dose within 21 days of MAO inhibitors.
- protriptyline
protriptyline, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- tranylcypromine
tranylcypromine increases effects of phenylephrine ophthalmic by pharmacodynamic synergism. Use Caution/Monitor. Some systemic absorption of ophthalmic phenylephrine; reduce dose within 21 days of MAO inhibitors.
- trazodone
trazodone, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- trimipramine
trimipramine, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
Minor (0)
Adverse Effects
Frequency Not Defined
Frequent: transient burning or stinging
Arrhythmia
Myocardial infarction
Subarachnoid hemorrhage
Headache or browache
Blurred vision
Syncope
Rebound myosis
Reactive hyperemia
Transient keratitis
Hypersensitivity reactions such as allergic conjunctivitis or dermatitis
Sensitivity to light
Warnings
Contraindications
Hypersensitivity, narrow-angle glaucoma, ventricular tachycardia, hypertension
Cautions
Reduce dose if used within 21 d of MAO inhibitors or TCAs
Wait 5 min between multiple drops (no >3 drops needed)
Rebound miosis may occur in elderly people 1 day after treatmentwith phenylephrine
Notify healthcare provider if vision changes, worsening of symptoms, or continued redness occur
Caution with marked hypertension, cardiac disorders, advanced arteriosclerotic changes, type 1 diabetes mellitus, hyperthyroidism; in children of low body weight; elderly
May cause false-normal tonometry readings, tonometry should be performed before phenylephrine is administered
Presence of sulfites in some products may cause allergic reactions in susceptible patients
Pregnancy & Lactation
Pregnancy
Not known whether drug can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity; administer to a pregnant woman only if clearly needed
Animal data
- Animal reproduction studies have not been conducted with topical phenylephrine
Lactation
It is not known whether this drug is excreted in human breast milk; because many drugs are excreted in human milk, caution should be exercised when therapy is administered to a nursing woman
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Acts directly on alpha-adrenergic receptors in eye producing contraction of dilator muscle of pupil & constriction of arterioles in conjunctiva
Pharmacokinetics
Onset of action: 15-30 min (mydriasis)
Duration: 1-3 hr (mydriasis)
Peak plasma time: <20 min
Absorption: Minimal (systemic)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| phenylephrine ophthalmic (eye) - | 10 % drops |  | |
| phenylephrine ophthalmic (eye) - | 2.5 % drops |  | |
| phenylephrine ophthalmic (eye) - | 10 % drops |  | |
| phenylephrine ophthalmic (eye) - | 2.5 % drops |  | |
| phenylephrine ophthalmic (eye) - | 2.5 % drops |  | |
| Vazculep injection - | 10 mg/mL vial |  | |
| Vazculep injection - | 10 mg/mL vial |  | |
| Vazculep injection - | 10 mg/mL vial |  | |
| Vazculep injection - | 10 mg/mL vial |  | |
| Vazculep injection - | 10 mg/mL vial |  | |
| Wal-Four nasal - | 1 % liquid |  | |
| Wal-Four nasal - | 1 % liquid |  | |
| Neo-Synephrine (phenylephrine) nasal - | 1 % liquid |  | |
| Neo-Synephrine (phenylephrine) nasal - | 1 % liquid |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| phenylephrine injection - | 10 mg/mL vial |  | |
| Nasal Decongestant (phenylephrine) oral - | 10 mg tablet |  | |
| Sinus Decongestant (PE) oral - | 10 mg tablet |  | |
| Sinus Decongestant (PE) oral - | 10 mg tablet |  | |
| Sinus Decongestant (PE) oral - | 10 mg tablet |  | |
| 4 Way nasal - | 1 % liquid |  | |
| Nasal Four nasal - | 1 % liquid |  | |
| Ephrine nasal - | 1 % drops |  | |
| Wal-phed PE oral - | 10 mg tablet | | |
| Sinus PE Decongestant oral - | 10 mg tablet | |
Copyright © 2010 First DataBank, Inc.
Patient Handout
phenylephrine ophthalmic (eye)
PHENYLEPHRINE - OPHTHALMIC
(FEN-il-EF-rin)
COMMON BRAND NAME(S): Mydfrin
USES: This medication is used to dilate the pupils for eye examinations or procedures, and to treat certain eye conditions. It belongs to a class of drugs known as decongestants. Phenylephrine works by narrowing blood vessels.
HOW TO USE: To apply eye drops, wash hands first. To avoid contamination, do not touch the dropper tip or let it touch your eye or any other surface.If you are wearing contact lenses, remove them before using eye drops. Wait at least 15 minutes before replacing your contact lenses. Tilt your head back, look upward, and pull down the lower eyelid to make a pouch. Hold the dropper directly over your eye and place one drop into the pouch. Use as often as directed by your doctor. Look downward, gently close your eyes, and place one finger at the corner of your eye (near the nose). Apply gentle pressure for 1 to 2 minutes before opening your eyes. This will prevent the medication from draining out. Try not to blink or rub your eye. Repeat these steps if your dose is for more than one drop. If directed to use this medication in both eyes, repeat these steps for your other eye. Wait several minutes for your vision to clear before driving or operating machinery. Do not rinse the dropper. Replace the dropper cap after each use.If you are using another kind of eye medication (such as drops or ointments), wait at least 10 minutes before applying other medications. Use eye drops before eye ointments to allow the drops to enter the eye.Use this medication as prescribed to get the most benefit from it.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Burning or stinging, headache, sensitivity to light, or blurred vision may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: eye pain, irregular heartbeat.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using phenylephrine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as sulfites found in some brands), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: glaucoma (angle-closure type), blood vessel disorders (such as aneurysm).After you apply this drug, your vision may become temporarily blurred. Do not drive, use machinery, or do any activity that requires clear vision until you can do it safely.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.
MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store in the refrigerator or at room temperature away from light. Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
