Ocurest AH

An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists.

Menthol (Ocurest AH) is a covalent organic compound made synthetically or obtained from peppermint or other mint oils. It is a waxy, crystalline substance, clear or white in color, which is solid at room temperature and melts slightly above. The main form of Menthol (Ocurest AH) occurring in nature is (-)-Menthol (Ocurest AH), which is assigned the (1R,2S,5R) configuration. Menthol (Ocurest AH) has local anesthetic and counterirritant qualities, and it is widely used to relieve minor throat irritation.

Naphazoline (Ocurest AH) is a rapid acting sympathomimetic vasoconstrictor of occular artierioles. It acts to decrease congestion of the conjunctiva and is found in many over-the-counter eye drops.

Phenylephrine (Ocurest AH) is a sympathomimetic amine that acts predominantly on α-adrenergic receptors. It is mainly used to treat nasal congestion, but may also be useful in treating hypotension and shock, hypotension during spinal anaesthesia, prolongation of spinal anaesthesia, paroxysmal supraventricular tachycardia, symptomatic relief of external or internal hemorrhoids, and to increase blood pressure as an aid in the diagnosis of heart murmurs.

this medicine is indicated for symptomatic control of all allergic conditions responsive to antihistamines, including hay fever, vasomotor rhinitis, urticaria, angioneurotic oedema, food Chlorpheniramine (Ocurest AH), drug and serum reactions, insect bites.

Also indicated for the symptomatic relief of itch associated with chickenpox

Oral

Nasal congestion; Throat irritation

Adult: As a loz (usually in combination with eucalyptus oil or cetylpyridinium chloride): 1 loz every 3 hr, to be sucked slowly.

Child: >6 yr: As a lozenge (usually in combination with eucalyptus oil or cetylpyridinium chloride): 1 lozenge every 3 hr, to be sucked slowly.

Topical/Cutaneous

Muscular aches and pains

Adult: As an ointment/cream (usually in combination with camphor, clove oil or methyl salicylate): Apply and rub gently onto the affected skin areas 2-3 times daily.

Naphazoline (Ocurest AH)® (Naphazoline (Ocurest AH) hydrochloride ophthalmic solution, USP) 0.1% is indicated for use as a topical ocular vasoconstrictor.

Phenylephrine (Ocurest AH) is used for the temporary relief of stuffy nose, sinus, and ear symptoms caused by the common cold, flu, allergies, or other breathing illnesses (e.g., sinusitis, bronchitis). This medication works by decreasing swelling in the nose and ears, thereby lessening discomfort and making it easier to breathe.

Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.

Chlorpheniramine (Ocurest AH) is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Chlorpheniramine (Ocurest AH) is used to treat runny nose, sneezing, itching, and watery eyes caused by allergies, the common cold, or the flu.

Chlorpheniramine (Ocurest AH) may also be used for purposes not listed in this medication guide.

Relieving minor pain caused by conditions such as arthritis, backache, bruising, bursitis, cramping, muscle strains or sprains, and tendonitis. It may also be used for other conditions as determined by your doctor.

Menthol (Ocurest AH) lotion is a topical analgesic. It works by temporarily relieving minor pain.

Naphazoline (Ocurest AH) nasal is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

Naphazoline (Ocurest AH) nasal (for the nose) is for temporary relief of stuffy nose caused by hay fever, allergies, or the common cold.

Naphazoline (Ocurest AH) nasal may also be used for purposes not listed in this medication guide.

Phenylephrine (Ocurest AH) ophthalmic causes constriction of blood vessels in the eyes. It also enlarges the pupils, reduces the production of fluid in the eyes, and increases the amount of fluid that drains from the eyes.

Phenylephrine (Ocurest AH) ophthalmic available over-the-counter is used to relieve redness, burning, irritation, and dryness of the eye caused by wind, sun, and other minor irritants. Prescription-strength Phenylephrine (Ocurest AH) ophthalmic is used to constrict blood vessels in the eye and to dilate (make bigger) the pupil for conditions such as glaucoma, before surgery, and before eye examinations.

Phenylephrine (Ocurest AH) ophthalmic may also be used for purposes other than those listed in this medication guide.

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Liquid,

Oral, as maleate:

Ed ChlorPed: 2 mg/mL (60 mL [DSC]) [contains fd&c red #40, propylene glycol, saccharin sodium, sodium benzoate; cotton candy flavor]

Syrup,

Oral, as maleate:

Chlorpheniramine (Ocurest AH): 2 mg/5 mL (120 mL [DSC]) [contains alcohol, usp, fd&c yellow #6 (sunset yellow), menthol, methylparaben, propylene glycol, propylparaben]

Chlorpheniramine (Ocurest AH): 2 mg/5 mL (120 mL) [contains alcohol, usp]

Ed Chlorped Jr: 2 mg/5 mL (118 mL [DSC], 473 mL) [alcohol free, sugar free; contains fd&c red #40, methylparaben, propylene glycol, propylparaben; cherry flavor]

Tablet,

Oral, as maleate:

Chlorpheniramine (Ocurest AH): 4 mg [scored; contains fd&c yellow #10 aluminum lake]

Chlorpheniramine (Ocurest AH): 4 mg [scored; contains corn starch, fd&c yellow #10 aluminum lake]

Chlorpheniramine (Ocurest AH) Relief: 4 mg [contains fd&c yellow #10 aluminum lake]

Chlorpheniramine (Ocurest AH)-Time: 4 mg [contains fd&c yellow #10 aluminum lake]

Chlorpheniramine (Ocurest AH): 4 mg [scored]

Ed-Chlortan: 4 mg [DSC] [scored; contains fd&c yellow #10 aluminum lake]

Pharbechlor: 4 mg

Generic: 4 mg

Tablet Extended Release,

Oral, as maleate:

Chlorpheniramine (Ocurest AH) Chlorpheniramine (Ocurest AH): 12 mg [contains fd&c blue #2 aluminum lake, fd&c yellow #10 aluminum lake, fd&c yellow #6 aluminum lake]

Chlorpheniramine (Ocurest AH) Chlorpheniramine (Ocurest AH): 12 mg [contains fd&c yellow #6 (sunset yellow), fd&c yellow #6 aluminum lake]

Generic: 12 mg

Dosing: Adult

Allergic symptoms, allergic rhinitis, urticaria, pruritus:

Oral:

Immediate release: 4 mg every 4 to 6 hours; do not exceed 24 mg/24 hours

Extended release: 12 mg every 12 hours; do not exceed 24 mg/24 hours

Motion sickness (off-label use): Immediate release: 4 to 12 mg administered 3 hours prior to initiating stimulus for motion sickness (Buckey 2004). Note: Avoid use if it is unsafe for patient to be sedated.

Dosing: Geriatric

Avoid use (Beers Criteria [AGS 2019]).

Dosing: Pediatric

Note: Safety and efficacy for the use of cough and cold products in infants and young children is limited; the AAP warns against the use of these products for respiratory illnesses in infants and young children; the FDA does not recommend OTC use in infants and children <2 years of age due to the risk of serious and life-threatening adverse effects (including death) and recommends to use with caution in pediatric patients ≥2 years of age (AAP 2018; FDA 2017).

Allergic symptoms:

Oral:

Immediate release:

Oral liquid (2 mg/5 mL):

Children 2 to <6 years: 1 mg every 4 to 6 hours; maximum daily dose: 6 mg/day.

Children 6 to <12 years: 2 mg every 4 to 6 hours; maximum daily dose: 12 mg/day.

Children ≥12 years and Adolescents: 4 mg every 4 to 6 hours; maximum daily dose: 24 mg/day.

Tablets:

Children 6 to <12 years: 2 mg every 4 to 6 hours; maximum daily dose: 12 mg/day.

Children ≥12 years and Adolescents: 4 mg every 4 to 6 hours; maximum daily dose: 24 mg/day.

Extended-release tablet: Children ≥12 years and Adolescents: 12 mg every 12 hours; maximum dose: 24 mg in 24 hours.

Oral

Nasal congestion; Throat irritation

Adult: As a loz (usually in combination with eucalyptus oil or cetylpyridinium chloride): 1 loz every 3 hr, to be sucked slowly.

Child: >6 yr: As a lozenge (usually in combination with eucalyptus oil or cetylpyridinium chloride): 1 lozenge every 3 hr, to be sucked slowly.

Topical/Cutaneous

Muscular aches and pains

Adult: As an ointment/cream (usually in combination with camphor, clove oil or methyl salicylate): Apply and rub gently onto the affected skin areas 2-3 times daily.

Nasal

Nasal congestion

Adult: 1-2 drops or spray of 0.05-0.1% solution every 6 hr.

Child: ≥12 yr: 1-2 drops or spray of 0.05% solution every 6 hr. Therapy should not exceed 3 days.

Ophthalmic

Conjunctival decongestant

Adult: 1-2 drops of 0.1% solution to the conjunctiva every 3-4 hr as needed. Alternatively, 1-2 drops of a 0.01-0.03% solution to the conjunctiva up to 4 times daily.

Prolonged exposure to air or strong light may cause oxidation and discoloration. Do not use if solution is brown or contains a precipitate.

Vasoconstriction and Pupil Dilatation

Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 10 percent ophthalmic solutions are especially useful when rapid and powerful dilatation of the pupil and reduction of congestion in the capillary bed are desired. A drop of a suitable topical anesthetic may be applied, followed in a few minutes by 1 drop of the Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 10 percent ophthalmic solutions on the upper limbus. The anesthetic prevents stinging and consequent dilution of the solution by lacrimation. It may occasionally be necessary to repeat the instillation after one hour, again preceded by the use of the topical anesthetic.

Uveitis: Posterior Synechiae

Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 10 percent ophthalmic solutions may be used in patients with uveitis when synechiae are present or may develop. The formation of synechiae may be prevented by the use of the 10 percent ophthalmic solutions and atropine to produce wide dilatation of the pupil. It should be emphasized, however, that the vasoconstrictor effect of Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride may be antagonistic to the increase of local blood flow in uveal infection.

To free recently formed posterior synechiae, 1 drop of the 10 percent ophthalmic solutions may be applied to the upper surface of the cornea. On the following day, treatment may be continued if necessary. In the interim, hot compresses should be applied for five or ten minutes three times a day, with 1 drop of a 1 or 2 percent solution of atropine sulfate before and after each series of compresses.

Glaucoma

In certain patients with glaucoma, temporary reduction of intraocular tension may be attained by producing vasoconstriction of the intraocular vessels; this may be accomplished by placing 1 drop of the 10 percent ophthalmic solutions on the upper surface of the cornea. This treatment may be repeated as often as necessary.

Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride may be used with miotics in patients with wide angle glaucoma. It reduces the difficulties experienced by the patient because of the small field produced by miosis, and still it permits and often supports the effect of the miotic in lowering the intraocular pressure. Hence, there may be marked improvement in visual acuity after using Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride in conjunction with miotic drugs.

Surgery

When a short-acting mydriatic is needed for wide dilatation of the pupil before intraocular surgery, the 10 percent ophthalmic solutions or 2.5 percent ophthalmic solution may be applied topically from 30 to 60 minutes before the operation.

Refraction

Prior to determination of refractive errors, Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 2.5 percent ophthalmic solution may be used effectively with homatropine hydrobromide, atropine sulfate, or a combination of homatropine and cocaine hydrochloride.

For adults, a drop of the preferred cycloplegic is placed in each eye, followed in five minutes by 1 drop of Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 2.5 percent ophthalmic solution and in ten minutes by another drop of the cycloplegic. In 50 to 60 minutes, the eyes are ready for refraction.

For children, a drop of atropine sulfate 1 percent is placed in each eye, followed in 10 to 15 minutes by 1 drop of Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 2.5 percent ophthalmic solution and in five to ten minutes by a second drop of atropine sulfate 1 percent. In one to two hours, the eyes are ready for refraction.

For a “one application method,” Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 2.5 percent ophthalmic solution may be combined with a cycloplegic to elicit synergistic action. The additive effect varies depending on the patient. Therefore, when using a “one application method,” it may be desirable to increase the concentration of the cycloplegic.

Ophthalmoscopic Examination

One drop of Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 2.5 percent ophthalmic solution is placed in each eye. Sufficient mydriasis to permit examination is produced in 15 to 30 minutes. Dilatation lasts from one to three hours.

Diagnostic Procedures

Provocative Test for Angle Block in Patients with Glaucoma: The 2.5 percent ophthalmic solution may be used as a provocative test when latent increased intraocular pressure is suspected. Tension is measured before application of Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride and again after dilatation. A 3 to 5 mm of mercury rise in pressure suggests the presence of angle block in patients with glaucoma; however, failure to obtain such a rise does not preclude the presence of glaucoma from other causes.

Shadow Test (Retinoscopy): When dilatation of the pupil without cycloplegic action is desired for the shadow test, the 2.5 percent ophthalmic solution may be used alone.

Blanching Test: One or 2 drops of the 2.5 percent ophthalmic solution should be applied to the injected eye. After five minutes, examine for perilimbal blanching. If blanching occurs, the congestion is superficial and probably does not indicate iritis.

How supplied

In Mono-Drop ® plastic dropper bottle: Low surface tension solutions

2.5 percent ophthalmic solution - Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 2.5 percent in a sterile, isotonic, buffered, low surface tension vehicle with sodium phosphate, sodium biphosphate, boric acid, and, as antiseptic preservative, benzalkonium chloride, NF, 1:7500. The pH is adjusted with phosphoric acid or sodium hydroxide. Bottles of 15 mL (NDC 0024-1358-01).

10 percent ophthalmic solution- Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 10 percent in a sterile, buffered, low surface tension vehicle with sodium phosphate, sodium biphosphate, and, as antiseptic preservative, benzalkonium chloride 1:10,000. The pH is adjusted with phosphoric acid or sodium hydroxide. Bottles of 5 mL (NDC 0024-1359-01).

Viscous solution

10 percent ophthalmic solution- Phenylephrine (Ocurest AH) (Phenylephrine (Ocurest AH) hydrochloride ophthalmic solution) hydrochloride 10 percent in a sterile, buffered, viscous vehicle with sodium phosphate, sodium biphosphate, methylcellulose, and, as antiseptic preservative, benzalkonium chloride 1:10,000. The pH is adjusted with phosphoric acid or sodium hydroxide. Bottles of 5 mL (NDC 0024-1362-01).

Store at 25° C (77° F); excursions permitted to 15° - 30° C (59° - 86° F)

Manufactured for Sanofi-Synthelabo Inc. New York, NY 10016 by Abbott Laboratories North Chicago, IL 60064. Revised September 1999. FDA revision date: n/a

See also:
What is the most important information I should know about Chlorpheniramine (Ocurest AH)?

Hypersensitivity to Chlorpheniramine (Ocurest AH) maleate or any component of the formulation; narrow-angle glaucoma; bladder neck obstruction; symptomatic prostate hypertrophy; during acute asthmatic attacks; stenosing peptic ulcer; pyloroduodenal obstruction. Avoid use in premature and term newborns due to possible association with SIDS.

OTC labeling: When used for self-medication, do not use to make a child sleep

See also:
What is the most important information I should know about Menthol (Ocurest AH)?

Not to be used in

No known conditions.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an Menthol (Ocurest AH). If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

See also:
What is the most important information I should know about Naphazoline (Ocurest AH)?

Naphazoline (Ocurest AH)® ophthalmic solution is contraindicated in the presence of an anatomically narrow angle or in narrow-angle glaucoma or in persons who have shown hypersensitivity to any component of this preparation.

See also:
What is the most important information I should know about Phenylephrine (Ocurest AH)?

Do not touch the dropper to any surface, including the eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in the eye.

If you wear contact lenses, remove them before applying Phenylephrine (Ocurest AH) ophthalmic. Ask your doctor if contact lenses can be reinserted after application of the medication. Phenylephrine (Ocurest AH) ophthalmic may contains preservative (benzalkonium chloride), which may cause discoloration of contact lenses.

Do not use Phenylephrine (Ocurest AH) ophthalmic more often or continuously for longer than 48 to 72 hours without consulting a doctor. Chronic use of this medication may damage the blood vessels (veins and arteries) in the eyes. Consult a doctor if your symptoms do not improve or appear to worsen.

Use caution when driving, operating machinery, or performing other hazardous activities. Phenylephrine (Ocurest AH) ophthalmic may cause blurred vision. If you experience blurred vision, avoid these activities.

Use Chlorpheniramine (Ocurest AH) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Chlorpheniramine (Ocurest AH) may be taken with or without food.
• Shake well before using.
• Use the dropper that comes with Chlorpheniramine (Ocurest AH) to measure your dose. Ask your pharmacist for help if you are unsure of how to measure your dose.
• If you miss a dose of Chlorpheniramine (Ocurest AH), take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Chlorpheniramine (Ocurest AH).

Use Menthol (Ocurest AH) spray as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Wash your hands before and right after using Menthol (Ocurest AH) spray.
• Spray Menthol (Ocurest AH) spray directly onto the affected area. Do not rub or massage the medicine into the skin.
• Do not wrap, bandage, or use a heating pad on the treated area.
• Do not apply Menthol (Ocurest AH) spray more than 4 times daily.
• If you miss a dose of Menthol (Ocurest AH) spray, use it as soon as you remember. Continue to use it as directed by your doctor or on the package label.

Ask your health care provider any questions you may have about how to use Menthol (Ocurest AH) spray.

Use Naphazoline (Ocurest AH) drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Naphazoline (Ocurest AH) drops is for use in the eye only. Avoid contact with the nose, mouth, or other mucous membranes.
• To use Naphazoline (Ocurest AH) drops, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.
• To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including your eye. Keep the container tightly closed.
• If you miss a dose of Naphazoline (Ocurest AH) drops and you are using it regularly, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Ask your health care provider any questions you may have about how to use Naphazoline (Ocurest AH) drops.

Use Phenylephrine (Ocurest AH) drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Phenylephrine (Ocurest AH) drops is for use in the eye only. Avoid contact with the nose or mouth.
• To use Phenylephrine (Ocurest AH) drops, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.
• To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including your eye. Keep the container tightly closed.
• Do not wear contact lenses while you are using Phenylephrine (Ocurest AH) drops. Sterilize contact lenses according to the manufacturer's directions and check with your doctor before using them.
• Do not use Phenylephrine (Ocurest AH) drops if it is brown or contains particles.
• If you miss a dose of Phenylephrine (Ocurest AH) drops, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Phenylephrine (Ocurest AH) drops.

Use: Labeled Indications

Allergic symptoms, allergic rhinitis, urticaria, pruritus: Perennial and seasonal allergic rhinitis and other allergic symptoms including urticaria, pruritus

Off Label Uses

Motion sickness

Data from a limited number of patients studied suggests that Chlorpheniramine (Ocurest AH) may be beneficial in the treatment of motion sickness. Additional data may be necessary to further define its role in this condition.

Pharmaceutical Aid

Naphazoline (Ocurest AH) is a decongestant used to relieve redness, puffiness, and itchy/watering eyes due to colds, allergies, or eye irritations (smog, swimming, or wearing contact lenses). It is known as a sympathomimetic (alpha receptor agonist) that works in the eye to decrease congestion.

Some brands of Naphazoline (Ocurest AH) eye drops also contain other ingredients. Lubricants (such as glycerin, hypromellose, or polyethylene glycol 300) help protect the eyes from more irritation. Zinc sulfate, an astringent, helps reduce redness and irritation.

How to use Naphazoline (Ocurest AH) ophthalmic

Follow all directions on the product package, or use as directed by your doctor. If you are uncertain about any of the information, consult your doctor or pharmacist.

To apply eye drops, wash your hands first. To avoid contamination, do not touch the dropper tip or let it touch your eye or any other surface.

Remove contact lenses before applying the eye drops. Wait at least 10 minutes after using this medication before inserting contact lenses.

Before using, check this product visually. Do not use if the liquid has changed color or is cloudy. Use in affected eye(s) as directed.

Tilt your head back, look upward, and pull down the lower eyelid to make a pouch. Hold the dropper directly over the eye and place 1 drop into the pouch. Look downward and gently close your eyes for 1 to 2 minutes. Place one finger at the corner of the eye near the nose and apply gentle pressure. This will prevent the medication from draining away from the eye. Try not to blink and do not rub the eye. Repeat these steps if your dose is for more than 1 drop and for the other eye if so directed.

Do not rinse the dropper. Replace the dropper cap tightly after each use.

If you are using another kind of eye medication (e.g., drops or ointments), wait at least 5 minutes before applying other medications. Use eye drops before eye ointments to allow the eye drops to enter the eye.

Overuse of this type of medication may result in increased eye redness (rebound hyperemia). Tell your doctor if this occurs or if your condition persists or worsens after 48 hours. If you develop eye pain/vision changes or think you may have a serious medical problem, seek immediate medical attention

Use: Labeled Indications

Hypotension/shock: Treatment of hypotension, vascular failure in shock. Note: Not recommended for routine use in the treatment of septic shock; use should be limited until more evidence demonstrating positive clinical outcomes becomes available (Rhodes 2017).

Guideline recommendations:

Cardiogenic shock: The 2017 American Heart Association (AHA) scientific statement for the Contemporary Management of Cardiogenic Shock recommends Phenylephrine (Ocurest AH), if needed, be considered for initial vasoactive management of cardiogenic shock due to aortic stenosis, mitral stenosis, or dynamic left ventricular outflow tract (LVOT) obstruction (AHA [van Diepen 2017]).

Hypotension during anesthesia: As a vasoconstrictor in regional analgesia

Nasal congestion: As a decongestant [OTC]

Off Label Uses

Hypotension in patients with obstructive hypertrophic cardiomyopathy

Phenylephrine (Ocurest AH) is a pure alpha1 agonist that will increase systemic vascular resistance without increasing heart rate or contractility. This is advantageous in patients with obstructive hypertrophic cardiomyopathy and hypotension since increases in both heart rate and contractility may cause the obstruction to worsen, leading to a decrease in cardiac output. Other vasopressors like dopamine, epinephrine, and norepinephrine may increase contractility and/or heart rate. Additional trials may be necessary to further define the role of Phenylephrine (Ocurest AH) in this condition.

Based on the American Urological Association guidelines for the management of priapism, due to the low risk of cardiovascular side effects intracavernous injection of Phenylephrine (Ocurest AH) is recommended for ischemic priapism that persists following aspiration/irrigation.

See also:
What other drugs will affect Chlorpheniramine (Ocurest AH)?

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray), antispasmodics (e.g., atropine, belladonna alkaloids), drugs for Parkinson's disease (e.g., anticholinergics such as benztropine, trihexyphenidyl), scopolamine, tricyclic antidepressants (e.g., amitriptyline).

Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, amitriptyline, trazodone). Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.

Chlorpheniramine (Ocurest AH) is very similar to dexchlorpheniramine. Do not use medications containing dexchlorpheniramine while using Chlorpheniramine (Ocurest AH).

This medication may interfere with certain laboratory tests (including Chlorpheniramine (Ocurest AH) skin testing), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Tell your doctor of any over-the-counter or prescription medication you may take including: blood thinners.

Do not start or stop any medicine without doctor or pharmacist approval.

See also:
What other drugs will affect Naphazoline (Ocurest AH)?

If you are using this product under your doctor's direction, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

Before using this product, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: other eye medications.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

See also:
What other drugs will affect Phenylephrine (Ocurest AH)?

Acetaminophen: May increase the serum concentration of Phenylephrine (Ocurest AH) (Systemic). Monitor therapy

Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1-Agonists may antagonize Alpha1-Blocker vasodilation. Monitor therapy

AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy

Benzylpenicilloyl Polylysine: Alpha1-Agonists may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Consider use of a histamine skin test as a positive control to assess a patient's ability to mount a wheal and flare response. Consider therapy modification

Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. Monitor therapy

Chloroprocaine: May enhance the hypertensive effect of Phenylephrine (Ocurest AH) (Systemic). Monitor therapy

CloZAPine: May diminish the therapeutic effect of Phenylephrine (Ocurest AH) (Systemic). Monitor therapy

Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Consider therapy modification

Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Monitor therapy

Ergot Derivatives: May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline. Avoid combination

FentaNYL: Alpha1-Agonists may decrease the serum concentration of FentaNYL. Specifically, fentanyl nasal spray serum concentrations may decrease and onset of effect may be delayed. Monitor therapy

Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Monitor therapy

Hyaluronidase: May enhance the vasoconstricting effect of Phenylephrine (Ocurest AH) (Systemic). Management: Avoid the use of hyaluronidase to enhance dispersion or absorption of Phenylephrine (Ocurest AH). Use of hyaluronidase for other purposes in patients receiving Phenylephrine (Ocurest AH) may be considered as clinically indicated. Avoid combination

Iobenguane Radiopharmaceutical Products: Alpha1-Agonists may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Avoid combination

Ioflupane I 123: Phenylephrine (Ocurest AH) (Systemic) may diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Consider therapy modification

Monoamine Oxidase Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Exceptions: Linezolid. Avoid combination

Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Management: Concomitant use of ozanimod with sympathomimetic agents is not recommended. If combined, monitor patients closely for the development of hypertension, including hypertensive crises. Consider therapy modification

Propacetamol: May increase the serum concentration of Phenylephrine (Ocurest AH) (Systemic). Management: Monitor patients closely for increased side effects of Phenylephrine (Ocurest AH) if propacetamol is used concomitantly. Patients with underlying blood pressure issues or arrhythmias may need closer monitoring and may warrant consideration of alternative therapies. Monitor therapy

Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Monitor therapy

Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy

Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy

Tricyclic Antidepressants: May enhance the therapeutic effect of Alpha1-Agonists. Tricyclic Antidepressants may diminish the therapeutic effect of Alpha1-Agonists. Monitor therapy

See also:
What are the possible side effects of Chlorpheniramine (Ocurest AH)?

Applies to Chlorpheniramine (Ocurest AH): capsules, controlled-release capsules, suspension drops, sustained-release capsules, syrup, tablets

Other dosage forms:

• suspension

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; dry mouth, nose, or throat; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur while taking Chlorpheniramine (Ocurest AH) (the active ingredient contained in Chlorpheniramine (Ocurest AH) (Chlorpheniramine (Ocurest AH)))

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, lightheadedness, or headache; tremor; trouble sleeping; vision changes.

See also:
What are the possible side effects of Menthol (Ocurest AH)?

May cause hypersensitivity reactions such as cutaneous dermatitis. Ingestion of large amount of Menthol (Ocurest AH) may cause GI effects such as severe abdominal pain, nausea, vomiting, vertigo, ataxia, drowsiness and coma.

See also:
What are the possible side effects of Naphazoline (Ocurest AH)?

Stinging, redness, widened pupils, or blurred vision may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: dizziness, nausea, sweating, drowsiness, weakness, nervousness, worsening redness/itching/swelling in or around the eyes.

Tell your doctor right away if any of these rare but very serious side effects occur: eye pain, other vision problems, headache, decrease in body temperature, irregular heartbeat.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

See also:
What are the possible side effects of Phenylephrine (Ocurest AH)?

Applies to Phenylephrine (Ocurest AH): intravenous solution

In addition to its needed effects, some unwanted effects may be caused by Phenylephrine (Ocurest AH) (the active ingredient contained in Phenylephrine (Ocurest AH)). In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking Phenylephrine (Ocurest AH), check with your doctor or nurse immediately:

Incidence not known:

• Blurred vision
• chest pain or discomfort
• difficult or labored breathing
• dizziness
• fainting
• fast, slow, or irregular heartbeat
• headache
• nausea or vomiting
• nervousness
• pain in the shoulders, arms, jaw, or neck
• pounding in the ears
• sweating
• tightness in the chest
• unusual tiredness

If any of the following symptoms of overdose occur while taking Phenylephrine (Ocurest AH), get emergency help immediately:

Symptoms of overdose:

• Feeling of fullness in the head
• pounding or rapid pulse
• tingling in the arms or legs
• vomiting

Minor Side Effects

Some of the side effects that can occur with Phenylephrine (Ocurest AH) may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not known:

• Heartburn
• itching skin
• nausea
• pain in the neck
• pain or discomfort in chest, upper stomach, or throat