Phenylephedrine for Pharmacy Techs

Phenylephedrine is now the most commonly used decongestant medication in the United States.

It gained popularity after many states began to heavily restrict and regulate the use of pseudoephedrine due to its use in manufacturing illegal drugs.

This has led to phenylephedrine replacing pseudoephedrine in almost every major brand of decongestant available in the United States. Pseudoephedrine-based decongestants are still available, but sales are usually restricted and monitored. Photo ID is typically required to purchase pseudoephedrine.

Partial List of Brands Containing Phenylephedrine in the US

This is a partial list of brands that use phenylephedrine in the United States:

  • Advil Congestion Relief
  • Sudafed PE Non-Drowsy Nasal Decongestant
  • Robitussin CF
  • Dayquil Capsules
  • Tylenol Sinus
  • Theraflu

Phenylephedrine-based decongestants are most commonly used to relieve sinus congestion from colds and allergies.

Anytime someone is having difficulty breathing through their nose because of congestion, a phenylephedrine-based decongestant is likely to help provide them with some relief.

It is used for the treatment of nasal and sinus congestion, not chest congestion.

How Phenylephedrine-Based Decongestants Work in the Human Body

It functions as a decongestant because it is a vasoconstrictor. This means that it constricts blood vessels and reduces blood flow to the nasal passages, which will slow down the production of mucus.

In common terms, taking it will help 'dry you up.' And because it's not a stimulant like pseudoephedrine, it doesn't have side effects like insomnia and irritability.

The specific difference between phenylephedrine and pseudoephedrine has to do with how they get metabolized by the body.

When they get metabolized, phenylephedrine does not cause the release of endogenous noradrenaline, while pseudoephedrine does. This is why pseudoephedrine has the properties of a stimulant and affects the nervous system.

The most common side effect of phenylephedrine is hypertension or high blood pressure.

Avoid If You Have High Blood Pressure

Patients that already have high blood pressure should almost always avoid this OTC product and find another decongestant to use when they need one.

There has been some debate over the effectiveness of phenylephedrine - based decongestants.

Several studies had initial findings that were inconclusive as to whether or not they outperformed a placebo.

Phenylephedrine is less powerful than pseudoephedrine, which is why pseudoephedrine was much more widely used until recently.

Currently, this debate is still unresolved. Some doctors and pharmacists feel that phenylephedrine isn't a powerful enough decongestant. The other side maintains that it is a slightly weaker but safer replacement for pseudoephedrine.

Background History on Phenylephedrine

Phenylephedrine was approved by the FDA for use as a decongestant in 1976, but it has only gained popularity for that function recently.

It is also used as an eye drop to dilate the pupil and as a vasopressor to help increase the blood pressure of unstable patients.

These types of uses of phenylephedrine were much more common until it became popular as a replacement for pseudoephedrine in decongestant products.

Phenylephedrine has been off patent for a long time, so it's a compound that every company had cheap and easy access to.

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