PHENYLEPHRINE HYDROCHLORIDE 10 mg/mL Injection, 25 vials
🆔 Identity & classification
Where does this data come from?
🏷️ RxNorm drug class
This medicine belongs to the alpha-1 Adrenergic Agonist class.
Where does this data come from?
🏭 Manufacturer & labeler
Where does this data come from?
🩺 Clinical
- Yes, it's the same active ingredient, but used in very different ways depending on the form. The nasal spray delivers a tiny amount directly to the nasal lining to temporarily shri...
- I see phenylephrine in nasal sprays at the pharmacy AND as an IV drug in the hospital — is it really the same medication?
- You should check with your doctor first. Phenylephrine constricts blood vessels, which can raise blood pressure and put extra strain on the heart — even from a nasal spray. If you...
- Can I use the nasal spray if I have high blood pressure or heart disease?
Patient education
Supplement & herbal interactions
Some supplements/herbs that may interact with Phenylephrine Hydrochloride — tap one for details:
Where does this data come from?
Ask a licensed pharmacist directly — free, answered by our team.
🧪 Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.
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1 mg / 1 mL
UNII 2968PHW8QP
A weak organic acid derived from citrus fruits or made through fermentation. It works as a buffer to control pH, a preservative to extend shelf life, and a flavoring agent in medications.
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UNII QTT17582CB
A strong acid used to adjust and maintain the proper pH level in liquid medicines, ensuring stability and preventing breakdown of active ingredients.
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3.5 mg / 1 mL
UNII 451W47IQ8X
Sodium chloride is common table salt. It's used in medicines as a buffer to maintain proper pH, as a filler to add bulk, or to adjust the osmotic balance in liquid formulations.
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UNII 55X04QC32I
A strong alkaline chemical used to adjust and maintain the pH balance of liquid medicines. It helps keep the medicine stable and ensures it stays effective during storage.
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2 mg / 1 mL
UNII 4VON5FNS3C
Sodium metabisulfite is a preservative derived from sulfur compounds. It prevents microbial growth and oxidation in medicines, helping extend shelf life and maintain product stability.
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4 mg / 1 mL
UNII B22547B95K
A salt derived from citric acid that helps maintain the proper acid-base balance in the medicine. It's used as a buffer to keep the product stable and at the right pH level.
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UNII 059QF0KO0R
Water is a liquid solvent that dissolves and mixes ingredients together in liquid medicines, syrups, and injections. It helps distribute the active drug evenly throughout the product.
7 inactive ingredients listed in the exact product block matched to this NDC.
Where does this data come from?
ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.Inactive ingredient FAQ
Are inactive ingredients the same for every manufacturer?
Why might an inactive ingredient be missing?
Can inactive ingredients matter?
💲 Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per each | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | Not in the retail survey — common for institutional, discontinued, or low-volume packs. | |
| Medicaid paysCMS SDUD · 12 mo | $2.36 | $59.00 / 25 vials |
| Medicare drug plans payPart D · quarterly | No Part D plan price is available for this NDC in our data. | |
| Medicare Part B allowsASP · J2371 | $0.002 / J2371 unit | — |
Where does this data come from?
🧾 Billing & reimbursement
Where does this data come from?
🔁 Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Phenylephrine Hydrochloride 10 mg/mL 00404-9931-99 | Henry | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00641-6142-25 | Hikma | 25 vials | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00641-6229-25 | Hikma | 25 vials | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00781-3422-92 | Sandoz | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00781-9226-92 | Sandoz | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 14335-0440-01 | Hainan | 25 vials | — | AP1 | FDA listed | — |
| phenylephrine hydrochloride 10 mg/mL 23155-0620-41 | Heritage | 25 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 25021-0315-01 | Sagent | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 31722-0343-32 | Camber | 10 vials | — | AP1 | FDA listed | — |
| phenylephrine hydrochloride 10 mg/mL 36000-0358-25 | Baxter | 25 vials | — | AP1 | FDA listed | — |
| Biorphen 10 mg/mL 43598-0199-10 | Dr. | 10 ampules | — | AP | FDA listed | — |
| Phenylephrine Hci 10 mg/mL 51662-1249-01 | HF | 1 ml | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 51662-1576-01 | HF | 1 ml | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 55150-0300-25 | Eugia | 25 vials | — | AP2 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 55154-8226-05 | Cardinal | 5 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 58657-0851-26 | Method | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 63323-0751-13 | Fresenius | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 65145-0115-25 | Caplin | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 65219-0388-01 | Fresenius | 25 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride Phenylephrine Hydrochloride 10 mg/mL 68083-0465-25 | Gland | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 70069-0801-25 | Somerset | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 70069-0811-25 | Somerset | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 70121-1577-05 | Amneal | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 70594-0063-02 | Xellia | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 70756-0621-25 | Lifestar | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71288-0807-02 | Meitheal | 25 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71839-0127-25 | BE | 25 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71872-7043-01 | Medical | 1 vial | — | — | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 71872-7159-01 | Medical | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71872-7267-01 | Medical | 1 vial | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71872-7273-01 | Medical | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 71872-7303-01 | Medical | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71872-7343-01 | Medical | 1 vial | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71872-7348-01 | Medical | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mLthis 72205-0264-25 | Novadoz | 25 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 72485-0504-25 | Armas | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 72572-0571-25 | Civica, | 25 vials | — | — | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 81284-0211-25 | Provepharm | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 84549-0621-25 | ProPharma | 1 ml | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00781-9227-95 | Sandoz | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00781-9228-70 | Sandoz | 1 vial | — | AP1 | FDA listed | — |
| phenylephrine hydrochloride 10 mg/mL 68083-0338-10 | Gland | 10 vials | — | AP1 | FDA listed | — |
| phenylephrine hydrochloride 10 mg/mL 68083-0339-01 | Gland | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71288-0808-76 | Meitheal | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 55150-0301-10 | Eugia | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 55150-0302-01 | Eugia | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71839-0128-10 | BE | 10 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71839-0129-10 | BE | 10 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 31722-0344-31 | Camber | 10 vials | — | AP1 | FDA listed | — |
| phenylephrine hydrochloride 10 mg/mL 36000-0362-05 | Baxter | 5 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00641-6188-10 | Hikma | 10 vials | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00781-3458-95 | Sandoz | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 72205-0265-07 | Novadoz | 10 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 14335-0442-01 | Hainan | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 42023-0215-01 | Par | 1 vial | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 58657-0853-01 | Method | 10 ml | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 70121-1578-07 | Amneal | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 70121-1579-01 | Amneal | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 58657-0852-11 | Method | 10 vials | — | AP1 | FDA listed | — |
| phenylephrine hydrochloride 10 mg/mL 36000-0360-10 | Baxter | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00781-3466-70 | Sandoz | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 42023-0214-10 | Par | 10 vials | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 72205-0266-07 | Novadoz | 10 vials | — | AP2 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 81284-0212-10 | Provepharm | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 31722-0345-10 | Camber | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 81284-0213-01 | Provepharm | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00641-6189-10 | Hikma | 10 vials | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 14335-0441-01 | Hainan | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 72572-0570-10 | Civica, | 10 vials | — | — | FDA listed | — |
Where does this data come from?
⏳ Availability & generic status
This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.
Where does this data come from?
🗺️ Medicaid utilization & spend
📦 Packaging — all sizes for this product
| Package NDC | Description | Marketing start | Status |
|---|---|---|---|
| 72205-0264-25 You're viewing this | 25 VIAL, SINGLE-DOSE in 1 CARTON (72205-264-25) / 1 mL in 1 VIAL, SINGLE-DOSE (72205-264-01) | 2024-05-04 | Active |
🧭 About this NDC listing & data coverage
What data is (and isn’t) available for this NDC — tap to expand
| NDC identity (package / product / labeler codes) | ✓ Available |
| Labeler | ✓ Available |
| Product & package description | ✓ Available |
| Marketing category & status | ✓ Available |
| Active ingredient / dosage form / route | ✓ Available |
| FDA label (SPL via DailyMed) | ✓ Available |
| Package photos | ✓ Available |
| Inactive ingredients (structured) | ✓ Available |
| NADAC pharmacy acquisition price (CMS) | — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey. |
| Orange Book / therapeutic-equivalence data | ✓ Available |
| HCPCS J-code billing crosswalk | ✓ Available |
| Medicaid utilization (CMS SDUD) | ✓ Available |
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📄 Full prescribing information FDA SPL
🎯 Indications and Usage ▾
1 INDICATIONS AND USAGE Phenylephrine Hydrochloride Injection 10 mg/mL is indicated for increasing blood pressure in adults with clinically important hypotension resulting primarily from vasodilation in the settings of anesthesia and septic shock. Phenylephrine Hydrochloride Injection 10 mg/mL is alpha-1 adrenergic receptor agonist indicated for increasing blood pressure in adults with clinically important hypotension resulting primarily from vasodilation in the settings of anesthesia and septic shock.
⏱️ Dosage and Administration ▾
2 DOSAGE AND ADMINISTRATION Phenylephrine Hydrochloride Injection 10 mg/mL: MUST BE DILUTED before administration. ( 2.1 ) Dosing for Perioperative Hypotension - Intravenous bolus administration: 50 mcg to 250 mcg (2.4) - Intravenous continuous infusion: 0.5 mcg/kg/minute to 1.4 mcg/kg/minute titrated to effect (2.4) Dosing for Patients with Vasodilatory Shock - Intravenous continuous infusion: 0.5 mcg/kg/minute to 6 mcg/kg/minute titrated to effect (2.5)
2.1General Administration Instructions Phenylephrine Hydrochloride Injection 10 mg/mL formulation (10 mg/mL, 50 mg/5mL, and 100 mg/10 mL) MUST BE DILUTED before administration as an intravenous bolus or for continuous intravenous infusion. The diluted solution should not be held for more than 4 hours at room temperature or for more than 24 hours under refrigerated conditions (2°C – 8°C). Parenteral drug products should be inspected for particulate matter and discoloration prior to administration.
Discard any unused portion. During Phenylephrine Hydrochloride Injection 10 mg/mL administration: Correct intravascular volume depletion. Correct acidosis.
Acidosis may reduce the effectiveness of phenylephrine.
2.2Preparation of Phenylephrine Hydrochloride Injection Preparing a 100 mcg/mL Solution for Intravenous Bolus Administration For intravenous bolus administration, withdraw 10 mg (1 mL of a 10 mg/mL concentration) of Phenylephrine Hydrochloride Injection 10 mg/mL and dilute with 99 mL of 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP. This will yield a final concentration of 100 mcg/mL. Withdraw an appropriate dose from the 100 mcg/mL solution prior to intravenous bolus administration.
Preparing a 20 mcg/mL Solution for Continuous Intravenous Infusion For continuous intravenous infusion, withdraw 10 mg (1 mL of 10 mg/mL concentration) of phenylephrine hydrochloride injection 10 mg/mL and add to 500 mL of 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP (providing a final concentration of 20 mcg/mL). Directions for Dispensing from Phenylephrine Hydrochloride Injection 10 mg/mL Pharmacy Bulk Vial The Pharmacy Bulk Vial is intended for dispensing of single doses to multiple patients in a pharmacy admixture program and is restricted to the preparation of admixtures for infusion.
Each closure shall be penetrated only one time with a suitable sterile transfer device or dispensing set that allows measured dispensing of the contents. The Pharmacy Bulk Vial is to be used only in a suitable work area such as a laminar flow hood (or an equivalent clean air compounding area). Dispensing from a pharmacy bulk vial should be completed within 4 hours after the vial is penetrated.
Dosing for Perioperative Setting In adult patients undergoing surgical procedures with either neuraxial anesthesia or general anesthesia: Phenylephrine Hydrochloride Injection 10 mg/mL (diluted to 20 mcg/mL): 0.5 mcg/kg/min to 1.4 mcg/kg/min by intravenous continuous infusion, titrated to blood pressure goal. Dosing for Septic or Other Vasodilatory Shock (Phenylephrine Hydrochloride Injection 10 mg/mL only) In adult patients with septic or other vasodilatory shock: No bolus. 0.5 mcg/kg/min to 6 mcg/kg/min by intravenous continuous infusion, titrated to blood pressure goal.
Doses above 6 mcg/kg/min do not show significant incremental increase in blood pressure.
💊 Dosage Forms and Strengths ▾
3 DOSAGE FORMS AND STRENGTHS Phenylephrine Hydrochloride Injection, USP: 10 mg/mL phenylephrine hydrochloride is a clear, colorless, essentially free of visible foreign matter sterile parenteral solution, available in three vial sizes: 10 mg in 1 mL (10 mg/mL) of Phenylephrine hydrochloride in a single-dose vial 50 mg in 5 mL (10 mg/mL) of Phenylephrine hydrochloride in a pharmacy bulk package vial 100 mg in 10 mL (10 mg/mL) of Phenylephrine hydrochloride in a pharmacy bulk package vial Phenylephrine Hydrochloride Injection: 10 mg in 1 mL (10 mg/mL) of Phenylephrine hydrochloride in a single-dose vial ( 3 ) 50 mg in 5 mL (10 mg/mL) of Phenylephrine hydrochloride in a pharmacy bulk package vial ( 3 ) 100 mg in 10 mL (10 mg/mL) of Phenylephrine hydrochloride in a pharmacy bulk package vial ( 3 )
⛔ Contraindications ▾
4 CONTRAINDICATIONS The use of Phenylephrine Hydrochloride Injection 10 mg/mL is contraindicated in patients with: Hypersensitivity to the products or any of their components Hypersensitivity to the products or any of their components ( 4 )
⚠️ Warnings and Cautions ▾
5 WARNINGS AND PRECAUTIONS Severe bradycardia and decreased cardiac output: ( 5.2 ) Extravasation : during intravenous administration may cause necrosis or sloughing of tissue ( 5.4 ) Concomitant use with oxytocic drugs: pressor effect of sympathomimetic pressor amines is potentiated ( 5.5 ) Allergic-type reactions with Phenylephrine Hydrochloride Injection 10 mg/mL : Sulfite ( 5.6 )
5.1Exacerbation of Angina, Heart Failure, or Pulmonary Arterial Hypertension Because of its pressor effects, phenylephrine hydrochloride can precipitate angina in patients with severe arteriosclerosis or history of angina, exacerbate underlying heart failure, and increase pulmonary arterial pressure.
5.2Bradycardia Phenylephrine Hydrochloride Injection 10 mg/mL can cause severe bradycardia and decreased cardiac output.
5.3Risk in Patients with Autonomic Dysfunction The pressor response to adrenergic drugs, including phenylephrine, can be increased in patients with autonomic dysfunction, as may occur with spinal cord injuries.
5.4Skin and Subcutaneous Necrosis Extravasation of phenylephrine can cause necrosis or sloughing of tissue.
5.5Pressor Effect with Concomitant Oxytocic Drugs Oxytocic drugs potentiate the pressor effect of sympathomimetic pressor amines including Phenylephrine Hydrochloride Injection 10 mg/mL [see Drug Interactions (7.1) ] , with the potential for hemorrhagic stroke.
5.6Allergic Reactions Phenylephrine Hydrochloride Injection 10 mg/mL contains sodium metabisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.
5.7Peripheral and Visceral Ischemia Phenylephrine Hydrochloride Injection 10 mg/mL can cause excessive peripheral and visceral vasoconstriction and ischemia to vital organs, particularly in patients with extensive peripheral vascular disease.
5.8Renal Toxicity Phenylephrine Hydrochloride Injection 10 mg/mL can increase the need for renal replacement therapy in patients with septic shock. Monitor renal function.
🤒 Adverse Reactions ▾
6 ADVERSE REACTIONS The following adverse reactions associated with the use of phenylephrine hydrochloride were identified in the literature. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to estimate their frequency reliably or to establish a causal relationship to drug exposure. Cardiac disorders: Bradycardia, AV block, ventricular extrasystoles, myocardial ischemia Gastrointestinal disorders: Nausea, vomiting General disorders and administrative site conditions: Chest pain, extravasation Immune system disorders: Sulfite sensitivity Nervous system disorders: Headache, nervousness, paresthesia, tremor Psychiatric disorders: Excitability Respiratory: Pulmonary edema, rales Skin and subcutaneous tissue disorders: Diaphoresis, pallor, piloerection, skin blanching, skin necrosis with extravasation Vascular disorders: Hypertensive crisis Most common adverse reactions: nausea and vomiting, headache, nervousness ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Novadoz Pharmaceuticals LLC at 1-855-668-2369 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
🔄 Drug Interactions ▾
7 DRUG INTERACTIONS Agonistic effects with monoamine oxidase inhibitors (MAOI), β-adrenergic blocking agents, α-2 adrenergic agonists, steroids, tricyclic antidepressants, norepinephrine transport inhibitors, ergot alkaloids, centrally-acting sympatholytic agents and atropine sulfate ( 7.1 ) Antagonistic effects on and by α-adrenergic blocking agents ( 7.2 )
7.1Agonists The pressor effect of phenylephrine hydrochloride is increased in patients receiving: Monoamine oxidase inhibitors (MAOI), such as selegiline. β-adrenergic blockers α-2 adrenergic agonists, such as clonidine Steroids Tricyclic antidepressants Norepinephrine transport inhibitors, such as atomoxetine Ergot alkaloids, such as methylergonovine maleate Centrally-acting sympatholytic agents, such as guanfacine or reserpine Atropine sulfate
7.2Antagonists α-adrenergic blocking agents, including phenothiazines (e.g., chlorpromazine) and amiodarone block phenylephrine and are in turn blocked by phenylephrine.
👥 Use in Specific Populations ▾
8 USE IN SPECIFIC POPULATIONS
8.1Pregnancy Risk Summary In animal reproductive and developmental studies, decreased fetal body weights were noted at 0.4 times the human daily dose (HDD) of 10 mg. No malformations were reported, however, an increased incidence of agenesis of the intermediate lobe of the lung, a visceral variation, was reported at levels as low as 0.08 times the HDD. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown.
All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. Data Animal Data No malformations were noted when normotensive pregnant rats were treated with a single daily intravenous bolus dose of 50 mcg, 150 mcg, or 300/200 mcg/kg phenylephrine hydrochloride from Gestation Day 6 to 17 (high dose is 0.3/0.2 times the human daily dose (HDD) of 10 mg/day based on body surface area).
Evidence of maternal toxicity, including mortality, was noted at the highest tested dose of 300/200 mcg/kg. Decreased fetal body weights but no clear treatment-related malformations were reported when normotensive pregnant rabbits were treated with a single daily intravenous bolus dose of 40 mcg, 100 mcg and 200 mcg/kg (0.08, 0.2, and 0.4 times the HDD based on body surface area) phenylephrine hydrochloride from Gestation Day 7 to 19. Maternal toxicity, as manifested by decreased food consumption and body weight gain at all doses.
An increased incidence of agenesis of the intermediate lobe of the lung, a visceral variation, was noted in all treatment groups compared to controls. No adverse effects on the offspring were reported when pregnant rats were treated via a single daily intravenous bolus dose of up to 200 mcg/day phenylephrine hydrochloride (0.2 times the HDD based on body surface area) from Gestation Day 6 to Lactation Day 20.
8.4Pediatric Use Safety and effectiveness in pediatric patients have not been established.
8.5Geriatric Use Clinical studies of phenylephrine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
8.6Hepatic Impairment In patients with liver cirrhosis [Child Pugh Class A (n=3), Class B (n=5) and Class C (n=1)], dose-response data indicate decreased responsiveness to phenylephrine. Consider using larger doses than usual in hepatic impaired subjects.
8.7Renal Impairment In patients with end stage renal disease (ESRD) undergoing hemodialysis, doseresponse data indicates increased responsiveness to phenylephrine. Consider using lower doses of phenylephrine hydrochloride in ESRD patients.
🤰 Pregnancy ▾
8.1Pregnancy Risk Summary In animal reproductive and developmental studies, decreased fetal body weights were noted at 0.4 times the human daily dose (HDD) of 10 mg. No malformations were reported, however, an increased incidence of agenesis of the intermediate lobe of the lung, a visceral variation, was reported at levels as low as 0.08 times the HDD. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown.
All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. Data Animal Data No malformations were noted when normotensive pregnant rats were treated with a single daily intravenous bolus dose of 50 mcg, 150 mcg, or 300/200 mcg/kg phenylephrine hydrochloride from Gestation Day 6 to 17 (high dose is 0.3/0.2 times the human daily dose (HDD) of 10 mg/day based on body surface area).
Evidence of maternal toxicity, including mortality, was noted at the highest tested dose of 300/200 mcg/kg. Decreased fetal body weights but no clear treatment-related malformations were reported when normotensive pregnant rabbits were treated with a single daily intravenous bolus dose of 40 mcg, 100 mcg and 200 mcg/kg (0.08, 0.2, and 0.4 times the HDD based on body surface area) phenylephrine hydrochloride from Gestation Day 7 to 19. Maternal toxicity, as manifested by decreased food consumption and body weight gain at all doses.
An increased incidence of agenesis of the intermediate lobe of the lung, a visceral variation, was noted in all treatment groups compared to controls. No adverse effects on the offspring were reported when pregnant rats were treated via a single daily intravenous bolus dose of up to 200 mcg/day phenylephrine hydrochloride (0.2 times the HDD based on body surface area) from Gestation Day 6 to Lactation Day 20.
🧒 Pediatric Use ▾
8.4Pediatric Use Safety and effectiveness in pediatric patients have not been established.
🧓 Geriatric Use ▾
8.5Geriatric Use Clinical studies of phenylephrine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
🆘 Overdosage ▾
10 OVERDOSAGE Overdose of phenylephrine hydrochloride injection 10 mg/mL can cause a rapid rise in blood pressure. Symptoms of overdose include headache, vomiting, hypertension, reflex bradycardia, and cardiac arrhythmias including ventricular extrasystoles and ventricular tachycardia, and may cause a sensation of fullness in the head and tingling of the extremities. Consider using an α-adrenergic antagonist. Consider using an α-adrenergic antagonist.
🧬 Clinical Pharmacology ▾
12 CLINICAL PHARMACOLOGY
12.1Mechanism of Action Phenylephrine hydrochloride is an α-1 adrenergic receptor agonist.
12.2Pharmacodynamics Phenylephrine is the active moiety. Metabolites are inactive at both the α-1 and α-2 adrenergic receptors. Following parenteral administration of phenylephrine hydrochloride, increases in systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, and total peripheral vascular resistance are observed.
The onset of blood pressure increase following an intravenous bolus phenylephrine hydrochloride administration is rapid and the effect may persist for up to 20 minutes. As mean arterial pressure increases following parenteral doses, vagal activity also increases, resulting in reflex bradycardia. Most vascular beds are constricted, including renal, splanchnic, and hepatic.
12.3Pharmacokinetics Following an intravenous infusion of phenylephrine hydrochloride, the effective half-life was approximately 5 minutes. The steady-state volume of distribution (340 L) exceeded the body volume by a factor of 5, suggesting a high distribution into certain organ compartments. The average total serum clearance (2095 mL/min) was close to one-third of the cardiac output.
A mass balance study showed that phenylephrine is extensively metabolized by the liver with only 12% of the dose excreted unchanged in the urine. Deamination by monoamino oxidase is the primary metabolic pathway resulting in the formation of the major metabolite (m-hydroxymandelic acid) which accounts for 57% of the total administered dose.
🧬 Mechanism of Action ▾
12.1Mechanism of Action Phenylephrine hydrochloride is an α-1 adrenergic receptor agonist.
📦 How Supplied / Storage and Handling ▾
16 HOW SUPPLIED/STORAGE AND HANDLING Phenylephrine Hydrochloride injection, USP, 10 mg/mL, is a clear colorless solution, free from visible particulate matter and supplied as follows: NDC No. Strength How Supplied NDC 72205-264-25 10 mg/mL 1 mL Single-dose vials packaged in cartons containing 25 vials per carton NDC 72205-265-07 50 mg/5 mL (10 mg/mL) 5 mL Pharmacy Bulk Package vials packed in cartons containing 10 vials per carton NDC 72205-266-07 100 mg/10 mL (10 mg/mL) 10 mL Pharmacy Bulk Package vials packed in cartons containing 10 vials per carton Store at 20°C to 25°C (68°F to 77°F), excursions permitted to 15°C to 30°C (59°F to 86°F) [See USP Controlled Room Temperature].
Protect from light. Keep covered in carton until time of use. The 1 mL vials are for single-dose only.
Discard any unused portion. The 5 mL and 10 mL vials are pharmacy bulk packages. The diluted solution should not be held for more than 4 hours at room temperature or for more than 24 hours under refrigerated conditions (2°C – 8°C).
Discard any unused portion.
📋 Description ▾
11 DESCRIPTION Phenylephrine Hydrochloride Injection contains active pharmaceutical ingredient phenylephrine in the form of hydrochloride salt. Phenylephrine is a synthetic sympathomimetic agent in sterile form for parenteral injection. Phenylephrine hydrochloride chemical name is (-)- m -Hydroxy-α-[(methylamino)methyl]benzyl alcohol hydrochloride and has the following structural formula: Phenylephrine hydrochloride is freely soluble in water and alcohol.
Phenylephrine hydrochloride is sensitive to light. Phenylephrine Hydrochloride Injection, USP, 10 mg/mL: Phenylephrine Hydrochloride injection, USP is a clear, colorless, aqueous solution that is essentially free of visible foreign matter. It MUST BE DILUTED before administration as bolus intravenous infusion or continuous intravenous infusion.
Each mL contains: 10 mg of Phenylephrine Hydrochloride (equivalent to 8.2 mg of phenylephrine base); 3.5 mg of Sodium Chloride USP as tonicity agent; 1 mg of Citric Acid Monohydrate USP and 4 mg of Sodium Citrate Dihydrate USP, as buffering agents; 2 mg of Sodium Metabisulfite USP, as antioxidant, and Sodium Hydroxide NF and Hydrochloric Acid NF, as pH adjusters in Water for Injection. Phenylephrine Hydrochloride injection pH range is 3.0 to 6.5. phenyl-inj-structure
💬 Information for Patients ▾
17 PATIENT COUNSELING INFORMATION Inform patients, families, or caregivers that the primary side effect of phenylephrine is hypertension and, rarely, hypertensive crisis. Patients may experience bradycardia (slow heart rate), which in some cases may produce heart block or other cardiac arrhythmias, extra ventricular beats, myocardial ischemia in patients with underlying cardiac disease, and pulmonary edema (fluid in the lungs) or rales. Common, less serious symptoms include the following: chest pain skin or tissue damage if the drug leaks out of the venous catheter into the surrounding tissue headache, nervousness, tremor, numbness/tingling (paresthesias) in hands or feet nausea, vomiting excitability, dizziness, sweating, flushing Manufactured by: MSN Laboratories Private Limited Telangana – 509 228, INDIA Distributed by: Novadoz Pharmaceuticals LLC Piscataway, NJ 08854-3714 Revised: December 2023