Indication
Phenylephrine Hydrochloride injection is indicated for the treatment of clinically important
hypotension resulting primarily from vasodilation in the setting of anesthesia.
Dosage & Administration
Dosing for treatment of hypotension during anesthesia: The recommended initial dose is
40 to 100 mcg administered by intravenous bolus. Additional boluses may be
administered every 1-2 minutes as needed; not to exceed a total dosage of 200 mcg in a
single administration. Do not use if the solution is colored or cloudy or if it contains
particulate matter. Discard any unused portion.
Use in Special Populations
Pregnancy: Data from randomized controlled trials and meta-analyses with
Phenylephrine injection use in pregnant women during caesarean section have not
established a drug-associated risk of major birth defects and miscarriage. There are no
data on the use of Phenylephrine during the first or second trimester.
Lactation: There are no data on the presence of Phenylephrine injection or its metabolite
in human or animal milk, the effects on the breastfed infant, or the effects on milk
production.
Precautions
Exacerbation of Angina, Heart Failure, or Pulmonary Arterial Hypertension: Because of
its increasing blood pressure effects, Phenylephrine can precipitate angina in patients
with severe arteriosclerosis or history of angina, exacerbate underlying heart failure, and
increase pulmonary arterial pressure.
Bradycardia: Phenylephrine can cause severe bradycardia and decreased cardiac
output.
Renal Toxicity: Phenylephrine can increase the need for renal replacement therapy in
patients with septic shock. Monitor renal function.
