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 |
|---|---|---|---|
| Neo-Synephrine (phenylephrine) nasal - | 1 % liquid |  | |
| Neo-Synephrine (phenylephrine) nasal - | 0.5 % liquid |  | |
| Neo-Synephrine (phenylephrine) nasal - | 0.25 % 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 |  | |
| 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 Four nasal - | 1 % liquid |  | |
| 4 Way nasal - | 1 % liquid |  | |
| Ephrine nasal - | 1 % drops |  | |
| Sinus PE Decongestant oral - | 10 mg tablet |  | |
| 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 |  | |
| Wal-Four nasal - | 1 % liquid |  | |
| Wal-Four nasal - | 1 % liquid |  | |
| 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-phed PE oral - | 10 mg tablet | | |
| 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 |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
phenylephrine nasal
DECONGESTANT DROPS - NASAL
USES: This medication is used for temporary relief of congestion in the nose caused by various conditions including the common cold, sinusitis, hay fever, and allergies. It works by narrowing the blood vessels in the nose area, reducing swelling and congestion.
HOW TO USE: Use this medication in the nose as directed. Follow all directions on the product package, or use as directed by your doctor. If you have any questions, ask your doctor or pharmacist.To apply nasal drops, wash your hands first. To avoid contamination, do not touch the dropper tip or let it touch your nose or any other surface. If needed, have another person place the drops in your nose.Gently blow your nose before using this drug. Tilt your head back while sitting on a chair or lying down. Hold the dropper over the affected nostril and apply the directed number of drops. Keep your head tilted for a few minutes. Repeat these steps with the other nostril if needed. Do not swallow the medication if it drips into the throat.This medication provides only temporary relief. Do not use more medication or use it more often or for longer than directed because doing so may increase the risk of side effects. Also, do not use this medication for more than 3 days because doing so may cause a condition called rebound congestion. Symptoms of rebound congestion include long-term redness and swelling inside the nose and increased runny nose. If this occurs, stop using this medication and consult your doctor or pharmacist.Inform your doctor if your condition gets worse or lasts after 3 days.
SIDE EFFECTS: Temporary burning, stinging, dryness in the nose, runny nose, and sneezing may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that 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: slow/fast/pounding heartbeat, dizziness, nausea, headache, mental/mood changes, trouble sleeping, shaking (tremors), unusual sweating, unusual weakness.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 this nasal decongestant, tell your doctor or pharmacist if you are allergic to it; or to other sympathomimetics (such as pseudoephedrine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.If you have any of the following health problems, consult your doctor or pharmacist before using this product: heart/blood vessel disease (such as coronary artery disease), overactive thyroid (hyperthyroidism), diabetes, high blood pressure, difficulty urinating (due to enlarged prostate).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Children may be more sensitive to the side effects of this drug. Check the product package or consult with your doctor or pharmacist about whether these nasal drops can be used by children.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether 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.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products or diet aids).
OVERDOSE: 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. Symptoms of overdose may include: drowsiness, slow heartbeat, dizziness, fainting.
NOTES: Do not share this medication with others. Use of this container by more than one person may spread infection.There are many nasal decongestants available, many without a prescription. Talk with your doctor or pharmacist about which product is best for you.
MISSED DOSE: Not applicable.
STORAGE: Refer to storage information printed on the package. Protect from heat and light. 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 November 2022. Copyright(c) 2022 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
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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- Compare formulary status to other drugs in the same class.
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