Oral Phenylephrine
Place in Therapy
Place in Therapy
Oral phenylephrine is an alpha-adrenergic agonist. It is primarily used as a decongestant and is available over-the-counter. The evidence for the efficacy of oral phenylephrine in relieving symptoms of nasal congestion is not robust.1,2 Studies on phenylephrine are limited with results finding little difference when compared to placebo.1,2 Oral pseudoephedrine has been shown to be superior in these trials.
In cases of allergic rhinitis phenylephrine should only be used as an adjunct to an antihistamine when patients present with nasal congestion. It should be used only if pseudoephedrine is contraindicated (or unavailable) as the evidence for pseudoephedrine in the relief of nasal congestion is better established. It’s dosed in adults at 10mg every 4 hours as needed (max 60mg/day).5 In children (6-11 years) it’s dosed at 5mg every 4 hours as needed (max 30mg/day).3 Phenylephrine is pregnancy risk factor category C.5
References
1. Horak F, Zieglmayer P, Zieglmayer R, Lemell P, Yao R, Staudinger H, Danzig M, (2009). A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber. Annals of Allergy, Asthma & Immunology 102 (2): 116–20.
2. Day JH, Briscoe MP, Ratz JD, Danzig M, Yao R. (2009). Efficacy of loratadine-montelukast on nasal congestion in patients with seasonal allergic rhinitis in an environmental exposure unit. Annals of Allergy, Asthma & Immunology 102 (4): 328.
3. Moote DW. Infectious Respiratory Disorders: Allergic Rhinitis. Canadian Pharmacists Association. Therapeutic Choices. 6th ed. Ottawa: Canadian Pharmacists Association; 2013.
4. Roy H. Respiratory Conditions: Allergic Rhinitis. Canadian Pharmacists Association. Patient Self-Care: Helping Your Patients Make Therapeutic Choices. 2nd ed. Ottawa: Canadian Pharmacists Association; 2010.
5. Lexi-Comp. [Internet] Professional Monograph. Phenylephrine (Systemic). Available at: http://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/1799564. Accessed July 19, 2014.
Oral phenylephrine is an alpha-adrenergic agonist. It is primarily used as a decongestant and is available over-the-counter. The evidence for the efficacy of oral phenylephrine in relieving symptoms of nasal congestion is not robust.1,2 Studies on phenylephrine are limited with results finding little difference when compared to placebo.1,2 Oral pseudoephedrine has been shown to be superior in these trials.
In cases of allergic rhinitis phenylephrine should only be used as an adjunct to an antihistamine when patients present with nasal congestion. It should be used only if pseudoephedrine is contraindicated (or unavailable) as the evidence for pseudoephedrine in the relief of nasal congestion is better established. It’s dosed in adults at 10mg every 4 hours as needed (max 60mg/day).5 In children (6-11 years) it’s dosed at 5mg every 4 hours as needed (max 30mg/day).3 Phenylephrine is pregnancy risk factor category C.5
References
1. Horak F, Zieglmayer P, Zieglmayer R, Lemell P, Yao R, Staudinger H, Danzig M, (2009). A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber. Annals of Allergy, Asthma & Immunology 102 (2): 116–20.
2. Day JH, Briscoe MP, Ratz JD, Danzig M, Yao R. (2009). Efficacy of loratadine-montelukast on nasal congestion in patients with seasonal allergic rhinitis in an environmental exposure unit. Annals of Allergy, Asthma & Immunology 102 (4): 328.
3. Moote DW. Infectious Respiratory Disorders: Allergic Rhinitis. Canadian Pharmacists Association. Therapeutic Choices. 6th ed. Ottawa: Canadian Pharmacists Association; 2013.
4. Roy H. Respiratory Conditions: Allergic Rhinitis. Canadian Pharmacists Association. Patient Self-Care: Helping Your Patients Make Therapeutic Choices. 2nd ed. Ottawa: Canadian Pharmacists Association; 2010.
5. Lexi-Comp. [Internet] Professional Monograph. Phenylephrine (Systemic). Available at: http://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/1799564. Accessed July 19, 2014.