Phenylephrine Hydrochloride 10 mg/mL Injection
🆔 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 | No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data. | |
| 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 00641-6188-10 | Hikma | 10 vials | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00641-6189-10 | Hikma | 10 vials | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00781-3458-95 | Sandoz | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00781-3466-70 | Sandoz | 1 vial | — | 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 14335-0441-01 | Hainan | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 14335-0442-01 | Hainan | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 25021-0315-01 | Sagent | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 31722-0344-31 | Camber | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 31722-0345-10 | Camber | 1 vial | — | AP1 | FDA listed | — |
| phenylephrine hydrochloride 10 mg/mL 36000-0360-10 | Baxter | 10 vials | — | AP1 | FDA listed | — |
| phenylephrine hydrochloride 10 mg/mL 36000-0362-05 | Baxter | 5 vials | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 42023-0214-10 | Par | 10 vials | — | — | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 42023-0215-01 | Par | 1 vial | — | — | 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 58657-0852-11 | Method | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 58657-0853-01 | Method | 10 ml | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 50 mg/5mL 65145-0116-01 | Caplin | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 100 mg/10mL 65145-0117-01 | Caplin | 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 50 mg/5mL 70069-0802-10 | Somerset | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 100 mg/10mL 70069-0803-01 | Somerset | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 50 mg/5mL 70069-0812-10 | Somerset | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 100 mg/10mL 70069-0813-01 | Somerset | 1 vial | — | 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 50 mg/5mL 70594-0064-02 | Xellia | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 100 mg/10mL 70594-0065-01 | Xellia | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 50 mg/5mL 70756-0622-10 | Lifestar | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 100 mg/10mL 70756-0623-86 | Lifestar | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71288-0808-76 | Meitheal | 10 vials | — | 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 72205-0265-07 | Novadoz | 10 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 72205-0266-07 | Novadoz | 10 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 50 mg/5mL 72485-0505-10 | Armas | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 100 mg/10mL 72485-0506-01 | Armas | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mLthis 72572-0570-10 | Civica, | 10 vials | — | — | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 81284-0212-10 | Provepharm | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 81284-0213-01 | Provepharm | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00781-9226-92 | Sandoz | 10 vials | — | AP1 | 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 70594-0063-02 | Xellia | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 63323-0751-13 | Fresenius | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 70069-0811-25 | Somerset | 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 72485-0504-25 | Armas | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 70121-1577-05 | Amneal | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 72205-0264-25 | Novadoz | 25 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00781-3422-92 | Sandoz | 10 vials | — | AP1 | FDA listed | — |
| Biorphen 10 mg/mL 43598-0199-10 | Dr. | 10 ampules | — | AP | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 84549-0621-25 | ProPharma | 1 ml | — | AP1 | FDA listed | — |
| phenylephrine hydrochloride 10 mg/mL 23155-0620-41 | Heritage | 25 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 51662-1576-01 | HF | 1 ml | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00404-9931-99 | Henry | 1 vial | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 55150-0300-25 | Eugia | 25 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 65219-0388-01 | Fresenius | 25 vials | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71872-7343-01 | Medical | 1 vial | — | AP2 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 14335-0440-01 | Hainan | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine hydrochloride 10 mg/mL 55154-8226-05 | Cardinal | 5 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00641-6142-25 | Hikma | 25 vials | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 65145-0115-25 | Caplin | 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 36000-0358-25 | Baxter | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 58657-0851-26 | Method | 25 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 00641-6229-25 | Hikma | 25 vials | — | — | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 31722-0343-32 | Camber | 10 vials | — | AP1 | FDA listed | — |
| Phenylephrine Hydrochloride 10 mg/mL 71872-7348-01 | Medical | 1 vial | — | AP1 | FDA listed | — |
Where does this data come from?
⏳ Availability & generic status
The FDA lists approved generic versions of this medicine, but that does not always mean a pharmacy can get one today. Patent rules, launch agreements, supply and pricing can affect when generics actually arrive.
Why the date isn’t exact: Generic timing can change because patents may be challenged, settled, licensed, added, removed, or worked around with a narrower label — and FDA approval does not always mean a pharmacy can get the generic today.
🛈 What do these terms mean?
- Patent
- Legal protection listed in the Orange Book that may delay generic approval or launch. Issued by the U.S. Patent & Trademark Office.
- Substance patent
- Covers the active drug molecule itself — the hardest to design around. A generic generally can’t launch until it expires.
- Formulation (product) patent
- Covers a specific formulation or dosage form. A generic can sometimes work around it with a different formulation.
- Method-of-use patent
- A patent covering one specific approved use of the drug — not necessarily the whole molecule. A generic can sometimes launch with a “skinny label” that carves out the protected use and keeps the others.
- Skinny label
- A generic label that omits a still-patented use when the FDA allows it — letting a generic reach the market for the unprotected uses.
- Exclusivity
- FDA-granted marketing protection, separate from patents — e.g. 5-yr new chemical entity, 7-yr orphan drug, or a +6-month pediatric extension.
- Paragraph IV
- A generic applicant’s formal challenge to a listed patent. It can potentially lead to earlier generic entry, but often involves litigation or a settlement.
- RLD / RS
- Reference Listed Drug — the brand product the FDA uses as the reference for generic applications. Reference Standard — the product the FDA expects generics to compare against in bioequivalence testing.
- TE / AB rating
- FDA therapeutic-equivalence rating. An AB rating generally means the FDA considers a generic therapeutically equivalent to — and substitutable for — the brand.
- LOE (loss of exclusivity)
- The latest patent or exclusivity currently listed — the loss-of-exclusivity / latest-listed-protection date shown on this page. Paragraph-IV challenges and settlements can move the real date earlier; FDA approval and a manufacturer’s decision to market can move it later.
Built from the FDA Orange Book. The bars above are scaled to each protection’s expiry; the red LOE marker is the last one to lapse.
| Patent | Type | Use code | Expires |
|---|---|---|---|
| US 11213480 ↗ | Drug product | — | Sep 26, 2036 |
| US 11471400 ↗ | Drug product | — | Aug 5, 2036 |
| US 11213480 ↗ | Drug product | — | Sep 26, 2036 |
| US 12257342 ↗ | Drug product | — | Sep 26, 2036 |
| US 11471400 ↗ | Drug product | — | Aug 5, 2036 |
| US 12257342 ↗ | Drug product | — | Sep 26, 2036 |
Is there a generic version of PHENYLEPHRINE 100 MG/10 ML VL?
The FDA approved a generic — why can’t I get it at my pharmacy yet?
Why do different websites show different generic release dates?
What does “FDA listed” mean?
What does a patent or protection date mean here?
What does “current Orange Book estimate” mean?
Can a generic come out before the last patent expires?
Can a generic come out after the listed dates?
What is the difference between patents and exclusivity?
Why are there multiple patent dates?
Where does this data come from?
📦 Packaging — all sizes for this product
| Package NDC | Description | Marketing start | Status |
|---|---|---|---|
| 72572-0570-10 You're viewing this | 10 VIAL, PHARMACY BULK PACKAGE in 1 CARTON (72572-570-10) / 10 mL in 1 VIAL, PHARMACY BULK PACKAGE (72572-570-01) | 2020-12-02 | 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) | — Not published for this NDC CMS reports utilization only for NDCs with Medicaid claims above its privacy threshold. |
Questions about this listing
Why is there no price listed?
Is the NDC printed on the package the same as the 11-digit billing NDC?
What do the three segments of this NDC mean?
Is this package still being marketed?
Who lists this product with the FDA?
Do I need a prescription for this product?
Does this product have a billing J-code?
Where does this data come from?
📄 Full prescribing information FDA SPL
🎯 Indications and Usage ▾
1 INDICATIONS AND USAGE Phenylephrine Hydrochloride is an alpha-1 adrenergic receptor agonist indicated for increasing blood pressure in adults with clinically important hypotension resulting primarily from vasodilation, in such settings as septic shock or anesthesia. Phenylephrine Hydrochloride is an alpha-1 adrenergic receptor agonist indicated for increasing blood pressure in adults with clinically important hypotension resulting primarily from vasodilation, in such settings as septic shock or anesthesia.
⏱️ Dosage and Administration ▾
2 DOSAGE AND ADMINISTRATION Dilute 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 must be diluted before administration as bolus intravenous infusion or continuous intravenous infusion. Inspect the solution for particulate matter and discoloration prior to administration. The diluted solution should not be held for more than 4 hours at room temperature or for more than 24 hours under refrigerated conditions.
Discard any unused portion. During phenylephrine hydrochloride administration: Correct intravascular volume depletion. Correct acidosis.
Acidosis may reduce the effectiveness of phenylephrine.
2.2Preparing a 100 mcg/mL Solution for Bolus Intravenous Administration For bolus intravenous administration, withdraw 10 mg (1 mL of a 10 mg/mL concentration) of phenylephrine hydrochloride injection 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 bolus intravenous administration.
2.3Preparing a Solution for Continuous Intravenous Infusion For continuous intravenous infusion, withdraw 10 mg (1 mL of 10 mg/mL concentration) of phenylephrine hydrochloride injection 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).
2.4Dosing for Perioperative Setting In adult patients undergoing surgical procedures with either neuraxial anesthesia or general anesthesia: 50 mcg to 250 mcg by intravenous bolus administration. The most frequently reported initial bolus dose is 50 mcg or 100 mcg. 0.5 mcg/kg/min to 1.4 mcg/kg/min by intravenous continuous infusion, titrated to blood pressure goal.
2.5Dosing for Septic or Other Vasodilatory Shock 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.
2.6Directions for Dispensing from 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.
2.6Directions for Dispensing from 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.
💊 Dosage Forms and Strengths ▾
3 DOSAGE FORMS AND STRENGTHS Injection: 10 mg/mL phenylephrine hydrochloride is supplied in two vial sizes: 1 mL single dose vial (10 mg of phenylephrine hydrochloride per vial) 10 mL Pharmacy Bulk Package vial (100 mg of phenylephrine hydrochloride per vial) that will provide ten 1 mL single doses Injection: 10 mg/mL supplied as a: 1 mL single dose vial ( 3 , 1 1 , 16 ) 10 mL pharmacy bulk package vial ( 3 , 11 , 16 )
⛔ Contraindications ▾
4 CONTRAINDICATIONS The use of phenylephrine hydrochloride is contraindicated in patients with: Hypersensitivity to it or any of its components Hypersensitivity to it or any of its 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: 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 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 [see Drug Interactions ( 7.1 )] , with the potential for hemorrhagic stroke.
5.6Allergic Reactions This product 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 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 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 Hikma Pharmaceuticals USA Inc. at 1-877-845-0689 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 Pregnancy Category C Animal reproduction studies have not been conducted with intravenous phenylephrine. It is also not known whether phenylephrine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Phenylephrine hydrochloride should be given to a pregnant woman only if clearly needed.
8.2Labor and Delivery The most common maternal adverse reactions reported in studies of phenylephrine use during neuraxial anesthesia during cesarean delivery include nausea and vomiting, which are commonly associated with hypotension, bradycardia, reactive hypertension, and transient arrhythmias. Phenylephrine does not appear to cause a decrease in placental perfusion sufficient to alter either the neonate Apgar scores or blood-gas status.
8.3Nursing Mothers It is not known whether this drug is excreted in human milk.
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, dose-response data indicates increased responsiveness to phenylephrine. Consider using lower doses of phenylephrine hydrochloride in ESRD patients.
🤰 Pregnancy ▾
8.1Pregnancy Pregnancy Category C Animal reproduction studies have not been conducted with intravenous phenylephrine. It is also not known whether phenylephrine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Phenylephrine hydrochloride should be given to a pregnant woman only if clearly needed.
🧒 Pediatric Use ▾
8.3Nursing Mothers It is not known whether this drug is excreted in human milk.
🧓 Geriatric Use ▾
8.4Pediatric Use Safety and effectiveness in pediatric patients have not been established.
🆘 Overdosage ▾
10 OVERDOSAGE Overdose of phenylephrine hydrochloride 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.
🧬 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-1and 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 supplied as follows: NDC 72572-571-25: 1 mL single dose vials packaged in cartons containing 25 vials per carton NDC 72572-570-10: 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 use only; the 10 mL vial is a pharmacy bulk package. The diluted solution should not be held for more than 4 hours at room temperature or for more than 24 hours under refrigerated conditions. Discard any unused portion.
📋 Description ▾
11 DESCRIPTION Phenylephrine hydrochloride is a synthetic sympathomimetic agent in sterile form for parenteral injection. Chemically, phenylephrine hydrochloride is (-)- m -Hydroxy-α-[(methylamino)methyl]benzyl alcohol hydrochloride and has the following structural formula: Phenylephrine hydrochloride is very soluble in water, freely soluble in ethanol, and insoluble in chloroform and ethyl ether. Phenylephrine hydrochloride is sensitive to light.
Phenylephrine Hydrochloride Injection, USP is a clear, colorless, aqueous solution that is essentially free of visible foreign matter. Each mL contains: Phenylephrine Hydrochloride 10 mg; Sodium Chloride 3.5 mg; Sodium Citrate Dihydrate 4 mg; Citric Acid Monohydrate 1 mg; and Sodium Metabisulfite 2 mg in Water for Injection. The pH may be adjusted in the range of 3.0 to 6.5 with Sodium Hydroxide and/or Hydrochloric Acid, if necessary.
Structural Formula
💬 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