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 |
|---|---|---|---|
| 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 - | 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 |  | |
| Sinus Decongestant (PE) oral - | 10 mg tablet |  | |
| Sinus Decongestant (PE) oral - | 10 mg tablet |  | |
| Sinus Decongestant (PE) oral - | 10 mg tablet |  | |
| Sinus PE Decongestant oral - | 10 mg tablet |  | |
| Nasal Decongestant (phenylephrine) oral - | 10 mg tablet | | |
| Ephrine nasal - | 1 % drops |  | |
| Nasal Four nasal - | 1 % liquid |  | |
| Wal-phed PE oral - | 10 mg tablet | | |
| 4 Way nasal - | 1 % liquid |  | |
| phenylephrine ophthalmic (eye) - | 10 % drops |  | |
| phenylephrine ophthalmic (eye) - | 2.5 % drops |  | |
| phenylephrine ophthalmic (eye) - | 2.5 % drops |  | |
| phenylephrine ophthalmic (eye) - | 10 % drops |  | |
| phenylephrine ophthalmic (eye) - | 2.5 % drops |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
phenylephrine injection
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your 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: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
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.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.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 for more details about how to safely discard your product.
Information last revised July 2016. 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.
