• Hypotension/shock:
    • IV bolus 100-500mcg/dose every 10 to 15 minutes as needed
      • Initial dose should not exceed 500mcg
    • IV infusion initially 100-180mcg/min OR5mcg/kg/minute
      • Titrate to desired response.
  • For initial vasoactive management of cardiogenic shock due to aortic stenosis, mitral stenosis or dynamic left ventricular outflow tract (LVOT) obstruction (Off-label):
    • IV 0.1-10mcg/kg/minute
      • Initially dose 0.5-2mcg/kg/minute, titrated to effect
  • Hypotension during anesthesia:
    • IV bolus 40-100mcg/dose every 1-2 minutes as needed
      • Max: 200mcg
    • IV infusion initially 10-35mcg/minute adjusted according to blood pressure goal
      • Not to exceed 200mcg/minute
  • Post-resuscitation stabilization (Off-label)
    • IV 0.5-2mcg/kg/min
  • Rapid sequence intubation adjunct (Off-label)
    • IV 50-100mcg *1
      • Max: 200mcg/total dose
      • For patients with shock or symptomatic hypotension during intubation
  • Priapism (Off-label):
    • 1mL (100-500mcg/mL) intracavernously every 3-5min for up to 1h
    • Max: 1000mcg/h
    • Dilute with normal saline to conc. 100-500mcg/mL
    • Use lower conc. or volume in patients with severe CVD
  • Pre-filled syringe:
    • 50mcg/mL
  • Bolus: Administer every 1-2 minutes as needed
  • Continuous IV infusion: Start infusion rate of 10-35mcg/min; not to exceed 200mcg/min
  • If extravasation occurs:
    • Stop infusion immediately and disconnect (leave cannula/needle in place)
    • Gently aspirate extravasated solution (do not flush the line)
    • Remove needle/cannula
    • Elevate extremity.
    • Initiate phentolamine (or alternative antidote)
    • Apply dry warm compresses

Alpha-Adrenergic Agonist

It causes increased peripheral vascular resistance and blood pressure and decreases cardiac output and renal perfusion

  • Headache
  • Dizziness
  • CNS stimulation
  • Anxiety
  • Palpitations
  • Reflex bradycardia
  • HTN
  • Arrhythmia
  • Tremor
  • Diaphoresis
  • Nausea
  • Vomiting
  • Pruritus
  • Hypersensitivity to drug or ingredient
  • Severe hypertension
  • Ventricular tachycardia
  • Dihydroergotamine
  • Isocarboxazid
  • Phenelzine
  • Iobenguane I 123
  • Linezolid
  • Procarbazine
  • Selegiline transdermal
  • Tranylcypromine

                                   Drug Status

Availability Prescription only
Pregnancy Contraindicated
Breastfeeding Contraindicated
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Phenylephrine 50mcg/mL Pre-Filled Syringe 10mL*10’s Laboratoire Renaudin Phillips Therapeutics