Phenylephrine (Nasal)

Phenylephrine comes in the form of a spray to be inserted into the nose in order relieve nasal congestion.

Overview

Phenylephrine comes in a nasal spray which is used to relieve patients temporarily of nasal congestion. The medication is used to relieve symptoms, rather than to treat illnesses, but can be used by patients suffering from allergies, hay fever, sinusitis, colds and flu. It works to narrow the blood vessels in the nasal passages, minimizing the swelling and inflammation and therefore reducing congestion. The medication comes in the form of a spray, which is inserted into the nostril before being released into the nasal passages.

Before taking the drug, patients should blow the nose gently in order to release any loose mucus. One finger should be used to close one nostril, and the spray nozzle should be inserted gently into the opposite nostril. The head should remain upright at all times. The medication should be sprayed into the nostril as many times as is instructed by a doctor or pharmacist. The patient should breathe in hard through their nose as they spray the medication, so that the drug can reach far up into the nasal passages. The patient should then repeat these steps with the second nostril to complete the dose.

This medication does not treat the root cause of an illness, but instead works to temporarily alleviate the symptoms caused by certain conditions. If the symptoms persist for more than three days, patients should seek the advice of their doctor or pharmacist.

Conditions treated

  • Nasal congestion caused by sinusitis,
  • colds
  • flu
  • hay fever and allergies

Type of medicine

  • Decongestant

Side Effects

This medication is available over-the-counter and therefore does not require a prescription from a doctor to obtain. When purchasing the medication, patients should make themselves aware of the side effects so that they can know what to expect when using the medication.

Possible common side effects of phenylephrine include:

  • Runny nose
  • Stinging sensation in the nose
  • Dry eyes
  • Temporary burning in the nose
  • Sneezing
  • Headaches

These side effects usually wear off soon after having taken phenylephrine. They are not normally a cause for concern but patients should contact their doctor or pharmacist if these side effects do not go away or start to get worse.

In very rare cases, phenylephrine nasal spray might cause more serious side effects. Most people who take phenylephrine do not experience any serious side effects. These effects can include:

  • Difficulty sleeping
  • Shaking and tremors
  • Unexplained weakness
  • Fast or irregular heartbeat
  • Severe headaches
  • Nausea
  • Changes to mood and mental state
  • Unusual or unexplained sweating
  • Dizziness or confusion

If any of the symptoms listed above are experienced, the patient should seek medical attention straight away and make sure that the healthcare professionals are aware that they have recently taken phenylephrine.

It is extremely rare for patients to have a serious allergic reaction to this drug. If patients experience any of the following symptoms following a dose of phenylephrine then they should visit a doctor as soon as possible:

  • Difficulty breathing
  • Severe dizziness
  • Swelling, particularly of the tongue, throat and/or face
  • Rash
  • Itching

If patients notice any other changes soon after taking phenylephrine then they should stop taking the medication and seek advice from their doctor or pharmacist before continuing.

Dosage

Adult Dose

1% spray to be sprayed 2 to 3 times in each nostril, at 4-hourly intervals.

Pediatric Dose

For children aged between 2 and 6 years old, 2 to 3 drops of phenylephrine solution should be dropped into each nostril at intervals 4 hours apart.

For children aged 6 and above: 1% spray to be sprayed 2 to 3 times in each nostril, at 4-hourly intervals.

Interactions

Phenylephrine nasal spray is available to purchase as an over-the-counter medication, meaning that you do not need a doctor's prescription in order to be able to obtain the drug. Whilst this does mean that the drug is deemed generally safe for members of the public to buy to treat themselves, phenylephrine is a pharmaceutical and there is still a risk of this medicine interacting with other forms of medication if taken at the same time.

When purchasing this medicine, patients should make sure to speak to their pharmacist first and make sure that they list all of the medications which they are currently taking. The pharmacist will then be able to advise about any potential interactions at the time of purchase.

Using a nasal spray containing phenylephrine whilst taking MOA inhibitors (such as methylene blue, tranylcypromine, procarbazine, phenelzine, linezolid, isocarboxazid or selegiline) could cause serious interactions. In most cases, doctors will recommend that patients only take phenylephrine if they have not taken any MAO inhibitors in the past 2 weeks. The interactions between these two pharmaceuticals can cause potentially life-threatening symptoms.

Phenylephrine is also known to interact with the following forms of medication:

  • certain types of medication to treat high blood pressure
  • tricyclic antidepressants
  • Some types of cold and flu medicine
  • Some diet aids

In order to avoid interactions, always be sure to seek medical advice before purchasing and using phenylephrine nasal sprays, and make sure to declare all of the medications which you are currently taking.

Warnings

Some pharmaceuticals can have unintended effects when taken in particular circumstances. It is important to let your doctor or pharmacist know of any existing medical conditions you might have before taking phenylephrine to ensure that it is safe. Before taking a phenylephrine, it is particularly important to make the pharmacist aware if any of the following statements are true:

  • You are allergic to this drug or any decongestants or sympathomimetics (such as pseudoephedrine)
  • You are allergic to any medications that you are aware of
  • You have an overactive thyroid
  • You have type 1 or type 2 diabetes
  • You have ever suffered from high blood pressure
  • You have an enlarged prostate
  • You suffer from difficult passing urine
  • You have a heart condition
  • You have ever suffered from a blood vessel disease
  • You are pregnant
  • You are breastfeeding, or plan to breastfeed whilst taking this medication
  • You are due to undergo surgery

Children may be more sensitive to phenylephrine than adults. Caution should therefore be advised when giving this drug to children. It is recommended that parents or guardians speak to a doctor or pharmacist before administering this medication to children without a prescription.

The medication should not enter direct contact with the eyes and the inside of the nasal septum. Patients should close their eyes when spraying the phenylephrine in order to avoid contact.

Phenylephrine is designed to offer patients temporary relief from their symptoms. It is not meant to be used over a long period of time. Patients should therefore not administer more sprays than recommended, or use the medication for longer than advised. Instead, if symptoms persist for more than 3 days, they should contact a doctor or pharmacist to seek further treatment.

Using this medication for longer than advised could lead to the development of a condition known as rebound congestion. This condition is comprised of swelling inside the nose and can cause a runny nose and inflammation of the nasal passages.

Storage

As with all medications, phenylephrine spray should be stored in the container in which it was supplied by the pharmacy. It should remain in an opaque box to protect the drug from direct sunlight. The medication should be clearly labeled so that it cannot be confused with other substances.

Phenylephrine should be stored at room temperature somewhere away from excess moisture. It should be kept well out of the way of pets and children.

After uses, the spray tip should be rinsed with hot water and wiped with a clean tissue in order to prevent the buildup of bacteria on the nozzle. Care should be taken to ensure that no water gets inside the container. The cap should be replaced on the clean nozzle after every use before the medication is stored away.

Summary

Phenylephrine nasal spray is a form of medication which is available to purchase over-the-counter. It is often self-prescribed and is most commonly used to relieve the symptoms of cold and flu.

Phenylephrine is used to relieve congestion in the nose and sinuses. This congestion could be as a result of allergies, hay fever, colds, flu or sinusitis. The active ingredient, phenylephrine, works by helping to contract the blood vessels, reducing the inflammation in the nose which causes congestion. The medication is typically administered multiple times in each nostril, multiple times a day.

Phenylephrine comes in the form of a nasal spray inside a plastic dispenser. The nozzle of the dispenser is placed up each of the nostrils in turn and patients spray the medication directly into the nose.

Due to the nature of the application method, it is particularly important to clean down the nozzle after every use so as not to cause contamination. Nozzles should not be shared between patients, as bacteria or infections could easily be passed from one person to another.