Phenylephrine
Dosing in kidney impairment
Renal Impairment In patients with end stage renal disease (ESRD), dose-response data indicate increased responsiveness to phenylephrine. Consider starting at the lower end of the recommended dose range, and adjusting dose based on the target blood pressure goal.
Dosing in liver impairment
Hepatic Impairment In patients with liver cirrhosis [Child Pugh Class B and Class C], dose-response data indicate decreased responsiveness to phenylephrine. Start dosing in the recommended dose range but more phenylephrine may be needed in this population.
Preparation and administration
General Dosage and Administration Instructions Phenylephrine hydrochloride Injection, 10 mg/mL must be diluted before administration as an intravenous bolus or continuous intravenous infusion to achieve the desired concentration: · Bolus : Dilute with normal saline or 5% dextrose in water. · Continuous infusion : Dilute with normal saline or 5% dextrose in water.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Do not use if the solution is colored or cloudy, or if it contains particulate matter. The diluted solution should not be held for more than 4 hours at room temperature or for more than 24 hours under refrigerated conditions.
Discard any unused portion. During Phenylephrine hydrochloride Injection administration: · Correct intravascular volume depletion. · Correct acidosis. Acidosis may reduce the effectiveness of phenylephrine.
Prepare a 100 mcg/mL Solution for Bolus Intravenous Administration For bolus intravenous administration, prepare a solution containing a final concentration of 100 mcg/mL of Phenylephrine hydrochloride Injection: · Withdraw 10 mg (1 mL of 10 mg/mL) of Phenylephrine hydrochloride Injection and dilute with 99 mL of 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP. · Withdraw an appropriate dose from the 100 mcg/mL solution prior to bolus intravenous administration.
Prepare a Solution for Continuous Intravenous Administration For continuous intravenous infusion, prepare a solution containing a final concentration of 20 mcg/mL of Phenylephrine hydrochloride Injection in 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP: · Withdraw 10 mg (1 mL of 10 mg/mL) of Phenylephrine hydrochloride Injection and dilute with 500 mL of 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP.