α1-adrenoceptor agonist (vasopressor)
Phenylephrine hydrochloride
Brand names: Boots Decongestant, Sudafed PE
Adult dose
Dose: IV bolus: 50–100 micrograms (peri-operative). Infusion: 25–500 micrograms/min titrated. Nasal congestion: 10mg PO QDS
Route: IV/PO/Topical
Frequency: per indication
Clinical pearls
- Peri-operative hypotension, septic shock (alternative to noradrenaline)
- Pure α-agonist — useful when chronotropy undesired
Contraindications
- Severe hypertension
- Severe coronary artery disease
- Concurrent MAOI
Side effects
- Hypertension
- Reflex bradycardia
- Reduced cardiac output (high doses)
- Headache
- Tissue necrosis if extravasation
Interactions
- MAOIs
- TCAs
- Sympathomimetics
Monitoring
- BP
- HR
- Cardiac output
Reference: BNF; AAGBI; SSC 2021; https://bnf.nice.org.uk/drugs/phenylephrine-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines