Question:
sedum41 wrote: > I had racing heart and skipping heart beats when I took Sudafed PE pills > which also has Phenylephrine as an active ingredient. Quite scary to > experience! Probably should have gone to an ER but instead just waited for > it to run its course.
I once made the mistake of taking both Sudafed and a big swig of cough medicine that also had pseudoephedrine in it. So I ended up getting more than twice as much pseudoephedrine dose as you’re supposed to. Not only did I experience the tachycardia and palpitations you’re describing, but I also got chest pains (a sign that my heart wasn’t liking this) and the feeling of "ants crawling on my skin." Scariest night I ever had. — Steven D. Litvintchouk Email: sdlit…@earthlinkNOSPAM.net Remove the NOSPAM before replying to me.
Response:
- Hide quoted text — Show quoted text -augustwestern wrote: > <ryancin…@aol.com> wrote in message > news:1126629657.604072.30970@g49g2000cwa.googlegroups.com… >>I am hoping that someone may be able to provide an answer to my >>question: >>I have been using 4-Way Nasal Spray (Phenylephrine HCL 1%) daily for >>the last 12 years, as a stop gap solution for congestion (which I’ve >>had my entire life) >>I typically use this spray every fifteen minutes, six squirts each >>nostril, and use about four bottles per week. At this point, the >>congestion is obviously terrible. However, that is not my main concern: >>One year ago back on Sept 8, I started to have strange symptoms, >>actually had to go via ambulance to the hospital twice. The symptoms >>are severe tachycardia, skipped beats, severe onset of shortness of >>breath, numbness, tingling, vertigo. They all seemed to come out of >>know where. >>Since, I have had cardiology and pulmonary testing done, but there are >>no answers. The only two things that turned up were a positive ANA and >>elevated Cortisol levels (not autoimmune, no Lupus found). >>I was placed on Atenolol 50 mg for the Tachycardia, which is useless. >>My question is, can the 1% solution of Phenylephrine as found in most >>nasal sprays have caused these symptoms? The doctor says no, but surely >>abusing this stuff cannot be good. Any insight? >>PS: Is Rhinocort any good? >>Best, >>Bill > That is a huge overdosage of Phenylephrine. You’ll need to > taper off and this won’t be easy. Measure and dilute each new bottle you > open by another 10% with saline water and always do the same amount of > squirts (1 or 2) and keep track of exactly how many times a day you use the > spray. Increase the dilution of each new bottle you open by another 10% > until you need to throw away a measured amount of a new bottle in order to > keep increasing dilution. Decrease the frequency of squirts used each day > and keep track so you can always be slowly decreasing frequency.
There is now at least one product on the market, "Rhinostat," specifically designed to assist the process of tapering off nasal sprays: http://nasalspray.com/ I’ve never used it so I don’t know how well it works. But it indicates how common this problem is. — Steven D. Litvintchouk Email: sdlit…@earthlinkNOSPAM.net Remove the NOSPAM before replying to me.
Response:
On 13 Sep 2005 09:40:57 -0700, ryancin…@aol.com wrote: >My question is, can the 1% solution of Phenylephrine as found in most >nasal sprays have caused these symptoms?
Yes Phenylephrine has well-known cardiac side-effects. You do need to get off it. Steven’s posts are exactly correct. The tachycardia is not necessarily of enormous consequence, but anything to do with your heart is more important than other things. >PS: Is Rhinocort any good?
Yes but it alone is probably not enough to deal with the rebound congestion you are going to experience when you start to cut back on the Phenylephrine. You may need a short-course of gradually-decreasing prescribed oral steroids, under the supervision of an ENT, to tide you over when you start cutting back on the Phenylephrine. However, oral steroids should not casually be taken long term as they can have even worse side-effects than the Phenylephrine, so really you will have to plot your course carefully with the help of an ENT, as Steven suggests…..
Response:
I had racing heart and skipping heart beats when I took Sudafed PE pills which also has Phenylephrine as an active ingredient. Quite scary to experience! Probably should have gone to an ER but instead just waited for it to run its course. Later found out I took the wrong dose 2 pills instead of 1 pill like the original Sudafed (Pseudoephedrine) dose. I called the makers of Sudafed and said their packaging was misleading (packed in groups of 2 if you can believe it). I think each person reacts differently to the various decongestants. I can’t believe that the doctor wouldn’t think this contributed to your symptoms. Just look at the package directions and see the warnings! I think the suggestions to do the withdrawal under an ENT’s care sound the most likely for success. Good luck!
Response:
I am hoping that someone may be able to provide an answer to my question: I have been using 4-Way Nasal Spray (Phenylephrine HCL 1%) daily for the last 12 years, as a stop gap solution for congestion (which I’ve had my entire life) I typically use this spray every fifteen minutes, six squirts each nostril, and use about four bottles per week. At this point, the congestion is obviously terrible. However, that is not my main concern: One year ago back on Sept 8, I started to have strange symptoms, actually had to go via ambulance to the hospital twice. The symptoms are severe tachycardia, skipped beats, severe onset of shortness of breath, numbness, tingling, vertigo. They all seemed to come out of know where. Since, I have had cardiology and pulmonary testing done, but there are no answers. The only two things that turned up were a positive ANA and elevated Cortisol levels (not autoimmune, no Lupus found). I was placed on Atenolol 50 mg for the Tachycardia, which is useless. My question is, can the 1% solution of Phenylephrine as found in most nasal sprays have caused these symptoms? The doctor says no, but surely abusing this stuff cannot be good. Any insight? PS: Is Rhinocort any good? Best, Bill
Response:
- Hide quoted text — Show quoted text -ryancin…@aol.com wrote: > I am hoping that someone may be able to provide an answer to my > question: > I have been using 4-Way Nasal Spray (Phenylephrine HCL 1%) daily for > the last 12 years, as a stop gap solution for congestion (which I’ve > had my entire life) > I typically use this spray every fifteen minutes, six squirts each > nostril, and use about four bottles per week. At this point, the > congestion is obviously terrible. However, that is not my main concern: > One year ago back on Sept 8, I started to have strange symptoms, > actually had to go via ambulance to the hospital twice. The symptoms > are severe tachycardia, skipped beats, severe onset of shortness of > breath, numbness, tingling, vertigo. They all seemed to come out of > know where. > Since, I have had cardiology and pulmonary testing done, but there are > no answers. The only two things that turned up were a positive ANA and > elevated Cortisol levels (not autoimmune, no Lupus found). > I was placed on Atenolol 50 mg for the Tachycardia, which is useless. > My question is, can the 1% solution of Phenylephrine as found in most > nasal sprays have caused these symptoms?
Absolutely. Phenylephrine is a stimulant and a vasoconstrictor. With a large enough dose, some of it will get absorbed systemically into your bloodstream right thru your nose (just like snorting cocaine). And it may end up causing both tachycardia and constricting the blood vessels in your heart–which can be disastrous. The symptoms you’re describing fit the combination of overstimulation and vasoconstriction exactly. You’ll have to taper off the phenylephrine. I think you should consult a physician who knows about this problem–the medical name is "rhinitis medicamentosa." He can prescribe a combination of systemic steroids (Medrol) and steroid nasal sprays (e.g., Nasonex) to help you cope with the withdrawal symptom of congestion till your body adjusts. Without these prescription meds, you may not be able to kick the habit on your own–though you can try it and see. Once you’re off the phenylephrine, you should consult an ENT who can finally help cure your congestion so you won’t ever have to go back to phenylephrine anymore. — Steven D. Litvintchouk Email: sdlit…@earthlinkNOSPAM.net Remove the NOSPAM before replying to me.
Response:
<ryancin…@aol.com> wrote in message
news:1126629657.604072.30970@g49g2000cwa.googlegroups.com… – Hide quoted text — Show quoted text -> I am hoping that someone may be able to provide an answer to my > question: > I have been using 4-Way Nasal Spray (Phenylephrine HCL 1%) daily for > the last 12 years, as a stop gap solution for congestion (which I’ve > had my entire life) > I typically use this spray every fifteen minutes, six squirts each > nostril, and use about four bottles per week. At this point, the > congestion is obviously terrible. However, that is not my main concern: > One year ago back on Sept 8, I started to have strange symptoms, > actually had to go via ambulance to the hospital twice. The symptoms > are severe tachycardia, skipped beats, severe onset of shortness of > breath, numbness, tingling, vertigo. They all seemed to come out of > know where. > Since, I have had cardiology and pulmonary testing done, but there are > no answers. The only two things that turned up were a positive ANA and > elevated Cortisol levels (not autoimmune, no Lupus found). > I was placed on Atenolol 50 mg for the Tachycardia, which is useless. > My question is, can the 1% solution of Phenylephrine as found in most > nasal sprays have caused these symptoms? The doctor says no, but surely > abusing this stuff cannot be good. Any insight? > PS: Is Rhinocort any good? > Best, > Bill
The Phenylephrine in 4-way is the obvious culprit and I’m really surprised your Dr didn’t know this. Phenylephrine can cause the exact same symptoms as overusing any stimulant, whether it is coffee or diet pills. 12 hr nose spray isn’t any better but the rebound happens a little quicker with Phenylephrine. I used 4-way for many years in the past, but never at 4 bottles a week. That is a huge overdosage of Phenylephrine. You’ll need to taper off and this won’t be easy. Measure and dilute each new bottle you open by another 10% with saline water and always do the same amount of squirts (1 or 2) and keep track of exactly how many times a day you use the spray. Increase the dilution of each new bottle you open by another 10% until you need to throw away a measured amount of a new bottle in order to keep increasing dilution. Decrease the frequency of squirts used each day and keep track so you can always be slowly decreasing frequency. After you get down to using .05% Phenylephrine or a twentyfold dilution and you are using only 1 squirt at a time, then try stopping entirely or alternating days. Then quit the Phenylephrine completely and don’t buy any more. You may need to use Sudafed for a few weeks while tapering off the Phenylephrine as the rebound will be severe. Also, start using a nasal steroid like Rhinacort or Flonase regularly. If you really stick with it, you can taper yourself off the Phenylephrine in 2-3 months. Suggest you monitor your blood pressure closely while using the Sudafed and see a good ENT to help you develop a better strategy for dealing with your congestion. Read the group FAQ and especially the section about saline nasal irrigation. Regular saline irrigation would be very helpful in getting your nose readjusted to life without Phenylephrine. good luck, AW ps-oral Phenylephrine tablets are now available but you really need a Dr’s advice if you are planning to switch from such a high dose of nasal spray to the tablets – especially considering the heart symptoms that you have already had.
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