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Phenylephrine

Phenylephrine is an active ingredient that has different uses in over-the-counter (OTC) medicines. When used as a nasal decongestant, phenylephrine relieves a stuffy nose due to the common cold or other ailments. Phenylephrine also shrinks the swelling caused by hemorrhoids. It may be written as phenylephrine, or phenylephrine hydrochloride, but it is the same active ingredient.

Phenylephrine can be found in single-ingredient oral nasal decongestant medicines or it can be combined with other ingredients in multi-symptom cold products. Phenylephrine also is available as a single ingredient in topical nasal decongestants. In topical hemorrhoid treatment medicines, phenylephrine is combined with other active ingredients that not only shrink swelling, but also protect irritated skin and relieve additional symptoms such as pain, burning, and itching.

Phenylephrine is approved by the U.S. Food and Drug Administration (FDA) and is safe and effective when used according to label directions. Topical nasal decongestants, which are available in both sprays and drops, should be applied directly inside of the nose. The medicine dispenser (spray bottle or dropper) should be wiped clean after each use and should not be shared with more than one person to avoid spreading infection.

*Phenylephrine may not be contained in all products marketed under these brands. Please read the OTC Drug Facts label carefully for active ingredient information for specific products. 

Tips for Medicines with Phenylephrine

When using nasal decongestants containing phenylephrine, it is important to know that:

  • You should not use a topical nasal decongestant containing phenylephrine (sprays or drops) for more than three days. Using these medicines for longer than directed may cause nasal congestion to become worse.
  • Using a topical nasal decongestant may cause temporary burning, stinging, sneezing, or an increase of nasal discharge.
  • Never use an oral medicine containing phenylephrine at the same time as a topical nasal decongestant that also contains phenylephrine.

Do not use an oral nasal decongestant if:

  • You are currently taking a prescription monoamine oxidase inhibitor (MAOI), or certain drugs for depression, or psychiatric or emotional conditions, or if you stopped taking an MAOI less than two weeks ago.

Ask a healthcare professional before use if:

  • You have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty urinating due to an enlarged prostate gland.
  • You are pregnant or breastfeeding.

Stop use and ask a doctor if:

  • Your symptoms last for more than seven days when using an oral medicine containing phenylephrine. Topical nasal decongestants should not be used for more than three days.
  • You take too much. Immediately contact a doctor or the poison control national helpline at 800.222.1222.
  • You get nervous, dizzy, or are unable to sleep while taking an oral medicine with phenylephrine.

When using hemorrhoid medicines containing phenylephrine, it is important to know that:

  • Topical hemorrhoid medicines should only be used externally or inserted gently into the rectum.
  • You should not use more than recommended unless a doctor tells you to.

Ask a healthcare professional before use if:

  • You have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty urinating due to an enlarged prostate gland.
  • You are pregnant or breastfeeding.
  • You are taking a prescription medicine for high blood pressure or depression.

Stop use and ask a doctor if:

  • Bleeding occurs.
  • Your condition gets worse or does not improve within seven days.
  • The insertion of a medicine applicator into the rectum causes additional pain.
  • Topical hemorrhoid medicines are for external or intrarectal use only. If swallowed, immediately contact a doctor or the poison control national helpline at 800.222.1222.

If you have questions about any of the medicines you are taking or if you have any unexpected side effects, talk to a healthcare professional. And of course, keep all medicines out of the reach and sight of children.

Tips for Parents

When using nasal decongestants containing phenylephrine:

  • Do not give an oral nasal decongestant or cough and cold medicine containing phenylephrine to a child under the age of four.
  • Some topical nasal decongestants may be used in children aged two and older. Read the Drug Facts label carefully for accurate dosing information.
  • Do not give any OTC medicine to a child that is only intended for use in adults.

When using hemorrhoid medicines containing phenylephrine:

  • Talk to a healthcare professional before using a topical hemorrhoid treatment containing phenylephrine a child under the age of 12.

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