Phenylephrine is a medication used as a decongestant for uncomplicated nasal congestion,[3] used to dilate the pupil, used to increase blood pressure (given intravenously in cases of low blood pressure), and used to relieve hemorrhoids.[2][4] It can be taken by mouth, as a nasal spray, given by injection into a vein or muscle, or applied to the skin.[2]
Common side effects when taken by mouth or injected include nausea, vomiting, headache, and anxiety.[2] Use on hemorrhoids is generally well tolerated.[2] Severe side effects may include a slow heart rate, intestinal ischemia, chest pain, kidney failure, and tissue death at the site of injection.[2][4] It is unclear whether its use during pregnancy and breastfeeding is safe.[2] Phenylephrine is a selective α1-adrenergic receptor agonist with minimal to no β-adrenergic receptor agonist activity.[3] It causes constriction of both arteries and veins.[2]
Phenylephrine was patented in 1933[5] and came into medical use in 1938.[6] It is available as a generic medication.[4][7][8] Unlike pseudoephedrine, abuse of phenylephrine is very uncommon.[9] Its effectiveness as a nasal decongestant has been questioned.[2][10][11] In 2023, a Food and Drug Administration panel concluded that the drug was ineffective as a nasal decongestant when taken orally.[12]
^Cite error: The named reference DB was invoked but never defined (see the help page).
^ abcdefghij"Phenylephrine Monograph for Professionals". Drugs.com. AHFS. 2 March 2022. Retrieved 9 May 2022. However, efficacy of oral phenylephrine for this use [as a decongestant] has been questioned.
^ abRichards E, Lopez MJ, Maani CV (2023). "Phenylephrine". StatPearls. Treasure Island, Florida: StatPearls Publishing. PMID 30521222. Retrieved 27 April 2023.
^ abcJoint Formulary Committee (2018). BNF 76 : September 2018 - March 2019. London: British Medical Association, Royal Pharmaceutical Society of Great Britain. pp. 188–189. ISBN 9780857113382. OCLC 1021215075.
^Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 541. ISBN 9783527607495.
^"Competitive Generic Therapy Approvals". U.S. Food and Drug Administration (FDA). 29 June 2023. Archived from the original on 29 June 2023. Retrieved 29 June 2023.
^"First Generic Drug Approvals 2023". U.S. Food and Drug Administration (FDA). 30 May 2023. Archived from the original on 30 June 2023. Retrieved 30 June 2023.
^"Max Strength Decongestant Tablets" (PDF). www.mhra.gov.uk. p. 10. Archived from the original (PDF) on 19 August 2019. Retrieved 10 January 2019.
^Hatton RC, Hendeles L (March 2022). "Why Is Oral Phenylephrine on the Market After Compelling Evidence of Its Ineffectiveness as a Decongestant?". Ann Pharmacother. 56 (11): 1275–1278. doi:10.1177/10600280221081526. PMID 35337187. S2CID 247712448.
^Lowe D (March 2022). "The Uselessness of Phenylephrine". Science (blog).
^Christensen J (12 September 2023). "Popular OTC medicines for colds and allergies don't work, FDA panel says". CNN. Retrieved 8 October 2023.
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