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Phenylephrine (Into the nose)

Treats stuffy nose due to colds, hay fever, and allergies.

What works?

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

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. It may also be used in ear infections to relieve congestion. This medicine may also be used for other conditions as determined by your doctor. This medicine is available without a prescription. Do not give any over-the-counter (OTC) cough and cold Read more
Brand names include
4 Way Menthol, 4-Way Fast Acting, 4-Way No Drip, Good Sense Nasal Four, Leader Nose Drops, Neo-Synephrine, Nostril, Pretz-D, Rhinall, TopCare Nasal Four, TopCare Nose Drops, Tur-Bi-Cal, Vicks Sinex
Other forms
By injection, By mouth, Into the eye, Into the rectum, On the skin
Drug classes About this
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.

Ephedrine versus phenylephrine for the management of hypotension during spinal anesthesia for cesarean section: an updated meta-analysis

This review concluded that use of ephedrine and phenylephrine were equally effective for preventing maternal hypotension during caesarean section under spinal anaesthesia. Phenylephrine was superior to ephedrine for treating hypotension in women giving birth, shown by higher umbilical blood pH values. Given the limited number of included women and trials for most outcomes, these conclusions should be treated with caution.

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Summaries for consumers

Techniques for preventing hypotension during spinal anaesthesia for caesarean section

The incidence of hypotension during spinal anaesthesia for caesarean section is reduced by administering intravenous fluids, the drugs ephedrine or phenylephrine, or by leg compression.

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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