Drug Interaction:
VASSOPRESSORS USED IN SHOCK- includes-
Inotropic effects -
Isoproternol, Dobutamine, Dopamine, Ephinephrine,
Mixed effects-
Norephinephrine, Ephedrine, Mephentermine
Pressors effects-
Metaraminol
Methoxamine
Phenylephrine
Interacting drugs- summary
+ Phenylephirine
Bretylium
bretylium may potentiate the action of vasopressors on adrenergic
receptors, possibly resulting in arrthythmias
Guanethidine
guanethidine may increase the pressor response of the direct-acting
vasopressors, possibly resulting in severe hypertension
Halogenated hydrocarbon anesthetics
halogenated hydrocarbon anesthetics may sensitise the effects of
catecholamines. Use of vasopressors may lead to serious
arrthythmias, use with extreme caution
Oxytocic drugs
if vasopressor drugsare used in obstertics to correct hyoptension
or added to local anesthetic solution, some oxytocic drugs may
cause severe persistent hypertension
Tricyclic antidep
tricyclic antidepressants have both increased and decreased
the sensitivity to IV phenylephrine
Monoamine oxidase inhibitors (MAOIs)
MAOIs may significantly enhance the adrenergic effects of
phenylephrine and its pressor response may be increased .
Avoid this combination.
Indication:
New Drugs Approved by (DCI) Drug Controller GENERAL - India For Marketing
(Ref- IDMA Publication)
Name of Drug Indication Date of Approval
Phenylephrine Hcl 5mg 31-05-2009
+ Chlorpheneramine Maleate 0.5mg
+ Paracetamol 125mg
+ Sodium Citrate 60mg
+ Menthol 1mg per 5ml syrup
For the treatment of Common cold and cough associated with fever
FIXED DOSE COMBINATIONS APPROVED BY DCG(I)
FROM JANUARY 1961 TILL NOVEMBER 2014
Name of Drug Indication Date of Approval
1. Phenylephrine 5mg + 31-01-2008
Chlorpheniramine maleate 0.5mg +
Paracetamol 125mg +
Sodium Citrate 60mg +
Menthol 1mg syrup
For the treatment of common cold andcough associated
with fever
2. Phenylephrine 5mg + 31-01-2008
Chlorpheniramine maleate 0.5mg +
Paracetamol 125mg +
Sodium Citrate 60mg +
Menthol 1mg per ml syrup
For the treatment of common cold and cough associated
with fever
Vascular failure in shock
Adverse Reaction:
Headache, reflux bradycardia, excitability, restlessness, arrhythmias
Contra-Indications:
Hypersensitivity to the drug, severe hypertension, ventricular tachycardia
Special precautions:
Hypovalemia, extravasation, sulfite sensitivity Use with extreme caution in elderly patients, patients with hypothyroidism, bradycardia, partial heart block, myocardial disease or severe arteriosclerosis.
Hypovalomia- use is not a substitute for replacement of blood, plasma, fluids, and electrolytes, which should be restored promptly when loss has occured.
Extravasation- extravasation may cause necrosis and sloughing of surrounding tissue. Monitor the infusion for free flow.
Warnings-
Pregnancy- use when clearly needed. and when the potential benefits outweigh the potential hazards to the fetus.
Lactation- safety for use in the nursing mother has not been established.
Dosages/ Overdosage Etc:
Aprroved on 2008
Indications:
Vascular failure in shock
Dosage:
Inject SC,IM, IV or in dilute solutionas a continuous infusion. SC or IM- 2 to 5mg (range 1 to 10mg). Do not exceed can initial dose of 5mg
Overdosage-
Symptoms Ventricular extrasystoles, short paroxysms of ventricular tachycardia, sensation of fullness in the head, tingling of extremities
Treatment
1. Relieve an excessive elevation f blood pressure by an alpha-adrenergic blocking agent- eg phentolamine
Missed dose- -
1. If you must take this medicine regularly and you miss a dose of this medicine, take it as soon as possible.
2. However, if it is almost time for next dose, skip the missed dose and go back to your regular dosing schedule.
3. Do not double doses.
Patient Information:
Ref - USP PDI Vol II 17th Edition (1997)
PHENYLEPHRINE - Nasal
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
Phenylephrine. Also tell your healthcare care professional if you are
allergic to any other substances such as foods, preservatives or dyes.
2.Pregnancy-
Nasal phenylephrine may be absorbed into the body. However, nasal
phenylephrine has not been shown to cause birth defects or other problems
in humans.
3. Breast-feeding-
Nasal phenylephrine may be absorbed into the body. However, it
is not known whether phenylephrine passes into the breast milk.
This medicine has not been reported to cause problems in nursing
babies.
4.Children-
Children may be especially sensitive to effects of nasal phenylephrine.
This may increase the chance of side effects during treatment.
5.Older adults-
There is no specific information comparing use of nasal phenylephrine
in the elderly with use in other age groups
6. Other medicines-
Tell your doctor if you are using any other prescription or non-prescription
(Over-the counter) OTC medicine.
7. Other medical problems-
Make sure you tell your doctor if you have any other medical problems
especially-
Diabetes mellitus or
Heart or blood vessel disease or
High blood pressure or
Overactive thyroid - nasal phenylephrine may make the conditions worse.
Pharmacology/ Pharmacokinetics:
Pharmacology:
Phenylephrine is a powerful postsynaptic alpha-receptor stimulant with little effect on beta receptors of the heart. The drug is a powerful vasoconstrictor, with properties similar to noepinephrine
Pregnancy and lactation:
Pregnancy:
Use only when needed.
Lactation:
Not known whether the drug is excreted in breast milk. Use caution while administering to nursing mothers.
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