Phenylephrine Intravenous for Adults

Who can administer

Administration RESTRICTED - see Appendix 1

Available preparations

Phenylephrine hydrochloride Injection 100micrograms/mL solution for injection/infusion (2mg/20mL)

Phenylephrine hydrochloride pre-filled syringe 50microgram/mL (500micrograms in 10mL)

Reconstitution

Already in solution

Infusion fluids

Not required- already in solution

Methods of intravenous administration

See under 'Dose' for which route of administration to use

Continuous intravenous infusion (administer using an electronically controlled infusion device)

Draw up 3 x 2mg/20mL vials using a 50ml syringe (which has graduations marked up to 60ml)
This solution contains 100micrograms/ml
Titrate dose to response
When an intravenous infusion is discontinued, slow the rate gradually - do not stop it abruptly (ref 1)

Slow intravenous injection (ref 1)

Administer required dose over 3 to 5 minutes

Dose in adults

Severe hypotension and shock - including drug-related hypotension - by continuous intravenous infusion - ICU, CCU, or other critical care areas only
Usual loading dose rate	Initially 25 to 50micrograms/minute (0.25 to 0.5mL/minute using a 100microgram/mL solution)
Usual maintenance dose (once the blood pressure has stabilised at a low normal level for the patient)	25 to 100microgram/minute (0.25 to 1mL/minute using a 100microgram/mL solution), adjusted according to response. This corresponds to 15 to 60ml/hour

Severe hypotension and shock - including drug-related hypotension - by continuous intravenous infusion - ICU, CCU, or other critical care areas only

Usual loading dose rate

Initially 25 to 50micrograms/minute (0.25 to 0.5mL/minute using a 100microgram/mL solution)

Usual maintenance dose (once the blood pressure has stabilised at a low normal level for the patient)

25 to 100microgram/minute (0.25 to 1mL/minute using a 100microgram/mL solution), adjusted according to response.

This corresponds to 15 to 60ml/hour

Acute hypotension - by slow intravenous injection

Dose range 50 to 100micrograms repeated as necessary after at least 15 minutes
Intravenous injections are effective for up to about 20 minutes^{(ref 2)}

Monitoring

Monitor for extravasation
Monitor blood pressure, heart rate, arterial blood gases, central venous pressure

Further information

Can cause extravasation

Storage

Store below 25⁰C

References

Phenylephrine (Aguettant) SPC June 2021
1: Injectable Medicines Administration Guide Medusa- downloaded 16th November 2021

2: Martindale, accessed online via medicinescomplete 2nd Feb 2022

Therapeutic classification

Sympathomimetic vasoconstrictor