4.5 Interaction with other medicinal products and other forms of interactionĬontraindicated combinations (see section 4.3) This medicine contains 3.4 mmol (78 mg) sodium per vial, equivalent to 4 % of the WHO recommended maximum daily intake of 2 g sodium for an adult. Particular attention should be paid when administering phenylephrine injection to avoid extravasation, since this may cause tissue necrosis. In patients with serious heart failure or cardiogenic shock, phenylephrine may cause deterioration in the heart failure as a consequence of the induced vasoconstriction (increase in afterload). In patients with reduced cardiac output or coronary vascular disease, vital organ functions should be closely monitored and dose reduction should be considered when systemic blood pressure is near the lower end of the target range. Consequently, it must be administered with extreme caution to patients with arteriosclerosis, to elderly and to patients with impaired cerebral or coronary circulation. Phenylephrine can induce a reduction in cardiac output. angina pectoris (phenylephrine can precipitate or exacerbate angina in patients with coronary artery disease and history of angina) non-severe peripheral vascular insufficiency coronary heart disease and chronic heart conditions Phenylephrine should be administered with care to patients with: The arterial blood pressure should be monitored during treatment. This medicine should only be administered by healthcare professionals with appropriate training and relevant experience. Intravenous bolus injection or intravenous infusion. The safety and efficacy of phenylephrine in children have not been established. Treatment of the elderly should be carried out with care. Higher doses of phenylephrine may be needed in patients with cirrhosis of the liver. Lower doses of phenylephrine may be needed in patients with impaired renal function. Doses can be increased up to 100 micrograms/min or reduced in order to maintain systolic blood pressure close to the normal value.ĭoses between 25 and 100 micrograms/min have been considered effective. One bolus dose should not exceed 100 micrograms. Normal dose is 50 to 100 micrograms, which can be repeated until the desired effect is obtained.
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