Phenylephrine is an active ingredient that has different uses in over-the-counter (OTC) medicines. When used as a nasal decongestant, phenylephrine relieves a stuffy nose due to the common cold or other ailments. Phenylephrine also shrinks the swelling caused by hemorrhoids. It may be written as phenylephrine or phenylephrine hydrochloride, but it is the same active ingredient.

Phenylephrine can be found in single-ingredient oral nasal decongestant medicines or it can be combined with other ingredients in multi-symptom cold products. Phenylephrine is also available as a single ingredient in topical nasal decongestants. In topical hemorrhoid treatment medicines, phenylephrine is combined with other active ingredients that not only shrink swelling, but also protect irritated skin and relieve additional symptoms such as pain, burning, and itching.

Phenylephrine is approved by the U.S. Food and Drug Administration (FDA) and is safe and effective when used according to the Drug Facts label. Topical nasal decongestants, which are available in both sprays and drops, should be applied directly to the inside of the nose. The medicine dispenser (spray bottle or dropper) should be wiped clean after each use and should not be shared with more than one person to avoid spreading infection.

When Using Nasal Decongestants

  • You have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty urinating due to an enlarged prostate gland.
  • You are pregnant or breastfeeding.
  • You are currently taking a prescription monoamine oxidase inhibitor (MAOI) or you stopped taking an MAOI less than two weeks ago.
  • You are currently taking certain drugs for depression or a psychiatric or emotional condition.
  • Your symptoms last for more than seven days when using an oral medicine containing phenylephrine. Topical nasal decongestants should not be used for more than three days.
  • You get nervous, dizzy, or are unable to sleep while taking an oral medicine with phenylephrine.
  • You take too much. Immediately contact a healthcare provider or the poison control national helpline at 800.222.1222.
  • Do not give an oral nasal decongestant or cough and cold medicine containing phenylephrine to a child under the age of 4.
  • Some topical nasal decongestants may be used in children aged 2 and older. Read the Drug Facts label carefully for accurate dosing information.
  • Do not give any OTC medicine that is only intended for use in adults to a child.
  • Click here for more information on giving OTCs to children.

When Using Hemorrhoid Medicines Containing Phenylephrine

  • Topical hemorrhoid medicines should only be used externally or inserted gently into the rectum.
  • You should not use more than recommended unless a healthcare provider tells you to.
  • You have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty urinating due to an enlarged prostate gland.
  • You are pregnant or breastfeeding.
  • You are taking a prescription medicine for high blood pressure or depression.
  • Bleeding occurs.
  • Your condition gets worse or does not improve within seven days.
  • The insertion of a medicine applicator into the rectum causes additional pain.
  • Topical hemorrhoid medicines are for external or intrarectal use only. If swallowed, immediately contact a healthcare provider or the poison control national helpline at 800.222.1222.
  • Talk to a healthcare provider before using a topical hemorrhoid treatment containing phenylephrine on a child under the age of 12.