Drug General Information (ID: DDIM3G8WIQ)
Drug Name			Phenylephrine (ophthalmic)		Drug Info		Mepenzolate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Mydriatics/Decongestants				Parasympatholytics
Structure

Mechanism of Phenylephrine (ophthalmic)-Mepenzolate Interaction (Severity Level: Moderate)
Additive hypertensive effects Click to Show/Hide Mechanism Graph
Drug Name		Phenylephrine (ophthalmic)				Mepenzolate
Mechanism		Phenylephrine				Enhance the pressor response to phenylephrine
Key Mechanism Factor 1
		Factor Name		Hypertensive effects
		Factor Description		Hypertension is defined as a blood pressure reading above a prescribed limit (130/90 mmHg). Most people with hypertension have no signs or symptoms; others may experience: severe headache, shortness of breath, nosebleeds, severe anxiety, and feeling a tingling sensation in the neck or head.
Mechanism Description		Additive hypertensive effects by the combination of Phenylephrine (ophthalmic) and Mepenzolate

Recommended Action
Management		Caution is advised if phenylephrine (systemic or ophthalmic) is used in combination with atropine or other antimuscarinic agents. Cardiovascular status, including blood pressure and heart rate, should be closely monitored. When using ophthalmic formulations, measures to minimize systemic absorption should be employed, such as digital compression of the lacrimal sac or lid closure after instillation. A milder strength (< 10%) is preferable if phenylephrine ophthalmic solution is given.

References
1	Levine MA, Leenen FH "Role of vagal activity in the cardiovascular responses to phenylephrine in man." Br J Clin Pharmacol 33 (1992): 333-6
2	Daelman F, Andrejak M, Rajaonarivony D, Bryselbout E, Jezraoui P, Ossart M "Phenylephrine eyedrops, systemic atropine and cardiovascular adverse events." Therapie 49 (1994): 467
3	Lai YK "Adverse effect of intraoperative phenylephrine 10%: case report." Br J Ophthalmol 73 (1989): 468-9