Phenylephrine is a medication that belongs to the class of sympathomimetic agents, which means it mimics the effects of the sympathetic nervous system. It is commonly used as a decongestant to relieve nasal congestion caused by conditions such as the common cold, hay fever, or sinusitis. Phenylephrine works by narrowing the blood vessels in the nasal passages, which leads to reduced swelling and congestion.
Topical Phenylephrine (AnuMed) is a sympathetic alpha-adrenergic receptor agonist that can cause vasoconstriction when applied topically. It is used to treat piles.
Topical Phenylephrine Uses:
- It is used as an OTC medicine for the treatment of hemorrhoids (piles).
Topical Phenylephrine (AnuMed) Dose in Adults
Topical Phenylephrine (AnuMed) Dose in the treatment of Hemorrhoids: Rectal:
- Ointment: Put the ointment on the clean and dry area around your rectum (where the hemorrhoids are) up to four times a day.
- Suppository: Insert one suppository into your rectum up to four times a day.
Topical Phenylephrine (AnuMed) Dose in Children
Topical Phenylephrine (AnuMed) Dose in the treatment of Hemorrhoids, anorectal protection:
If kids who are 12 years or older or teenagers have hemorrhoids:
- Ointment: Put the ointment on the area around the rectum (where the hemorrhoids are) up to four times a day. You can apply it directly or use a special applicator to put it inside the rectum. Do this in the morning, at night, and after bowel movements.
- Suppository: Insert one suppository into the rectum up to four times a day. Do this in the morning, at night, and after bowel movements.
Pregnancy Risk Category: C
- If phenylephrine is given through a vein (intravenously), it can pass from the mother to the baby during pregnancy.
- You can find more details about this in the information about phenylephrine when it's used throughout the whole body (systemically).
- Using phenylephrine on the skin for treating hemorrhoids doesn't have a lot of information to support its use.
- If you're pregnant, and especially if you have high blood pressure or diabetes, you should be careful when using products that contain phenylephrine.
Use of phenylephrine during breastfeeding
- We don't have clear information about whether phenylephrine, when taken, goes into breast milk.
Use in Renal Disease:
No dosage adjustment has been recommended by the manufacturer.
Use in Liver Diseases:
No dosage adjustments have been recommended by the manufacturer.
Side effects of Topical Phenylephrine (AnuMed):
Rare systemic effects may occur. See: Phenylephrine Injection Side effects
Contraindications to Topical Phenylephrine (AnuMed):
- If you are allergic to phenylephrine or any part of the medicine, or if you have high blood pressure or a specific type of abnormal heart rhythm called ventricular tachycardia, you should avoid using it.
Warnings and precautions
- Cardiovascular disease, which includes ischemic heart disease.
- Be aware that the drug is not fully absorbed and can cause angina or ventricular arrhythmias.
- Diabetes mellitus:
- Be careful. Some patients may experience an increase in their diabetes control.
- Hyperthyroidism:
- Please exercise caution. Hyperthyroidism symptoms may get worse.
Phenylephrine (topical): Drug Interaction
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Risk Factor C (Monitor therapy) |
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Alpha1-Blockers |
May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1Agonists may antagonize Alpha1-Blocker vasodilation. |
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AtoMOXetine |
May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. |
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Cannabinoid-Containing Products |
May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. |
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Doxofylline |
Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. |
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Guanethidine |
might make sympathomimetics more arrhythmogenic. Guanethidine could make sympathomimetic drugs more hypertensive. |
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Solriamfetol |
Sympathomimetics may intensify Solriamfetol's hypertensive effects. |
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Sympathomimetics |
might intensify the hazardous or harmful effects of other sympathomimetics. |
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Tedizolid |
might make sympathomimetics' hypertensive effects stronger. The tachycardic impact of sympathomimetics may be increased by tedizolid. |
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Tricyclic Antidepressants |
Alpha1-Agonists' potential therapeutic effects could be improved. The therapeutic benefit of Alpha1-Agonists may be diminished by Tricyclic Antidepressants. |
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Risk Factor D (Consider therapy modification) |
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Cocaine (Topical) |
May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. |
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Linezolid |
May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. |
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Risk Factor X (Avoid combination) |
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Ergot Derivatives |
May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline. |
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Iobenguane Radiopharmaceutical Products |
Alpha1-Agonists may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. |
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Monoamine Oxidase Inhibitors |
Alpha1-Agonists' ability to increase hypertension. Despite the fact that linezolid is anticipated to interact through this mechanism, treatment guidelines differ from those for other monoamine oxidase inhibitors. For information, consult the individual monographs for linezolid. Examples are Linezolid and Tedizolid. |
Monitoring Parameters:
- Monitor the response to therapy.
- Observe for symptoms of sympathetic overdrive such as tachycardia and hypertension.
How to administer Topical Phenylephrine (AnuMed)?
Ointment:
- Clean the anorectal area with a wipe. Gently dry the area by padding. apply the ointment gently into the outer anal canal and external area.
Suppository:
- Insert the suppository after each bowel movement and cleansing the area into the lower anal canal.
Mechanism of action of Topical Phenylephrine (AnuMed):
- Phenylephrine is a strong and direct-acting stimulator of alpha-adrenergic receptors with very little effect on beta-adrenergic receptors.
- It primarily causes the narrowing of blood vessels in a specific area, leading to localized constriction.
- This action is known as vasoconstriction, which can be beneficial in various medical situations, such as reducing nasal congestion when used in nasal decongestants.
International Brand Names of Phenylephrine:
- Anu-Med
- GoodSense Hemorrhoidal
- GRX Hemorrhoidal
- Hemorrhoidal
- Major-Prep Hemorrhoidal
- Preparation H
- Rectacaine
- Rectogel HC
Phenylephrine Brand Names in Pakistan:
Not Available.
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