1672 nasal use as probably not porphyrinogenic; it may be used Pentqxyverine, hyqrogenootrate . de; PentoxyYenni (itras; mineral acids and in solutions of alkali hydroxides. Store in as a drug of first choice and no precautions are needed.1 Pento,.;yverini Hydrogenpdtras; UCB-2543; 0eHToKCr1BE'P11Ha airtight containers. Protect from light. l. The Drug Database for Acute Porphyria. Available at: http://www. drugs-porphyria.org (accessed 19110/ll) Phenylephrine Acid Ta rtrate · Interactions Sitarfrato d�;> fen i.fefrina; • F All cross-references refer to entries in Volume A 1673 rine has also been used in orthostatic hypotension (see Priapism. Alpha agonists, including phenylephrine, may Effects on menial function. Hallucinations and paranoid under Fludrocortisone, p. 1634.3). For hypotension, an be used in the management of priapism (see under Met delusions have been reported1 in a patient after excessive initial dose of phenylephrine hydrochloride 2 to 5 mg may araminol, p. 1430.2). For reference to phenylephrine in use of a nasal spray containing phenylephrine 0.5%. be given as a 1% solution subcutaneously or intramuscu low dosage and dilute solution being given by intracaver Mania bas also followed the use of large oral doses.' larly with further doses of l to lOmg if necessary, according nosal injection to reverse priapism, see under Alprostadil, 1. Snow SS, et a/. Nasal spray 'addiction' and psychosis: a case report. Br J to response. A dose of 100 to 500 micrograms by slow p. 2353.2. Psychiatry 1980; 136: 297-9. intravenous injection as a 0.1% solution, repeated as 2. Waters BGH, Lapierre YD. Secondary mania a:;.sociated with sympathomimetic drug use. Am 1 Psychiatry 1981; 138: 837-40. necessary after at least 15 minutes, has also been used. In severe hypotensive states, 10 mg in 500 ml of glucose 5% or Adverse Effects and Precautions Hypersensitivity. Cross-sensitivity to phenylephrine has sodium chloride 0. 9% has been infused intravenously, As for Sympathomimetics, p. 1508.2 and p. 1508.3; been reported in a patient hypersensitive to pseudoephe initially at a rate of up to 180 micrograms/minute, reduced, phenylephrine has mainly alpha-agonist effects. It has a drine.1 See also Effects on the Eyes, above. according to the response, to 30 to 60micrograms/minute. longer duration of action than noradrenaline and an l. Buzo-Sanchez G, er al. Stereoisomeric cutaneous hypersensitivity. Ann For doses in children, see below. excessive vasopressor response may cause a prolonged rise Pharmacother I997; 31: 1091. Phenylephrine hydrochloride has been given by intra in blood pressure. It induces tachycardia or reflex venous injection to stop paroxysmal supraventricular bradycardia and should therefore be avoided in severe Porphyria, The Drug Database for Acute Porphyria, com tachycardia but other drugs are preferred (see Cardiac hyperthyroidism and used with caution in severe ischaemic piled by the Norwegian Porphyria Centre (NAPOS) and Arrhytlunias, p. 1266.1). The initial dose is usually not heart disease. Patients with diabetes mellitus or prostatic the Porphyria Centre Sweden, classifies phenylephrine for greater than 500 micrograms given as a 0.1% solution with hyperplasia should also avoid phenylephrine. cardiac or ophthalmic use as probably not porphyrino subsequent doses gradually increased in increments of 100 Since phenylephrine is absorbed through the mucosa genic; it may be used as a dn1g of first choice and no pre to 200 micrograms up to I mg if necessary. systemic effects may follow application to the eyes or the cautions are needed.1 Phenylephrine hydrochloride has been used for its nasal mucosa. In particular, phenylephrine 10% eye drops I. The Drug Database for Acute Porphyria. Available at: http://www. vasoconstrictor action as an adjunct to local anaesthetics. drugs-porphyria.org (accessed I9/IO/l1) can have powerful systemic effects. They should be avoided Phenylephrine has also been used as the acid tartrate to or only used with extreme caution in infants, the elderly, prolong the bronchodilator effects of isoprenaline when and in patients with cardiac disease, significant hyper Interactions given by inhalation. However, isoprenaline is now little tension, or advanced arteriosclerosis. Fatalities have been used by this route. As for Sympathomimetics, p. 1508.3. Phenylephrine has Phenylephrine tannate has also been used. reported in patients with pre-existing cardiovascular mainly direct alpha-agonist properties and is less liable than disease. adrenaline or noradrenaline to induce ventricular fibrilla Use of phenylephrine in the eye may liberate pigment tion if used as a pressor agent during anaesthesia with Administration in children. Phenylephrine hydrochloride granules from the iris, especially when given in high doses inhalational anaesthetics such as cyclopropane and halo is used for the symptomatic relief of nasal congestion; to elderly patients. Ophthalmic solutions of phenylephrine thane; nevertheless, caution is necessary. Since phenyl however, over-the-counter cough and cold preparations are contra-indicated in patients with angle-closure glauc ephrine is absorbed through the mucosa, interactions may containing sympathomimetic decongestants (including oma. Cornealclouding may occur if corneal epithelium has also follow topical application, particularly in patients phenylephrine) should be used with caution in children been denuded or damaged. receiving an MAO! (including a RIMA). See also under and generally avoided in young children, for details see Excessive or prolonged use of phenylephrine nasal drops Phenelzine (p. 445.1) and Moclobemide (p. 438.1). Cough, p. 1651.2. In the USA, phenylephrine hydro can lead to rebound congestion. chloride may be used in children aged from 6 to 12 years; Phenylephrine hydrochloride is irritant and may cause Cardiovascular drugs. Hypertensive reactions have been 2 or 3 drops, or 1 or 2 sprays, of a 0.25% solution may be local discomfort at the site of application; extravasation of reported in a patient stabilised on debrisoquine when given instilled into each nostril every four hours as needed. In the injection may even cause local tissue necrosis. phenylephrine orally, 1 in patients receiving reserpine or the UK, oral preparations for nasal congestion associated guanethidine when given phenylephrine eye drops,2 and a with colds and hay fever are not licensed in children fatal reaction occurred in a patient receiving propranolol under 12 years of age. Effects on the cardiovascular system. Systemic adverse and hydrochlorothiazide also after the instillation of phenyl mydriasis Phenylephrine hydrochloride is used for in effects have occurred after the use of phenylephrine as ephrine eye drops. 3 diagnostic or therapeutic procedures. Solutions containing eye drops (particularly at a strength of 10%), or nasal l. Aminu J, et a!. Interaction between debrisoquine and phenylephrine. 2.5% are used in children as the 10% strength is drops. Lancet 1970; ii: 935-6. contra-indicated owing to the risk of systemic effects. Hypertension 1 and hypertension with pulmonary 2. Kim JM. et a!. Hypertensive reactions to phenylephrine eyedrops in For acute hypotension, phenylephrine hydrochloride oedema2 have been described in infants and children after patients with sympathetic denervation. Am J Ophthalmol 1978; 85: 862- may be given subcutaneously or intramuscularly; the the use of phenylephrine 10% eye drops. Hypertension 8. 3. Ca�� E, et af. HaLanh of phcnvh,nlu·inc topical medication in person� following doses, according to age, are suggested in the BNFC: with arrhythmias has also been reported in an 8-year-old taking propranolol. Can I979; 120: 1261-2. I to 12 years: IOOmicrograms/kg every I to 2 hours as • child3 and in an adult4 after phenylephrine 10% eye drops needed (to a maximum dose of 5 mg) had been used. Details have also been published on a series 12 to 18 years: 2 to 5 mg, followed if necessary by further Pharmacokinetics • of 32 patients who had systemic cardiovascular reactions, doses of 1 to 10mg (maximum initial dose 5mg) including fatal myocardial infarctions, after the use of Phenylephrine has low oral bioavailability owing to Although the intravenous route is not licensed in the UK for phenylephrine 10% solutions in the eye.5 Severe irregular absorption and first-pass metabolism by monoa such use in children, intravenous injection is preferred to cardiovascular adverse reactions have also been reported mine oxidase in the gut and liver. When injected the other parenteral routes; the BNFC recommends the with the use of phenylephrine as topical I 0% ocular6 or subcutaneously or intramuscularly it takes 10 to 15 minutes following doses given as a 0. I% solution: 0.25% nasal' pledgets. to act; subcutaneous and intramuscular injections are I to 12 years: 5 to 20 micrograms/kg (maximum effective for up to about I hour and up to about 2 hours, • Although the incidence of such reactions seems low,8 the 500micrograms), repeated as needed after at least 15 use of lower concentrationsL5 and caution in susceptible respectively. Intravenous injections are effective for about minutes patients such as those with cardiovascular disorders or the 20 minutes. 12 to 18 years: 100 to 500micrograms, repeated as Systemic absorption follows topical application. • elderly,' have been advocated. A reduction in the eye-drop needed after at least 15 minutes volume has been found to produce adequate mydriasis and For intravenous infusion, the solution is diluted with may reduce systemic absorption and the risk of adverse P epa a ons ...... r ...... r...... ti .... glucose 5% or sodium chloride 0.9% to a concentration of , cardiovascular effects.9 IO Proprietary Preparations (details are given in Volume B) 20 micrograms/mL and given as a continuous infusion via a l. Borromeo-McGrail V, et at. Systemic hypertension following ocular central venous catheter. The BNFC gives the following administration of 10% phenylephrine in the neonate. Pediatrics 1973; Single-ingredient Preparations. Arg.: Fadalefrina; Poen Efrina; doses: 51: 1032-6. Prefrin; Qura Nasal; Austral.: Actifed PEt; Albalon Relief; 2. Baldwin FJ. Morley Intraoperative pulmonary oedema in a child 1 to 16 years: 100 to 500 nanograms/kg per minute, AP. Codral Relief Decongestant; Dimetapp PE Nasal Decongestant; • following systemic absorption of phenylephrine eyedrops. Br J Anaesth Nco-Synephrine; Nyal Cold Flu; Nyal Decongestant; Nyal adjusted according to response 2002; 88: 440-2. + Nasal Decongestant PE; Nyal Sinus Relief PE; Prefrin; Sudafed 16 to 18 years: initially up to I 80 micrograms/minute, 3. Vaughan RW. Ventricular arrhythmias after topical vasoconstrictors. • PE; Austria: Visadron; Belg.: Spraydil; Visadron; Braz. : Dena reduced to 30 to 60 micrograms/minute according to Anesth Analg 1973; 52: 161-5. 4. Lai Y-1<. Adverse effect of intraoperative phenylephrine 10%: case son; Canad.: Ak-Dilate; Dionephrine; Hemorrhoidal Relief; Lit response report. Br J Ophthalmol l989; 73: 468-9. tle Noses Decongestant; Mydfrin; Nco-Synephrine; Prefrint; 5. Fraunfelder FT, Scafidi AF. Possible adverse effects from topical ocular Sudafed PE; Triarninic Thin Strips Nasal Congestion; Chile: Faecal incontinence. Topical application of phenylephrine IO% phenylephrine. Am J Ophthalmol l978; 85: 447-53. Mydfrin; China: Wei Li Ang (ti.:i:J �); Cz.: Rumex Nosni; Neo 6. et a!. Fraunfelder FW, Adverse systemic effects from pledgets nf topical Synephrine; Fin.: Oftan Metaoksedrin; Fr. : Humoxal; Ger.: gel has been shown to increase resting anal tone1 and has ocular phenylephrine 10%. Am J Ophthalmol 2002; 134: 624-5. been investigated in patients with faecal incontinence.2 7. Hecker RB, et al. Myocardial ischemia and stunning induced by topical Neosynephrin-POS; Otriven Babyt; Visadron; Gr. : Ibition; Pre Although application of a 10% gel did not appear to be of intranasal phenylephrine pledgets. Mil Med 1997; 162: 832-5. frin; Hong Kong: Mydfrin; Prefrint; Visoptt; India: Drosyn; 8. Brown .MM et al. lack of side effects from topically administered 10% clinical benefit in a double-blind crossover study in 36 , Fencel; Frenin; Lefrine; Nefrisol; Israel: Efrin; Neo-Synephr phenylephrine eyedrops: a controlled study. Arch Ophthalmol l980; 98: Ital.: Malay patients -with faecal incontinence caused by internal inet; lsonefrine; Nasomixin CM; Neo-Synephrine; 487-9. sia: Mydfrin; Prefrin; Mex. : Actifed Advance; Dilufrint; Lefr sphincter dysfunction, 3 continence was improved in 9. Craig EW, Griffiths PG. Effect on mydriasis of modifying the volume of inet; Nefrin; Plegh; Rinolan; Mon.: Neosynephrine; Neth.: another small study in patients with ileoanal pouches 4 phenylephrine drops. Br J Ophthalmol l99l; 75: 222-3. 10. Wheatcroft S, et al. Reduction in mydriatic drop size in premature Boradrinet; Visadron; NZ: Albalon Relief; Neosynephrine; Pre I. Cheetham MJ, et a!. Topical phenylephrine increases anal canal resting infants. Br J Ophthalmo/ I993; 77: 364-5. frin; Sudafed PE Nasal Decongestant; Philipp.: Decolgent; pressure in patients with faecal incontinence. Gut 200I; 48: 356-9. Mydfrin; Neo-Synephrine; Pol. : Neosynephrin; Port.: Davinefri 2. Cheetham MJ, et al. Drug treatment for faecal incontinence in adults. Available in The Cochrane Database of Systematic Reviews; Issue 3. na; Neo-Sinefrina; VibrodlFen; Visadron; Rus.: Irifrin Chichester: John Wiley; 2002 (accessed 04/0I/07). Effects on the eyes. Acute and chronic conjunctivitis has (llpu¢pHH); Mesaton (MeJaTOH); Nazol Baby (Hroon £3611); Nazol 3. Carapeti EA, et al. Randomized controlled trial of topical phenylephrine been reported1 after use of over-the-counter ophthalmic Kids (Ha3on KH,a;c); Rhinopront (PHHOrrpOHT); S.Afr. : 1-Glo; in the treatment of faecal incontinence. Br J Surg 2000; 87: 38-42. decongestant preparations of phenylephrine, naphazoline, Naphensyl; Prefrin; Singapore: Mydfrint; Prefrin; Spain: 4. Carapeti EA, et al. Randomized, controlled trial of topical phenylephrine ADAt; Boralinet; Disneumon Mentolt; Disneumon Pernasal; Dis or tetryzoline. The conjunctival inflammation took several for fecal incontinence in patients after ileoanal pouch construction. Mirazul; Visadron; Vistafrint; Switz.: Neo-Synephrine; Rexoph Colon Rectum 2000; 43: I059-63. weeks to resolve in some cases. Dermatoconjunctivitis2 has also been reported after use of phenylephrine eye tal Nt; Spray nasal pour enfantst; Turk. : Mydfrin; UK: Boots drops. Decongestant Capsules; Fenox; Non-Drowsy Sudafed Conges Nasal congestion. A meta -analysis concluded that there tion Relief; Ukr. : Glycodin (rniKo.Ilnn)t; Nasal Baby (Hroon was insufficient evidence that phenylephrine l 0 mg was I. Soparkar CN, et al. Acute and chronic conjunctivitis due to over-the £e6H); USA: AH-chew D; Ak-Dilate; Anu-Med; Children's Nos counter ophthalmic decongestants. Arch Ophthalmo! I997; 115: 34-8. an effective oral decongestant (p. 1652.1) 1 2. Moreno-Ancillo A, et a!. Allergic contact reactions due to phenylephrine tril; Hemorrhoidal Suppositories; Lusonal; Mydfrin; Nasopt; 1. Hatton RC, et al. Efficacy and safety of oral phenylephrine: systematic hydrochloride in eyedrops. Ann Allergy Asthma lmmunol 1997; 78: 569- Neo-Synephrine; Neofrin; Nostril; Ocu-Phrin; Pedia Care Chil review and meta-analysis. Ann Pharmacother 2007; 41: 381-90. 72. drens Decongestant; Phenyl-Tt; Rectacaine; Relieft; Rhinall; The symbol t denotes a preparation no longer actively marketed 1674 Cough Suppressants Expectorants Mucolytics and Nasal Decongestants Sinex; Sudafed PE; Triaminic Infant Strips Decongestantt; Thin An extensive and detailed review' of adverse effects Porphyria. The Drug Database for Acute Porphyria, com Triaminic Thin Strips Cold; Tronolane. attributed to phenylpropanolamine noted in 1990 that piled by the Norwegian Porphyria Centre (NAPOS) and Multi-ingredient Preparations. Numerous preparations are listed many of the adverse drug reactions reported in Europe the Porphyria Centre Sweden, classifies phenylpropanol in Volume B. described an alteration of mental status whereas those in amine as not porphyrinogenic; it may be used as a drug of North America were more often compatible with hyper first choice and no precautions are needed.1 as an adjunct in:. Braz.: Anestesico. Used tension. The author suggested that this might be due to a l. The Drug Database for Acute Porphyria. Available at: http:lfwww. PharmacopoeialPreparations difference in the isomers present in phenylpropanolamine drugs-porphyria.org (accessed 19110111) BP 2014: Phenylephrine Eye Drops; Phenylephrine Injection; preparations, based on earlier reports that d-norpseudoe USP 36: Antipyrine, Benzocaine, and Phenylephrine Hydro phedrine, the most potent of several isomeric forms as a Interactions chloride Otic Solution; Isoproterenol Hydrochloride and stimulant of the CNS, was present in European preparations Phenylephrine Bitartrate Inhalation Aeroso� Phenylephrine As for Sympathomimetics, p. 1508.3. For a comment that of phenylpropanolamine. However. later investigation Hydrochloride Injection; Phenylephrine Hydrochloride Nasal drug interactions were likely to have been involved in many suggests that currently the racemic mixture (±)-norephe Jelly; Phenylephrine Hydrochloride Nasal Solution; Phenyleph adverse events associated with phenylpropanolamine see rine Hydrochloride Ophthahnic Solution. drine (d)-norephedrine) is the isomeric form present in under Adverse Effects and Precautions, above. Due to its 2 commercial preparations in both Europe and the USA. indirect action, hypertensive crisis is a particular risk in The original review' concentrated on North American patients receiving MAOis. For mention of the potential that cases. The majority of products available were deconges phenylpropanolamine can increase plasma-caffeine con tants or cough or cold remedies; a small number were centrations, see Sympathomimetics, under Caffeine, promoted as diet aids. p. 1206.2. The data suggested that over-the-counter (OTC) products were more likely to be associated with an adverse Amantadine. Severe psychosis has been reported' in a reaction than a prescription medication; this may be woman taking amantadine with phenylpropanolamine. In because such OTC products were more likely to be overused another report, 2 a 39-year-old man had intense and recur and to be considered innocuous by the patient. It was also rent dijd vu experiences after taking amantadine with likely that drug interactions (below) rather than 'true phenylpropanolamine for viral influenza. The effect ceased overdosages' were involved in many of the adverse events, when he stopped both drugs. The authors suggested that particularly as many OTC preparations contain other his symptoms were due to increased dopamine activity ingredients. (See also Abuse under Ephedrine, p. 1664. 1, for caused by the combination. Street names. The following terms have been used as 'street further discussion about the consequences of use of OTC l. Stroe AE, et a/. Psychotic episode related to phenylpropanolamine and names' (see p. vii) or slang names for various forms of preparations containing sympathomimetics, including amantadine in a healthy female. Gen Hosp Psychiatry 1995; 17: 457-8. phenylpropanolamine: 2. Taiminen T, Jiiiiskeliilnen SK. Intense and recurrent deja vu experiences phenylpropanolamine.) related to amantadine and phenylpropanolamine in a healthy male. J Pseudocaine. The adverse reactions varied widely ranging from Clin Neurosd 200 1; 8: 460-2. . headache and elevated blood pressure to cardiopulmonary PhenylpropanolamineHydrochloride arrest, intracranial haemorrhage, and death. Mild reactions Antipsychotics. A 27 -year-old woman with schizophrenia (BANM, r/NNM) included blurred vision, dizziness, anxiety, agitation, and T-wave abnormality of the heart, who had responded tremor, confusion, and hypersensitivity reaction. Severe to thioridazine IOOmg daily with procyclidine 2.5 mg twice reactions included hypertensive crisis with hypertensive daily, died from ventricular fibrillation within 2 hours of encephalopathy, seizures, arrhythmias, psychosis, and taking a single dose of a preparation reported to contain acute tubular necrosis. One unifying theme of many of chlorphenamine maleate 4 mg with phenylpropanolamine the severe cases was that high blood pressure or symptoms hydrochloride 50mg (Contac C), concurrently with thiorid suggestive of this were the presenting feature; an acute, azine.1 persistent, severe headache was also noted in many cases. 1. Chouinard G, et al. Death attributed to ventricular arrhythmia induced by thioridazine in combination with a single Contac C capsule. Can Med It was pointed out that overall phenylpropanolamine Assoc J 1978; 119: 729-3 1. was relatively safe. Although billions of doses were consumed annually, few cases of adverse drug reactions had Antivirals. A patient taking an over-the-counter nasal been reported. decongestant preparation containing phenylpropanol It was believed that certain groups may be at particular amine and clemastine as well as a triple-drug HN prophy risk of adverse reactions to phenylpropanolamine: persons lactic regimen, had a hypertensive crisis 3 days after stavu with elevated blood pressure, overweight persons (who are dine was substituted for zidovudine;1 the other antivirals in likely to be both hypertensive and to use diet aids), patients the regimen were indinavir and lamivudine. Pharmacopoeias. In Bur. (see p. vii) and US. with eating disorders (who tend to abuse substances 1. Khurana V, et al. Hypertensive crisis secondary to phenylpropanolamine US also includes phenylpropanolamine bitartrate. including diet aids), and the elderly (who may be multiple interacting with triple-drug therapy for HIV prophylaxis. Am J Med 1999; 106: 118-19. Ph. Eur. 8: (Phenylpropanolamine Hydrochloride). A white drug takers and likely to be hypertensive and at risk already or almost white, crystalline powder. Freely soluble in water of a stroke). Bromocriptine. For a report of hypertension and life and in alcohol; practically insoluble in dichloromethane. Subsequently, after a large case-control study in the USA threatening complications after use of phenylpropanol which found an increased risk of haemorrhagic stroke USP 36: (Phenylpropanolamine Hydrochloride). A white amine with bromocriptine, see Sympathomimetics, associated with the use of preparations containing phenyl crystalline powder, having a slight aromatic odour. Soluble p. 899.1. I in 1.1 of water, I in 7.4 of alcohol, and I in 4100 of propanolamine (and in particular in women who used chloroform; insoluble in ether. pH of a 3% solution in water phenylpropanolamine as an appetite suppressant),' the FDA NSAIDs. A 27-year-old woman who had been taking n is between 4.2 and 5.5. Store in airtight containers. Protect took steps to remove phenylpropanolamine from all drug phenylpropanolamine [sic] 85 mg daily for some months, from light. products in the USA and requested that it no longer be had severe hypertension when she also took indometadn marketed. Products containing phenylpropanolamine have 25 mg. It was considered that the inhibition of prostaglan Uses and Administration also been withdrawn in some other countries. However, this din synthesis by indometacin might have caused enhance study and the FDA decision have been criticised•·• notably ment of the sympathomimetic effect of phenylpropanol Phenylpropanolamine is a mainly indirect-acting sym on the basis that there was no evidence of an increased risk amine.1 pathomimetic (p. 1507.3) with an action similar to that of with the amount of phenylpropanolamine normally present 1. Lee KY, et al. Severe hypertension after ingestion of an appetite ephedrine (p. 1663.2) but less active as a CNS stimulant. in decongestant preparations and the study may have been suppressant (phenylpropanolamine) with indomethacin. Lancet 1979; i: Phenylpropanolamine has been given orally as the subject to confounding. The UK CSM7 considered that the 1110-11. hydrochloride for the symptomatic treatment of nasal evidence of a link between UK products containing congestion (p. 1652.1). It has frequently been used in phenylpropanolamine and haemorrhagic stroke was weak Pharmacokinetics combination preparations for the relief of cough and cold (phenylpropanolamine is not licensed as an appetite symptoms. Phenylpropanolamine is readily and completely absorbed suppressant in the UK and the maximum recommended In the management of nasal congestion, phenyl from the gastrointestinal tract and peak plasma concentra dose of IOOmg daily was lower than the 150mg daily propanolamine hydrochloride has been given in oral doses tions occur about 1 or 2 hours after oral doses. It undergoes recommended in the USA). It was therefore suggested by of up to 50 mg twice daily as modified-release preparations. some metabolism in the liver, to an active hydroxylated UK commentators that use of licensed doses, with Other uses of phenylpropanolamine have included the metabolite, but up to 80 to 90% of a dose is excreted appropriate precautions, posed no additional risk.' How control of urinary incontinence in some patients and the unchanged in the urine within 24 hours. The half -life has ever, subsequently, UK preparations containing phenyl management of some forms of priapism. Phenylpropanol been reported to be about 3 to 5 hours. propanolamine have either been reformulated (mainly with amine has been used to suppress appetite in the References. management of obesity but the use of stimulants is no pseudoephedrine) or withdrawn by the manufacturers. 1. Simons FER, et al. Pharmacokinetics of the orally administered 1. Lake CR, et al. Adverse drug effects attributed to phenylpropanolamine: decongestants pseudoephedrine and phenylpropanolamine in children. longer recommended. 129: a review of 142 case reports. Am J Med 1990; 89: 195-208. J Pediatr 1996; 729-34. Phenylpropanolamine polistirex (a phenylpropanol 2. Moffatt T, et al. Phenylpropanolamine: putting the record straight. Pharm 2. Chester N, et al. Elimination of ephedrines in urine following multiple amine and sulfonated diethenylbenzene-ethenylbenzene J 2000; 26S: 817. dosing: the consequences for athletes, in relation to doping control. Br J Clin Pharmaco/ 2004; 57: 62-7. copolymer complex) has also been used, as have phenyl 3. Kernan WN,et al. Phenylpropanolamine and the risk of hemorrhagic propanolamine bitartrate, phenylpropanolamine maleate, stroke. N Eng! J Med 2000; 143: 1826-32. and phenylpropanolamine sulfate. 4. Ernst ME, Hartz A. Phenylpropanolamine and hemorrhagic stroke. N E11fJlJ Med 2001; 344: 1094. �:.�P.�.��-��<>.��---········································································· Proprietary Preparations (details are given in Volume B) 5. Wolowich WR, et al. Phenylpropanolamine and hemorrhagic stroke. N Engl J Med 2001; 344: 1094-5. Adverse Effects and Precautions Fin.: Rinexin; Ger.: Boxogetten 6. Stier BG, Hennekens CH. Phenylpropanolamine and hemorrhagic Single-ingredient Preparations. As for Ephedrine, p. 1663.3 and p. 1664. 1. stroke in the Hemorrhagic Stroke Project: a reappraisal in the context of S; Recatol mono; Norw. : Rinexin; Philipp.: Desotapf; Disudrin; Severe hypertensive episodes have followed phenyl science, the Food and Drug Administration, and the law. Ann Epidemiol Naldec; Nasadec; Nasaphent; Nasalhera P; Neo-Coldan; Swed. : propanolamine ingestion (see below). As with other 2006; 16: 49-52. Rinexin. CUrrent indirect-acting sympathomimetics, tolerance to the ther 7. CSMIMCA. Phenylpropanolamine and haemorrhagic stroke. Problems 2001; 2.7: 5-6. Also available at: http://www.mhra.gov.uk/ Multi-ingredient Preparations. Chile: Contact; Matinor; Sinutab; apeutic effects of phenylpropanolamine has been reported home/idcplg?IdcService=GET_FIT.E&dDocName=CON007458&Revi Fin.: Rinomar; Ger.: Antiadipositum; Basoplex; Wick Daymed with prolonged use. sionSelectionMethod=LatestReleased (accessed 04/01107) Erkaltungs; Gr.: Dimetapp New; Dimetapp; Omade-2; Rhino· All cross-references refer to entries in Volume A