phenylephrine and witch hazel topical

Action and Spectrum

Actions and spectrum: 

phenylephrine and witch hazel topical is a combination medication commonly used for its actions as a vasoconstrictor and astringent. phenylephrine constricts blood vessels, reducing swelling and inflammation, while witch hazel has astringent properties that help tighten and soothe the skin.

This combination is often used topically to relieve minor skin irritations, itching, and hemorrhoids. Its spectrum of action primarily targets the affected skin areas and associated symptoms. 

Drug Interaction

Adverse Reaction

None 

Black Box Warning

Black Box Warning: 

There is no specific black box warning associated with the use of phenylephrine and witch hazel topical. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Known hypersensitivity or allergy to phenylephrine, witch hazel, or any other ingredients in the product. 
• Open wounds or broken skin in the area of application. 
• Severe skin conditions or dermatitis. 
• Inflammatory skin conditions like eczema or psoriasis.

Caution: 

• Avoid contact with eyes or mucous membranes. If accidental contact occurs, rinse thoroughly with water. 
• Do not apply to large areas of the body or use for an extended period without medical advice. 
• Discontinue use if excessive skin irritation or allergic reactions occur. 
• Use with caution in individuals with known allergies or sensitivities to similar medications or ingredients. 
• Keep out of reach of children.

Comorbidities: 

• Skin conditions: If you have any pre-existing skin conditions such as eczema, psoriasis, or dermatitis, it is important to consult with a healthcare professional before using phenylephrine and witch hazel topical to ensure it is safe and appropriate for your specific condition. 
• Allergies: If you have a known allergy or sensitivity to phenylephrine, witch hazel, or any other ingredients in the product, it is important to avoid using it to prevent allergic reactions. 
• Other medical conditions: If you have any other medical conditions, it is important to consult with a healthcare professional before using phenylephrine and witch hazel topical. 

Pregnancy / Lactation

Pregnancy consideration: Pregnancy Category: C 

Lactation: excreted into human milk: unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

phenylephrine is a sympathomimetic drug that acts as a selective alpha-1 adrenergic receptor agonist. When applied topically, phenylephrine causes vasoconstriction (narrowing of blood vessels) in the skin, leading to reduced swelling and redness. 

witch hazel, on the other hand, is a natural astringent which is derived from the leaves and bark of the witch hazel plant. It acts as anti-inflammatory agent and can help to soothe irritated skin. 

When combined in a topical preparation, phenylephrine, and witch hazel work together to provide relief from minor skin irritations, itching, and swelling. The vasoconstrictive effect of phenylephrine helps reduce blood flow to the affected area, while the astringent properties of witch hazel help tighten and tone the skin.  

Pharmacodynamics: 

The pharmacodynamics of phenylephrine and witch hazel topical involve their specific actions on the skin and blood vessels. phenylephrine acts as a selective alpha-1 adrenergic receptor agonist. When applied topically, it binds to alpha-1 adrenergic receptors on smooth muscle cells of the blood vessels in the skin. This binding leads to vasoconstriction, causing the blood vessels to narrow. As a result, blood flow to the area is reduced, which can help decrease swelling and redness. 

witch hazel, on the other hand, has astringent properties. It contains tannins that have the ability to tighten and constrict tissues. When applied topically, witch hazel acts as a mild astringent, causing the skin to contract and shrink. This can help reduce inflammation, soothe irritated skin, and provide relief from itching. 

The combination of phenylephrine and witch hazel in a topical formulation allows for a synergistic effect. phenylephrine’s vasoconstrictive action reduces blood flow to the area, while witch hazel’s astringent properties help tighten and tone the skin.  

Pharmacokinetics: 

Absorption 

When applied topically, phenylephrine and witch hazel can be absorbed through the skin. The extent of absorption can depend on factors such as skin integrity, application site, formulation, and individual variation. 

Distribution 

After absorption, the components of the topical preparation may distribute to the surrounding tissues. phenylephrine may have systemic effects if a significant amount is absorbed into the bloodstream. witch hazel is primarily distributed locally in the skin. 

Metabolism 

phenylephrine undergoes metabolism primarily in the liver, where it is metabolized by enzymes such as monoamine oxidase (MAO). The metabolites are then excreted primarily in the urine. witch hazel is not extensively metabolized. 

Elimination and excretion 

phenylephrine and its metabolites are primarily excreted in the urine. witch hazel, being a topical agent, does not undergo significant systemic excretion. 

Adminstartion

Administration: 

• Clean the affected area: Before applying the topical preparation, make sure the skin is clean and dry. Gently wash affected area with mild soap and water and pat it dry. 
• Apply a thin layer: Take a small amount of the topical preparation and apply it to the affected area. Use your fingers or a clean applicator to spread the product evenly over the skin. 
• Massage or gently rub: Depending on the instructions, you may be advised to massage or gently rub the product into the skin. This helps facilitate absorption and ensures even distribution. 
• Follow dosing instructions: Pay attention to the recommended frequency and duration of use provided with the specific product. 
• Avoid contact with eyes, mucous membranes, or open wounds: phenylephrine and witch hazel topical preparations are meant for external use only. Avoid applying them near the eyes, inside the nose or mouth, or on open wounds or broken skin. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: phenylephrine and witch hazel topical 

Pronounced: (fen-il-EF-rin/ WITCH HAY-zel)  

Why do we use phenylephrine and witch hazel topical? 

• Hemorrhoid relief: They can help reduce itching, swelling, and discomfort associated with hemorrhoids. 
• Skin irritation and inflammation: They may be used to soothe and calm skin irritations, such as minor cuts, scrapes, insect bites, and rashes. 
• Skin toner: witch hazel is known for its astringent properties, and when combined with phenylephrine, it can be used as a facial toner to help tighten pores and reduce oiliness. 
• Skin cleansing: witch hazel has gentle cleansing properties and can be used as part of a skincare routine to remove excess oil, dirt, and impurities from the skin. 
• Sore muscle relief: When applied topically, these preparations may provide temporary relief from muscle aches and pains.