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Overview: Rectal phenylephrine is used for hemorrhoids. Some rectal phenylephrine products also have other ingredients that act as protectants to also provide relief. Ask your pharmacist if you have questions or need help selecting a product. Stop using rectal phenylephrine and call your health care provider if your symptoms get worse, you do not notice improvement after seven days, or you have bleeding. 

Uses

What is rectal phenylephrine used for?

Rectal phenylephrine is commonly used to reduce swelling, itching, burning, irritation, and discomfort from hemorrhoids or other rectal problems. 

Rectal phenylephrine may also be used for other conditions as determined by your health care provider.

How does rectal phenylephrine work (mechanism of action)?

Rectal phenylephrine causes blood vessels to shrink in the area where it is applied. This helps to reduce swelling and irritation from hemorrhoids or other rectal problems.

How is rectal phenylephrine supplied (dosage forms)?

Brands and other names

  • Preparation H

Dosage forms and strengths

  • 0.25% cream
  • 0.25% ointment
  • 0.25% suppository

Phenylephrine is also available in a form that is applied to the nose or taken by mouth. See Phenylephrine nasal and Phenylephrine for more information.

How should I store rectal phenylephrine?

Store rectal phenylephrine at room temperature, between 68 F and 77 F (20 C and 25 C).

Side Effects

What are the most common side effects of rectal phenylephrine?

Many people using rectal phenylephrine do not have any side effects. Tell your health care provider if you have any side effects that bother you. 

There may be some side effects of rectal phenylephrine that are not mentioned here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of rectal phenylephrine?

While less common, the most serious side effects of rectal phenylephrine are described below, along with what to do if they happen.

Severe Allergic Reactions. Rectal phenylephrine may cause allergic reactions, which can be serious. Stop using rectal phenylephrine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use rectal phenylephrine?

Allergies to Ingredients. People who are allergic to any of the following should not use rectal phenylephrine.

  • Phenylephrine
  • Preparation H
  • Any of the ingredients in the specific product

Your pharmacist can tell you all of the ingredients in the specific rectal phenylephrine products they stock.

What should I know about rectal phenylephrine before using it?

Follow the instructions that come with your medicine. Ask your health care provider if you have any questions about how to use it. 

Some rectal phenylephrine products have other ingredients that act as protectants to also provide relief. These ingredients can include petrolatum, mineral oil, or cocoa butter. Ask your pharmacist if you have questions or need help selecting a product.

Keep rectal phenylephrine out of the reach of children.

Rectal phenylephrine should not be swallowed. It should only be used in the rectal area. 

Stop using rectal phenylephrine and call your health care provider if your symptoms get worse, you do not notice improvement after seven days, or you have bleeding. If the specific product you are using comes with an applicator, you should also stop using it if the applicator causes more pain. If you have concerns, talk with your health care provider. 

If the rectal phenylephrine product you are using comes with a reusable applicator, be sure to wash the applicator with soap and water after each use. Ask your pharmacist if you have any questions. 

What should I tell my health care provider before using rectal phenylephrine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if rectal phenylephrine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Heart disease
  • High blood pressure 
  • Thyroid problems
  • Diabetes
  • Trouble peeing due to a large prostate

Other Medicines and Supplements. Rectal phenylephrine may interact with other medicines and supplements. Before using rectal phenylephrine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how rectal phenylephrine could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if rectal phenylephrine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does rectal phenylephrine interact with foods or drinks?

There are no known interactions between rectal phenylephrine and foods or drinks.

It is unknown if drinking alcohol will affect rectal phenylephrine.

Does rectal phenylephrine interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are taking any medicine to lower your blood pressure before using rectal phenylephrine.

There may be other medicines that can interact with rectal phenylephrine. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much rectal phenylephrine?

If you or someone else has used too much rectal phenylephrine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of rectal phenylephrine?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.