ibuprofen + phenylephrine hydrochloride: clinical use

Prescribing considerations

• Confirm that both an NSAID and systemic decongestant are appropriate and that symptoms include congestion.
• Review cardiovascular, gastrointestinal, renal, hepatic and asthma risks, hydration and concurrent medicines.
• Older people are more susceptible to NSAID-associated gastrointestinal bleeding and perforation.
• The combination may mask fever and pain from infection; reassess persistent or worsening symptoms.

Contraindications and cautions

• Hypersensitivity to either ingredient, excipients, aspirin or another NSAID
• Previous NSAID-associated bronchospasm, rhinitis, angioedema or urticaria
• Active or recurrent peptic ulceration, gastrointestinal haemorrhage, or previous NSAID-related bleeding or perforation
• Hypertension, severe coronary or cardiovascular disease, severe heart, renal or hepatic failure
• Hyperthyroidism, phaeochromocytoma or prostatic enlargement
• Current or recent MAOI treatment
• Concurrent NSAID or COX-2 inhibitor use
• Third trimester of pregnancy

Monitoring

• Assess blood pressure and cardiovascular symptoms where risk factors or interacting medicines are present.
• Consider renal function and hydration in older, dehydrated or renally vulnerable patients and with ACE inhibitors, angiotensin-receptor blockers or diuretics.
• Watch for gastrointestinal bleeding, fluid retention, bronchospasm, severe skin reactions and persistent infection symptoms.

Clinical pharmacology

Ibuprofen is a propionic-acid NSAID that inhibits prostaglandin synthesis and reversibly inhibits platelet aggregation. Phenylephrine is a postsynaptic alpha-receptor agonist that reduces nasal mucosal oedema through vasoconstriction; oral bioavailability is limited by first-pass metabolism.

Formulation and product differences

• The selected preparation is a yellow film-coated oral tablet marked with an identifying motif.
• It contains Sunset Yellow E110, which may cause allergic reactions.
• The formulation is described as essentially sodium-free.

Tablet

Route: Oral

Strengths: 200 mg + 5 mg