PHENYLEPHRINE (Ophthalmic)

Some commonly used brand names are:

In the U.S.—

• Ak-Dilate
• Ak-Nefrin
• Dilatair
• I-Phrine
• Isopto Frin
• Mydfrin
• Neofrin
• Neo-Synephrine
• Ocugestrin
• Ocu-Phrin Sterile Eye Drops
• Ocu-Phrin Sterile Ophthalmic Solution
• Phenoptic
• Prefrin Liquifilm
• Relief Eye Drops for Red Eyes

In Canada—

• Ak-Dilate
• Dionephrine
• Minims Phenylephrine
• Mydfrin
• Prefrin Liquifilm
• Spersaphrine

Generic name product may be available in the U.S.

• Decongestant, ophthalmic
• Diagnostic aid, mydriatic
• Mydriatic

Ophthalmic phenylephrine (fen-ill-EF-rin) in strengths of 2.5 and 10% is used to dilate (enlarge) the pupil. It is used before eye examinations, before and after eye surgery, and to treat certain eye conditions. In the U.S., these preparations are available only with your doctor's prescription.

Ophthalmic phenylephrine in the strength of 0.12% is used to relieve redness due to minor irritations of the eye, such as those caused by allergy, dust, smoke, wind, and other irritants. This preparation is available without a prescription; however, your doctor may have special instructions on the proper use of phenylephrine for your eye problem.

Phenylephrine is available in the following dosage form:

• Ophthalmic
• Ophthalmic solution (eye drops) (U.S. and Canada)

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For phenylephrine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to phenylephrine or to sulfites. Also tell your health care professional if you are allergic to any other substances, such as preservatives.

Pregnancy—Ophthalmic phenylephrine may be absorbed into the body. However, studies on effects in pregnancy have not been done in either humans or animals.

Breast-feeding—Ophthalmic phenylephrine may be absorbed into the mother's body. However, it is not known whether phenylephrine passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Children may be especially sensitive to the effects of phenylephrine. This may increase the chance of side effects during treatment. In addition, the 10% strength is not recommended for use in infants. Also, the 2.5 and 10% strengths are not recommended for use in low birth weight infants.

Older adults—Repeated use of 2.5 or 10% phenylephrine may increase the chance of problems during treatment with this medicine. In addition, heart and blood vessel problems have occurred more often in elderly patients than in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of phenylephrine. Make sure you tell your doctor if you have any other medical problems, especially:

• Type 2 diabetes mellitus or
• Heart or blood vessel disease or
• High blood pressure—The 2.5 and 10% strengths of phenylephrine may make the condition worse

• Idiopathic orthostatic hypotension (a certain kind of low blood pressure)—Use of this medicine may cause a large increase in blood pressure to occur

Do not use if the solution turns brown or becomes cloudy.

To use:

• First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 2 or 3 minutes to allow the medicine to be absorbed by the eye.
• Immediately after using the eye drops, wash your hands to remove any medicine that may be on them.
• To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed.

For patients using the 2.5 or 10% eye drops :

• It is very important that you use this medicine only as directed . Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of too much medicine being absorbed into the body and the chance of side effects. This is especially important when this medicine is used in children or in patients with heart disease or high blood pressure , since high doses of this medicine may cause an irregular heartbeat and an increase in blood pressure.

Dosing—The dose of ophthalmic phenylephrine will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of ophthalmic phenylephrine. If your dose is different, do not change it unless your doctor tells you to do so.

• For ophthalmic solution (eye drops) dosage form:
  • For eye redness:
    • Adults and children—Use one drop of 0.12% solution every three or four hours as needed.
  • For eye exams:
    • Adults and children—Use one drop of 2.5% solution. Depending on the eye test to be done, it will take from fifteen minutes to one or two hours for the medicine to work before you can have the eye test.
  • For use before eye surgery:
    • Adults and teenagers—Use one drop of 2.5 or 10% solution thirty to sixty minutes before the start of eye surgery.
    • Children—Use one drop of 2.5% solution thirty to sixty minutes before the start of eye surgery.
  • For certain eye conditions:
    • Adults and teenagers—Depending on the eye condition being treated, your doctor may tell you to use one drop of 2.5 or 10% solution in the eye from once a day to three times a day.
    • Children—Depending on the eye condition being treated, your doctor may tell you to use one drop of 2.5% solution in the eye from once a day to three times a day.

Missed dose—If you are using the 2.5 or 10% eye drops and you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

If eye pain or change in vision occurs or if redness or irritation of the eye continues, gets worse, or lasts for more than 72 hours, stop using the medicine and check with your doctor .

For patients using the 2.5 or 10% eye drops :

• After you apply this medicine to your eyes, your pupils will become unusually large. This will cause your eyes to become more sensitive to light than they are normally. When you go out during the daylight hours, even on cloudy days, wear sunglasses that block ultraviolet (UV) light to protect your eyes from sunlight and other bright lights . Ordinary sunglasses may not protect your eyes. If you have any questions about the kind of sunglasses to wear, check with your doctor. Also, if this effect continues for longer than 12 hours after you have stopped using this medicine, check with your doctor.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Symptoms of too much medicine being absorbed into the body—Less common with 10% solution; rare with 2.5% or weaker solution

Dizziness; fast, irregular, or pounding heartbeat; increased sweating; increase in blood pressure; paleness; trembling

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common with 2.5 or 10% solution

Burning or stinging of eyes; headache or browache; sensitivity of eyes to light; watering of eyes

Less common

Eye irritation not present before use of this medicine

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 10/2/2000

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