From the Guidelines
Phenylephrine should be dosed at 100 to 500 mg/ml for intracavernous injections in adult patients, with 1 ml injections made every 3 to 5 minutes for approximately 1 hour, as recommended by the American Urological Association guideline on the management of priapism 1. When considering the dose of Phenylephrine (PE), it's essential to prioritize the context in which it is being used.
Key Considerations
- The dose of Phenylephrine can vary significantly depending on the specific use case, such as intracavernous injections for priapism or intravenous administration for hypotension.
- For intracavernous injections, the recommended concentration is 100 to 500 mg/ml, with a volume of 1 ml injected every 3 to 5 minutes, as stated in the American Urological Association guideline 1.
- In other contexts, such as hypotension, the dose may be different, but the provided evidence does not support a specific dose for this indication.
Important Details
- The American Urological Association guideline provides clear recommendations for the dose of Phenylephrine in the context of priapism management 1.
- Lower concentrations and smaller volumes should be used in children and patients with severe cardiovascular disease, as stated in the guideline 1.
- It's crucial to consider the patient's specific condition and medical history when determining the appropriate dose of Phenylephrine.
Additional Context
- While other studies, such as the 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, provide information on vasoactive drugs, including Phenylephrine 1, they do not supersede the recommendations from the American Urological Association guideline for the specific context of priapism management.
- The dose of Phenylephrine for hypotension may vary, but the provided evidence does not support a specific recommendation for this indication.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Phenylephrine Hydrochloride Injection 10 mg/mL: MUST BE DILUTED before administration. (2.1) Dosing for Perioperative Hypotension - Intravenous bolus administration: 50 mcg to 250 mcg (2.4) - Intravenous continuous infusion: 0.5 mcg/kg/minute to 1.4 mcg/kg/minute titrated to effect (2.4) Dosing for Patients with Vasodilatory Shock - Intravenous continuous infusion: 0.5 mcg/kg/minute to 6 mcg/kg/minute titrated to effect (2.5)
The dose of Phenylephrine (PE) is:
- Intravenous bolus administration: 50 mcg to 250 mcg
- Intravenous continuous infusion for Perioperative Hypotension: 0.5 mcg/kg/minute to 1.4 mcg/kg/minute
- Intravenous continuous infusion for Vasodilatory Shock: 0.5 mcg/kg/minute to 6 mcg/kg/minute 2, 2
From the Research
Dose of Phenylephrine (PE)
- The dose of Phenylephrine (PE) is typically 10 mg, as studied in several research papers 3, 4, 5, 6
- However, some studies have also investigated the efficacy of higher doses, such as 20 mg, 30 mg, and 40 mg 6
- One study found that Phenylephrine 10 mg was significantly more effective than placebo at reducing nasal airway resistance (NAR) in adults with acute nasal congestion due to the common cold 3
- Another study found that Phenylephrine 25 mg showed a significant reduction in maximal NAR compared with placebo, but there was no consistent effect on heart rate or blood pressure for doses of 25 mg or less 4
- A study on the efficacy of loratadine-montelukast on nasal congestion in patients with seasonal allergic rhinitis found that Phenylephrine 10 mg was not significantly better than placebo in relieving nasal congestion 5
- A systematic review and meta-analysis of nasal decongestants in monotherapy for the common cold found that the evidence for the effectiveness of Phenylephrine was limited, and the clinical relevance of its small effect was unknown 7
- A randomized, open-label, placebo-controlled study found that Phenylephrine HCl, at doses of up to 40 mg every 4 hours, was not significantly better than placebo at relieving nasal congestion in adults with seasonal allergic rhinitis 6