Phenylephrine (phenylephrine hydrochloride)

What is phenylephrine?

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.

Phenylephrine can be found in single-ingredient oral nasal decongestant medicines or it can be combined with other ingredients in multi-symptom cold products. 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.

What is phenylephrine used to treat?

  • Nasal congestion
  • Swelling of hemorrhoids
Common brands containing phenylephrine:

For nasal congestion:

  • 4-Way
  • Advil
  • Dimetapp
  • Little Noses
  • Neo-synephrine
  • Robitussin
  • Sudafed
  • Theraflu
  • Triaminic
  • Tronolane
  • Store brands (ex. Walmart’s “Equate” store brand or CVS Health’s store brand)

For hemorrhoids:

  • Preparation H
  • Store brands (ex. Walmart’s “Equate” store brand or CVS Health’s store brand)

How much phenylephrine can you take?

Different types of products containing this active ingredient have different strengths. That’s why it is always important to read and follow the Drug Facts label. Most medicines warn against use of an active ingredient for longer than 7-10 days. Stop use and ask a doctor if symptoms persist.

Safety guide for phenylephrine

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.

Ask a healthcare provider before use if:

For 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.
  • Before giving a topical nasal decongestant in children under 2 years old.
For hemorrhoid medicines:
  • 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.
  • Before using a topical hemorrhoid treatment containing phenylephrine on a child under the age of 12.

Do not use if:

For nasal decongestants:
  • Never use an oral medicine containing phenylephrine at the same time as a topical nasal decongestant that also contains phenylephrine.
  • 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.
  • Do not give an oral 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.

Stop use and ask a doctor if:

For nasal decongestants:
  • 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.
For hemorrhoid medicines:
  • 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.

What are the side effects of phenylephrine?

For nasal decongestants:
  • Using a topical nasal decongestant may cause temporary burning, stinging, sneezing, or an increase of nasal discharge.
For hemorrhoid medicines:
  • Mild pain/stinging may occur.