Phenylephrine Eye Drops are used as a topical ophthalmic solution to dilate the pupils as in certain local procedures and for the examination of the retina. It may be used as an OTC medicine for bloodshot eyes (allergic conjunctivitis).

Phenylephrine Eye Drops Uses:

• Mydriasis:
  • It is used to dilate the pupils for examination and local procedures.
  • It may be used as an OTC medicine for the symptomatic treatment of patients with red eyes (allergic conjunctivitis).

Phenylephrine Eye Drops Dose in Adults

Phenylephrine Eye Drops Dose in the treatment of Mydriasis:

• Ophthalmic: 2.5% or 10% solution:
  • Instill one drop every 3 to 5 minutes as needed.
  • The maximum dose: 3 drops per eye.
  • If necessary, the dose may be repeated.

Phenylephrine Eye Drops Dose in Childrens

Phenylephrine Eye Drops Dose in the treatment of Mydriasis: Ophthalmic:

• 5% Solution:
  • Infants, Children, and Adolescents:
    • Instill one drop 15 to 30 minutes before a procedure;
    • Administer every 3 to 5 minutes;
    • The maximum total dose is 3 drops per eye.
• 10% Solution:
  • Children and Adolescents:
    • Instill one drop 15 to 30 minutes before a procedure;
    • Administer every 3 to 5 minutes as required;
    • The maximum total dose: 3 drops per eye.

Pregnancy Risk Factor C

• It has not been tested in animal reproduction studies and is therefore classified as pregnancy category C by the manufacturer.
• It is possible for intravenous medication to cross the placental barriers and should not be used during pregnancy. See Phenylephrine Injection.
• The systemic absorption after ophthalmic administration can be minimal and only for short periods.

Use during breastfeeding:

• It is unknown how phenylephrine can be excreted into breast milk. It is recommended that breastfeeding mothers avoid using it.

Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer’s labeling.   

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer’s labeling.   

Side effects of Phenylephrine Eye Drops:

Systemic effects are rare at normal dosages.

• Ophthalmic:
  • Burning Sensation Of Eyes
  • Eye Irritation
  • Miosis (Rebound)
  • Visual Disturbance
  • Vitreous Opacity (Transient)

Contraindications to Phenylephrine Eye Drops:

Solution: 2.5%

• The manufacturer's labeling does not list any contraindications.

Solution 10%

• Hypertension;
• thyrotoxicosis;
• Infants under 1 year old

There may be cross-sensitivity with other formulations.

Warnings and precautions

• Cardiovascular events
  • Although rare, myocardial injury and cardiac arrhythmias have been reported using 10% ophthalmic solution.
  • Preexisting heart conditions, such as those with cardiac medication or elderly patients, may make you more susceptible to adverse effects from the drug.
  • The smallest concentration of the drug (2.5%) should always be used.
• Hypertension:
  • Due to its vasoconstricting effects, significant blood pressure elevations may occur.
  • Patients younger than five years old, those with hyperthyroidism and patients with pre-existing heart disease should be advised to take the drug with caution.
  • Patients with high blood pressure or angina symptoms, as well as those suffering from endocrine disorders such hyperthyroidism, should have their blood pressure checked after treatment.
• Rebound miosis
  • One day after treatment, rebound miosis can occur. Mydriatic effects may be lessened by re-instillation.

Phenylephrine (ophthalmic): Drug Interaction

Monitoring Parameters:

Monitor the response to therapy.   

How to administer Phenylephrine Eye Drops?

Ophthalmic:

• Wash hands before and after instilling the eye drops.
• It is only indicated for topical ophthalmic use. Avoid contamination. Do not touch the tip of the dropper to other surfaces or the eyelids while placing the drops.
• Instill the eye drops into the conjunctival fornix unless otherwise directed.
• Protect eyes from bright light whne the pupils are dilated.

Mechanism of action of Phenylephrine Eye Drops:

• It is a potent alpha-adrenergic antagonist with little to no beta-adrenergic activity. 
• It can be applied topically to cause local vasoconstriction.

The beginning of action:

• Mydriasis: 15 minutes;
• maximal mydriasis: 20 to 90 minutes;
• Time to recover: 3-8 hours

Absorption:

• Minimal systemic absorption.

Time to peak, plasma:

• ≤20 minutes.

International Brand Names of Phenylephrine Eye Drops:

• Altafrin
• Minims Phenylephrine HCl

Phenylephrine Eye Drops Brand Names in Pakistan: