Locotrix IV/IM/SC Inj

Indications

Phenylephrine hydrochloride is used in several forms:

• By mouth, usually in combination cold and flu products: to relieve a blocked nose and sinus congestion from colds, flu and allergies.
• Nasal drops or spray: short-term relief of a blocked nose.
• Eye drops: by eye doctors to widen the pupil for eye examinations and surgery, and in low strength to relieve eye redness.
• Injection: in hospital to raise low blood pressure, for example during anaesthesia.

How It Works

Phenylephrine stimulates alpha-1 receptors on blood vessels, making them narrow. In the nose this shrinks swollen tissue and opens the airway. In the eye it widens the pupil, and in the bloodstream it raises blood pressure.

Dosage and Administration

• Tablets or syrup (adults and children 12 years and over): usually 10 mg every 4 to 6 hours when needed; do not take more than 4 doses (40 mg) in 24 hours unless the pack or doctor says otherwise. In combination products, follow the pack dose. Children under 12: only as advised by a doctor or as stated on a children's product.
• Nasal drops or spray: as directed on the pack; do not use for more than 7 days in a row.
• Eye drops and injection: used by a doctor or nurse, as prescribed.

Interactions

Do not use it with, or within 14 days of stopping, MAO inhibitor medicines (for example Selegiline, or Linezolid), as a dangerous rise in blood pressure can occur. Take care with other decongestants or stimulants, tricyclic antidepressants such as Amitriptyline, beta-blockers, blood pressure medicines (it can reduce their effect) and Digoxin. Check that you are not taking two cold products that both contain phenylephrine or Paracetamol.

Contraindications

• Allergy to phenylephrine or any ingredient.
• Severe high blood pressure or severe heart disease, including serious heart rhythm problems.
• Overactive thyroid.
• Use of an MAO inhibitor within the last 14 days.
• Eye drops: angle-closure glaucoma.

Side Effects

Common: nervousness, restlessness, headache, trouble sleeping, dizziness, raised blood pressure and a fast or pounding heartbeat. Nasal use can cause stinging and, with long use, a blocked nose that comes back worse (rebound congestion). Eye drops may sting and cause blurred vision and light sensitivity for a few hours.

Get urgent medical help for: a severe headache, chest pain, a very fast, slow or irregular heartbeat, confusion, fits (seizures), severe eye pain, or signs of an allergic reaction (swelling of the face, lips or throat, difficulty breathing).

Pregnancy and Lactation

Avoid oral decongestants during pregnancy, especially in the first three months, unless a doctor advises them. It is not known how much passes into breast milk and it may reduce milk supply; ask a doctor or pharmacist before using it while breastfeeding.

Precautions and Warnings

Use with care and ask a doctor first if you have high blood pressure, heart disease, diabetes, an enlarged prostate or difficulty passing urine, or glaucoma. Do not give cough and cold products to children under 6 years without medical advice. If symptoms last more than 7 days or come with a high fever, see a doctor.

Overdose

Too much can cause very high blood pressure, severe headache, slow or irregular heartbeat, vomiting, anxiety and fits. Seek emergency medical help straight away. Combination cold products may also contain Paracetamol, which is dangerous in overdose even if the person feels well.

Therapeutic Class

Sympathomimetic (alpha-1 adrenergic agonist); nasal decongestant, pupil-widening agent and vasopressor.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Throw away eye or nasal drops 4 weeks after opening. Injections are stored and handled by hospital staff.