Oral decongestants

Jw, McLAURIN; Wf, Shipman; Rosedale, Richard

doi:10.1288/00005537-196101000-00007

Cited by 32 publications

(4 citation statements)

References 3 publications

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“…The standard OTC 10-mg dose of phenylephrine appears to be well tolerated by the majority of people; however, increases in blood pressure and decreases in heart rate are reported with doses over 15 mg [ 6 , 7 ]. It has been estimated that a 20-mmHg increase in systolic blood pressure would occur with an oral dose of 45 mg phenylephrine in normotensive healthy people [ 8 ].…”

Section: Resultsmentioning

confidence: 99%

“…placebo doses ≥10 mg ↓ BP cf. placebo doses ≥15 mg Cohen et al [ 6 ] 10 mg Normotensive participants with nasal congestion ( n = 88) NC BP Conflicting results —20 % of participants showed ↑ BP, while 32 % showed ↓ BP 60 min after administration —30 % of participants showed ↑ HR, while 44 % showed ↓ HR 60 min after administration —Nine participants had ↑HR >10 bpm McLaurin et al [ 7 ] 250 mg Normotensive volunteers ( n = 7) Average ↓ in HR = 21 bpm Average ↑ in BP = 31 mmHg Threshold for pressor response estimated to be 50 mg. Keys and Violante [ 8 ] 45 mg Normotensive volunteers ( n = 4), concurrent MOA inhibitors Significant ↑ in BP Significant ↓ in HR ≥67 mmHg ↑ in BP in two participants administered single 45-mg dose of phenylephrine after 7 days of MOA inhibitor therapy (tranylcypromine or phenelzine). Required intervention with phentolamine.…”

Section: Methodsmentioning

confidence: 99%

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Potential cardiovascular adverse events when phenylephrine is combined with paracetamol: simulation and narrative review

Atkinson

Potts

Anderson

2015

Eur J Clin Pharmacol

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BackgroundIncreased bioavailability of phenylephrine is reported when combined with paracetamol in over-the-counter formulations for the symptomatic treatment of the common cold and influenza. Such formulations could increase phenylephrine-related cardiovascular adverse events particularly in susceptible individuals. Quantification of the effect of phenylephrine concentration on blood pressure allows simulation of potential adverse combination therapy effects.MethodsMEDLINE and EMBASE databases were searched for papers discussing or describing any adverse effect, hypersensitivity or safety concerns related to phenylephrine alone or in combination with other drugs.The pharmacodynamic relationship between plasma phenylephrine concentration and mean arterial blood pressure was characterized using published observations of blood pressure changes after ophthalmic eye drops. The resulting pharmacokinetic and pharmacodynamic parameters were then used to predict mean arterial blood pressure (MAP) changes in that population if given an oral combination of phenylephrine and paracetamol.ResultsThere were 1172 papers identified for examination. Forty-seven reports fulfilled the inclusion criteria. Increases in blood pressure and decreases in heart rate have been reported with doses over 15 mg. It has been estimated that a 20-mmHg increase in systolic blood pressure would occur with an oral dose of 45 mg phenylephrine in normotensive healthy people. Those taking monoamine oxidase inhibitors report increased systolic blood pressure of greater than 60 mmHg. Blood pressure and heart rate changes are potentiated in patients with underlying hypertension. Simulation showed a modest increase in MAP when phenylephrine 10 mg was co-administered with paracetamol 1 g (4.2 vs 12.3 mmHg).ConclusionsCombination paracetamol phenylephrine oral therapy has potential to increase blood pressure more than phenylephrine alone in those with cardiovascular compromise.Electronic supplementary materialThe online version of this article (doi:10.1007/s00228-015-1876-1) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Potential cardiovascular adverse events when phenylephrine is combined with paracetamol: simulation and narrative review

Atkinson

Potts

Anderson

2015

Eur J Clin Pharmacol

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“…Sympathomimetics are currently used in combination with an antihistamine, because the efficacy of each with regard to nasal decongestion is enhanced by the synergism (McLaurin et al, 1961;Aschan, 1974). Roth et al (1977) have demonstrated that pseudoephedrine is an orally effective nasal decongestant and it has now become widely used (Grundfast, 1981).…”

Section: Introductionmentioning

confidence: 99%

A slow release combined preparation (dexchlorpheniramine┼pseudoephedrine) for symptomatic treatment of the common cold

Virtanen

1983

J. Laryngol. Otol.

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“…,3 Stoksted,4 and Mc-Laurin 5,6. The technique that we have developed is essentially a modification of that reported by McLaurin, dependent only upon a pressure transducer and a direct writing recorder.Standard airflow measurements depend upon variations of pressure drop relative to a standard external pressure, an oxygen tank, for example.…”

mentioning

confidence: 99%