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Phenylephrine

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

By mouth

Treats stuffy nose and sinuses… Read more

Brand names include: Children's Sudafed PE Nasal Decongestant, Childrens Triaminic Thin Strips

Into the eye

Ophthalmic phenylephrine in strengths of 2.5 and 10% is used to dilate (enlarge) the pupil. It is used before eye examinations, before and after eye surgery,… Read more

Brand names include: AK-Dilate, Altafrin

Into the nose

Phenylephrine is used for the temporary relief of congestion or stuffiness in the nose caused by hay fever or other allergies, colds, or sinus trouble… Read more

Brand names include: 4 Way Menthol, 4-Way Fast Acting

On the skin

Treats hemorrhoids… Read more

Into the rectum

Treats hemorrhoids… Read more

By injection

Phenylephrine injection is used to treat hypotension (low blood pressure) that may occur during surgery. This medicine is to be given only by or under… Read more

Brand names include: Neo-Synephrine HCl, Vazculep

Drug classes About this
Anesthetic Adjunct, Decongestant, Hemorrhoidal Agent, Mydriatic-Cycloplegic, Vasopressor
Combinations including this drug

What works? Research summarized

Evidence reviews

Efficacy and safety of oral phenylephrine: systematic review and meta-analysis

BACKGROUND: Oral phenylephrine is used as a decongestant, yet there has been no previously published systematic review supporting its efficacy and safety.

Prophylactic phenylephrine for caesarean section under spinal anaesthesia: systematic review and meta-analysis

We conducted a systematic review to determine the harm and benefit associated with prophylactic phenylephrine for caesarean section under spinal anaesthesia. We included 21 randomised controlled trials with 1504 women. The relative risk (95% CI) of hypotension with phenylephrine infusion – as defined by authors – before delivery was 0.36 (0.18–0.73) vs placebo, p = 0.004; 0.58 (0.39–0.88) vs an ephedrine infusion, p = 0.009; and 0.73 (0.55–0.96) when added to an ephedrine infusion, p = 0.02. After delivery, the relative risks of hypotension and nausea and vomiting with phenylephrine compared with placebo were 0.37 (0.19–0.71), p = 0.003, and 0.39 (0.17–0.91), p = 0.03, respectively. There was no evidence that hypertension, bradycardia or neonatal endpoints were affected. Phenylephrine reduced the risk for hypotension and nausea and vomiting after spinal doses of bupivacaine generally exceeding 8 mg, but there was no evidence that it reduced other maternal or neonatal morbidities.

Meta-analysis of the efficacy of a single dose of phenylephrine 10 mg compared with placebo in adults with acute nasal congestion due to the common cold

This review assessed the efficacy of oral phenylephrine 10 mg as a nasal decongestant. The authors concluded that the evidence supports the effectiveness of a single dose of phenylephrine as a decongestant in adults with a common cold. There was insufficient information to judge whether the results were reliable, therefore this conclusion should be treated with caution.

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Summaries for consumers

Techniques for preventing a decrease in blood pressure during spinal anaesthesia for caesarean section

Spinal anaesthesia is a commonly used technique for caesarean birth as the mother is able to be awake for the birth and usually remains comfortable afterwards. In addition, the technique avoids the risks of general anaesthesia. The most common adverse effect of spinal anaesthesia is a fall in blood pressure (hypotension).

Drug interventions for deliberately altering blood pressure in acute stroke

Background: In people who have just had a stroke (a sudden brain attack due to either blockage or rupture of an artery in the brain), very high and very low blood pressures may be harmful. Therefore, drugs that raise low blood pressure or lower high blood pressure might be beneficial. Up to 50% of people admitted with acute stroke are taking blood pressure tablets on hospital admission and it is not clear whether these medications should be continued or discontinued in the acute situation. This review looked at those trials that deliberately altered blood pressure or compared continuing or stopping blood pressure‐lowering tablets taken before stroke.

Topical anaesthetic or vasoconstrictor (blood vessel narrowing) preparations for flexible fibre‐optic nasal pharyngoscopy and laryngoscopy

Topical medications are often applied to the inside of a patient's nose prior to examining the nose, sinuses and throat with a flexible nasopharyngolaryngoscope. The aim of this is to reduce any discomfort the patient may feel and also to improve the adequacy of the examination.

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