phenylephrine nasal (OTC)

Brand and Other Names:NeoSynephrine Nasal, Neo-Synephrine Cold & Sinus Mild Strength Spray
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

nasal spray

  • 0.25%
  • 0.5%
  • 1%

Nasal Congestion

Instill 2-3 sprays or 2-3 gtt q4hr of 0.25-0.1% solution PRN; not to exceed 3 days

Dosage Forms & Strengths

nasal spray

  • 0.25%
  • 0.5%
  • 1%

Nasal Congestion

<2 years

  • Consult a physician

2-6 years

  • 1-3 gtt intranasally q2-4hr of 0.125% solution PRN; not to exceed 3 days

6-12 years

  • 2-3 gtt intranasally q4hr of 0.25% solution PRN; not to exceed 3 days

>12 years old

  • Instill 1-2 sprays or 1-2 gtt intranasally q4hr of 0.25-0.1% solution PRN; not to exceed 3 days
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Interactions

Interaction Checker

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (2)

                • nicotine intranasal

                  phenylephrine nasal decreases levels of nicotine intranasal by Other (see comment). Use Caution/Monitor. Comment: Nasal vasoconstrictors prolong the time to peak concentrations by ~40% and decreases peak concentration by ~20%.

                • safinamide

                  phenylephrine nasal and safinamide both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Monitor patients for hypertension if safinamide is prescribed concomitantly with prescription or nonprescription sympathomimetics, including nasal, oral, or ophthalmic decongestants and cold remedies.

                Minor (0)

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                  Adverse Effects

                  Frequency Not Defined

                  Stinging

                  Dryness

                  Rebound congestion

                  Sneezing

                  Burning

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                  Warnings

                  Contraindications

                  Hypersensitivity to product or excipients

                  Use for >3 days

                  Cautions

                  Rebound congestion may occur

                  Temporary discomfort such as burning, stinging, sneezing, or an increase in nasal discharge may occur

                  Use of container by more than one person may spread infection

                  Use only as directed; frequent or prolonged use may cause nasal congestion to recur or worsen

                  Ask a healthcare professional before in heart disease, high blood pressure, thyroid disease, diabetes, trouble urinating due to an enlarged prostate gland

                  Stop use and ask healthcare professional if symptoms persist

                  Stop use if symptoms persist

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                  Pregnancy & Lactation

                  Pregnancy Category: C

                  Lactation: not known if excreted in breast milk

                  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.

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                  Pharmacology

                  Mechanism of Action

                  Alpha adrenergic agonist; stimulates alpha-adrenergic receptors in nasal conjunctiva and arterioles to produce vasoconstriction that results in nasal decongestion

                  Pharmacokinetics

                  Absorption: Minimal systemic

                  Duration: 2.5 - 4 hr

                  Onset: < 2 min

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                  Images

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                  Patient Handout

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                  Patient Education
                  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 any of these unlikely but serious side effects occur: 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, seek immediate medical attention 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 that you are using this medication.Caution is advised when this drug is used by children because they may be more sensitive to the effects of the 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: If your doctor has directed you to use this product, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.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.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: medication for high blood pressure, tricyclic antidepressants (such as amitriptyline).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).This document does not contain all possible interactions. Before using this product, tell your doctor or pharmacist of all the products you use. 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. 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 medicines 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 for more details about how to safely discard your product.

                  Information last revised December 2021. 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.

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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.