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Phenylephrine

SUDAFED PE

What it isSelective alpha-1 agonist; hypotension, topical nasal congestion and mydriasis.

Why this oneThe IV form raises blood pressure without direct tachycardia, useful when tachyarrhythmia limits other pressors.

What limits it⚑ Oral phenylephrine does not relieve congestion; IV use can cause reflex bradycardia and ischemia.

FDA-approved for

Off-label

FDA label

FDA dosingPopulationStartTargetMax
Nasal/sinus congestion (OTC decongestant)Adults & children ≥12 yr1 tablet q4h1 tablet q4h6 tablets/24h

Renal Undefined

Hepatic Undefined

Do not exceed 6 tablets in 24 hours.

Instructions

Contraindications

Cautions

Adverse reactions

Pregnancy OTC carton: if pregnant or breast-feeding, ask a health professional before use

Lactation OTC carton: if pregnant or breast-feeding, ask a health professional before use

NO BOXED WARNINGS

Principal riskOral dosing for congestion does not work

Cost, est. cash$10–$400/month

Generic entry2018

Classes and tags

Clinical profile

Therapeutic safety burden0 / 4
Overdose danger0 / 4
Weight-gain liability0 / 4
Sedation liability0 / 4
QT / Torsades0 / 4
Direct muscarinic antagonism0 / 4
Embryofetal risk0 / 4

Legacy pregnancy categoryC

Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.

Mechanism of action: Phenylephrine ballicule

Phenylephrine ballicule: receptor binding, kinetics and half-life diagram

Open Phenylephrine in the interactive console ↗