Matching articles for "phenylephrine"

Ophthalmic Phentolamine (Ryzumvi) for Drug-Induced Mydriasis

   
The Medical Letter on Drugs and Therapeutics • June 24, 2024;  (Issue 1705)
The FDA has approved a 0.75% ophthalmic solution of the alpha-adrenergic antagonist phentolamine (Ryzumvi – Viatris) for treatment of mydriasis produced by adrenergic agonists such as phenylephrine or...
The FDA has approved a 0.75% ophthalmic solution of the alpha-adrenergic antagonist phentolamine (Ryzumvi – Viatris) for treatment of mydriasis produced by adrenergic agonists such as phenylephrine or parasympatholytic agents such as tropicamide in patients ≥3 years old. Ryzumvi is the first drug to be approved in the US for reversal of pharmacologically induced mydriasis.
Med Lett Drugs Ther. 2024 Jun 24;66(1705):100-1 | Show Full IntroductionHide Full Introduction

Drugs for Allergic Rhinitis and Allergic Conjunctivitis

   
The Medical Letter on Drugs and Therapeutics • April 19, 2021;  (Issue 1622)
The choice of drugs for treatment of allergic rhinitis depends on the severity of symptoms and whether they are intermittent or persistent (see Table...
The choice of drugs for treatment of allergic rhinitis depends on the severity of symptoms and whether they are intermittent or persistent (see Table 1).
Med Lett Drugs Ther. 2021 Apr 19;63(1622):57-64 | Show Full IntroductionHide Full Introduction

OTC Drugs for Seasonal Allergies

   
The Medical Letter on Drugs and Therapeutics • April 22, 2019;  (Issue 1570)
Patients with seasonal allergies often experience nasal itching and congestion, sneezing, rhinorrhea, and itchy, watery eyes. Oral, intranasal, and ophthalmic preparations are widely available over the...
Patients with seasonal allergies often experience nasal itching and congestion, sneezing, rhinorrhea, and itchy, watery eyes. Oral, intranasal, and ophthalmic preparations are widely available over the counter (OTC) for relief of symptoms. Prescription products for management of allergic rhinitis and allergic conjunctivitis are reviewed separately.
Med Lett Drugs Ther. 2019 Apr 22;61(1570):57-60 | Show Full IntroductionHide Full Introduction

Drugs for Cough

   
The Medical Letter on Drugs and Therapeutics • December 17, 2018;  (Issue 1562)
Acute cough (<3 weeks in duration) generally does not require pharmacologic treatment, especially in children. Suppression of productive cough may be harmful. Management of patients with cough...
Acute cough (<3 weeks in duration) generally does not require pharmacologic treatment, especially in children. Suppression of productive cough may be harmful. Management of patients with cough should include elimination of any precipitating factor (e.g., cigarette smoking) and treatment of any underlying cause such as upper airway cough syndrome, gastroesophageal reflux disease, asthma, or other pulmonary disease.
Med Lett Drugs Ther. 2018 Dec 17;60(1562):206-8 | Show Full IntroductionHide Full Introduction

FDA Warns Against Use of Codeine and Tramadol in Children and Breastfeeding Women

   
The Medical Letter on Drugs and Therapeutics • May 22, 2017;  (Issue 1521)
The FDA has issued new warnings about the use of the opioid analgesics codeine and tramadol in children, particularly those...
The FDA has issued new warnings about the use of the opioid analgesics codeine and tramadol in children, particularly those <12 years old, and in breastfeeding women due to concerns about the risk of respiratory depression and death. The FDA previously issued warnings about these drugs in 2013 and 2015.
Med Lett Drugs Ther. 2017 May 22;59(1521):86-8 | Show Full IntroductionHide Full Introduction

Drugs for Allergic Disorders

   
The Medical Letter on Drugs and Therapeutics • May 8, 2017;  (Issue 1520)
Allergic rhinitis can be classified as seasonal, perennial, or episodic. It is often associated with allergic conjunctivitis, rhinosinusitis, and asthma. H1-ANTIHISTAMINES — Oral – Oral...
Allergic rhinitis can be classified as seasonal, perennial, or episodic. It is often associated with allergic conjunctivitis, rhinosinusitis, and asthma.

H1-ANTIHISTAMINES — Oral – Oral second-generation H1-antihistamines are the preferred first-line treatment for relief of the itching, sneezing, and rhinorrhea that characterize mild-to-moderate allergic rhinitis. They are less effective for nasal congestion.
Med Lett Drugs Ther. 2017 May 8;59(1520):71-82 | Show Full IntroductionHide Full Introduction

In Brief: Oral Phenylephrine for Nasal Congestion

   
The Medical Letter on Drugs and Therapeutics • December 21, 2015;  (Issue 1484)
In 2007, an FDA advisory committee asked that placebo-controlled, dose-ranging trials be conducted to establish the efficacy of the oral decongestant phenylephrine (Sudafed PE, and others), which is sold over...
In 2007, an FDA advisory committee asked that placebo-controlled, dose-ranging trials be conducted to establish the efficacy of the oral decongestant phenylephrine (Sudafed PE, and others), which is sold over the counter (OTC) as a single agent and in combination with other drugs for treatment of cold and allergy symptoms. Phenylephrine replaced pseudoephedrine (Sudafed, and others) in many OTC formulations when access to pseudoephedrine-containing products was restricted in an effort to reduce their use in the synthesis of methamphetamine.

CLINICAL STUDIES — In a randomized, open-label, dose-ranging trial in 539 patients with seasonal allergic rhinitis, phenylephrine doses up to four times the recommended dose of 10 mg were no more effective than placebo in reducing symptomatic nasal congestion.1 Other recent studies have also found oral phenylephrine no more effective than placebo in reducing nasal congestion.2-4

ALTERNATIVES – Oral pseudoephedrine reduces nasal congestion, but has no effect on other symptoms such as sneezing, itching, or rhinitis, and tolerance to its effects can occur with repeated use. Potential adverse effects include insomnia, excitability, headache, nervousness, anorexia, palpitations, tachycardia, arrhythmias, hypertension, nausea, vomiting, and urinary retention. Pseudoephedrine should be used cautiously in patients with cardiovascular disease, hypertension, diabetes, hyperthyroidism, narrow-angle glaucoma, or bladder neck obstruction.

Intranasal decongestants such as oxymetazoline (Afrin, and others) are effective and less likely than pseudoephedrine to cause systemic adverse effects, but they can cause stinging, burning, sneezing, dryness of the nose and throat, and, if used for more than 3-5 consecutive days, rebound congestion (rhinitis medicamentosa). Intranasal corticosteroids are the most effective drugs available for prevention and relief of nasal congestion and other seasonal allergic rhinitis symptoms.5

CONCLUSION — Oral phenylephrine is not effective for treatment of nasal congestion.

  1. EO Meltzer et al. Oral phenylephrine HCl for nasal congestion in seasonal allergic rhinitis: a randomized, open-label, placebo-controlled study. J Allergy Clin Immunol Pract 2015; 3:702.
  2. EO Meltzer at al. Phenylephrine hydrochloride modified-release tablets for nasal congestion: a randomized, placebo-controlled trial in allergic rhinitis patients. Ann Allergy Asthma Immunol 2015 November 7 (epub).
  3. F Horak et al. A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber. Ann Allergy Asthma Immunol 2009; 102:116.
  4. JH Day et al. Efficacy of loratadine-montelukast on nasal congestion in patients with seasonal allergic rhinitis in an environmental exposure unit. Allergy Asthma Immunol 2009; 102:328.
  5. Drugs for allergic disorders. Treat Guidel Med Lett 2013; 11:43.


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Med Lett Drugs Ther. 2015 Dec 21;57(1484):174 | Show Full IntroductionHide Full Introduction

Drugs for Allergic Disorders

   
The Medical Letter on Drugs and Therapeutics • May 1, 2013;  (Issue 129)
The use of drugs to prevent and control symptoms of allergic disorders can be optimized when patients avoid exposure to specific allergens and/or environmental conditions that trigger or worsen their...
The use of drugs to prevent and control symptoms of allergic disorders can be optimized when patients avoid exposure to specific allergens and/or environmental conditions that trigger or worsen their symptoms.
Treat Guidel Med Lett. 2013 May;11(129):43-52 | Show Full IntroductionHide Full Introduction

Vasopressors and Inotropes

   
The Medical Letter on Drugs and Therapeutics • November 14, 2011;  (Issue 1377)
The main purpose of vasopressors is to raise arterial blood pressure, while that of inotropes is to increase cardiac contractility. The choice of drugs is dictated by the clinical setting. Controlled trials...
The main purpose of vasopressors is to raise arterial blood pressure, while that of inotropes is to increase cardiac contractility. The choice of drugs is dictated by the clinical setting. Controlled trials comparing the efficacy and safety of these drugs are generally lacking.
Med Lett Drugs Ther. 2011 Nov 14;53(1377):90-2 | Show Full IntroductionHide Full Introduction

Drugs for Allergic Disorders

   
The Medical Letter on Drugs and Therapeutics • August 1, 2007;  (Issue 60)
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, anaphylaxis and asthma (reviewed in Treatment Guidelines 2005; 3:33 and not included here), are prevalent worldwide, especially in...
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, anaphylaxis and asthma (reviewed in Treatment Guidelines 2005; 3:33 and not included here), are prevalent worldwide, especially in industrialized countries. Pharmacologic treatment of these disorders continues to improve in efficacy and safety. In addition to using drugs to prevent and control the symptoms of their allergic diseases, patients should also be instructed to avoid, if possible, specific allergens and/or environmental conditions that trigger or worsen their symptoms.
Treat Guidel Med Lett. 2007 Aug;5(60):71-80 | Show Full IntroductionHide Full Introduction

Drugs for Allergic Disorders

   
The Medical Letter on Drugs and Therapeutics • November 1, 2003;  (Issue 15)
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria and anaphylaxis, along with asthma (reviewed in Treatment Guidelines 2002; 1:7 and not included here), have increased in prevalence...
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria and anaphylaxis, along with asthma (reviewed in Treatment Guidelines 2002; 1:7 and not included here), have increased in prevalence during the past 30 years and are now epidemic worldwide, especially in industrialized countries. Many safe and effective drugs are currently available for prevention and relief of symptoms in these disorders, but pharmacological treatment alone may not be sufficient. Patients should also be instructed to avoid specific allergens or environmental conditions that trigger their symptoms. Allergen-specific immunotherapy, parenteral administration of gradually increasing doses of the allergen ("allergy shots"), has been effective in allergic rhinitis, allergic conjunctivitis and allergic asthma, and also in prevention of anaphylaxis triggered by stings from bees, yellow jackets, hornets and wasps. It has not been effective in food allergy, atopic dermatitis or urticaria.
Treat Guidel Med Lett. 2003 Nov;1(15):93-100 | Show Full IntroductionHide Full Introduction

Cardiovascular Drugs in the ICU

   
The Medical Letter on Drugs and Therapeutics • December 1, 2002;  (Issue 4)
Ever-increasing specialization has made it difficult for many physicians to keep up with therapeutic standards in intensive-care units (ICUs). This issue of Treatment Guidelines offers current recommendations...
Ever-increasing specialization has made it difficult for many physicians to keep up with therapeutic standards in intensive-care units (ICUs). This issue of Treatment Guidelines offers current recommendations for use of cardiovascular drugs in the ICU for treatment of hypertensive emergencies; shock, cardiac arrest or decompensated heart failure; and ventricular arrhythmias.
Treat Guidel Med Lett. 2002 Dec;0(4):19-24 | Show Full IntroductionHide Full Introduction

Phenylpropanolamine and Other OTC Alpha-Adrenergic Agonists

   
The Medical Letter on Drugs and Therapeutics • December 11, 2000;  (Issue 1094)
The US Food and Drug Administration has ordered removal of phenylpropanolamine from over-the-counter cold remedies and weight loss aids. The FDA based its decision on a recent study showing an increased risk of...
The US Food and Drug Administration has ordered removal of phenylpropanolamine from over-the-counter cold remedies and weight loss aids. The FDA based its decision on a recent study showing an increased risk of hemorrhagic stroke in young women taking the drug.
Med Lett Drugs Ther. 2000 Dec 11;42(1094):113 | Show Full IntroductionHide Full Introduction

The Viralizer For The Common Cold

   
The Medical Letter on Drugs and Therapeutics • January 27, 1989;  (Issue 784)
Recently, full-page advertisements have appeared in the New York Times and other newspapers promoting the Viralizer (Viral Response Systems, Greenwich, CT), a heated nebulizer-sprayer device marketed for...
Recently, full-page advertisements have appeared in the New York Times and other newspapers promoting the Viralizer (Viral Response Systems, Greenwich, CT), a heated nebulizer-sprayer device marketed for treatment of colds, sore throats, allergy and sinusitis symptoms. The device is available without a prescription for about $30 to $40.
Med Lett Drugs Ther. 1989 Jan 27;31(784):8 | Show Full IntroductionHide Full Introduction