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Phenylephrine or neosynephrine is an α-adrenergic receptor agonist used primarily as a decongestant, as an agent to dilate the pupil, and rarely to increase blood pressure. It has the CAS number 61-76-7.

Uses


Decongestant

Phenylephrine is used as a decongestant, available as an oral medicine or as a nasal spray. Phenylephrine is not the most common over-the-counter (OTC) decongestant; oxymetazoline is a more common nasal spray. Pseudoephedrine has generally been a more common oral decongestant, although this is changing; pseudoephedrine's notoriety as a methamphetamine precursor has led governments around the world to restrict its sale.

Oral phenylephrine is extensively metabolised by monoamine oxidase, an enzyme which is present in the stomach and liver. Therefore, compared to orally-taken pseudoephedrine, it has a reduced bioavailability, and is less effective as a nasal decongestant. Because phenylephrine is a direct selective alpha-adrenergic receptor agonist, it does not cause the release of endogeneous noradrenaline like pseudoephedrine does. Therefore, phenylephrine is less likely to cause side-effects like central nervous system stimulation, insomnia, anxiety, irritability and restlessness.

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