Propylhexedrine (Monograph)

Brand name: Benzedrex
Drug class: Vasoconstrictors

Medically reviewed by Drugs.com on May 10, 2025. Written by ASHP.

Introduction

Vasoconstrictor; α-adrenergic sympathomimetic amine that is structurally related to amphetamine.

Uses for Propylhexedrine

Nasal Congestion

Self-medication for temporary relief of nasal congestion due to cold, hay fever, or other upper respiratory allergies (allergic rhinitis).

When administered intranasally, reduces swelling and inflammation of the nasal mucosa.

Intended only for short-term use; prolonged use may cause worsening or recurrence of nasal congestion.

Propylhexedrine Dosage and Administration

Administration

Intranasal Administration

Administer topically to the nasal mucosa as an inhalation.

Inhaler is for single-patient use only.

Use in children 6–12 years of age should be under adult supervision.

Dosage

Benzedrex propylhexedrine inhaler delivers 0.4–0.5 mg of the drug in each 800 mL of air.

Pediatric Patients

Nasal Congestion

Intranasal

Children ≥6 years of age: 2 inhalations (0.4–0.5 mg) in each nostril no more than every 2 hours.

Do not use for more than 3 days; if symptoms are not improved after 3 consecutive days, consult a clinician.

Adults

Nasal Congestion

Intranasal

2 inhalations (0.4–0.5 mg) in each nostril no more than every 2 hours.

Do not use for more than 3 days; if symptoms are not improved after 3 consecutive days, consult a clinician.

Special Populations

No special populations dosage recommendations at this time.

Cautions for Propylhexedrine

Warnings/Precautions

Adverse Nasal Effects

May cause transient burning, stinging, sneezing, or increased nasal discharge. Frequent or prolonged use may cause nasal congestion to worsen or recur.

Administration Precautions

Use propylhexedrine only as directed. Do not exceed the recommended dosage and duration of use.

Use of propylhexedrine inhaler by more than one individual may spread infection.

Abuse and Misuse

Abuse and misuse of propylhexedrine reported, particularly by routes other than nasal inhalation (e.g., oral ingestion, injection). Serious cardiac and psychiatric events, including death, have occurred.

Reported adverse effects were generally related to sympathomimetic effects of the drug. In some cases, life-threatening effects resulted in hospitalization, ICU admission, or death.

Propylhexedrine is safe and effective when used as directed in accordance with the Drug Facts label.

In the event of a suspected overdose, determine whether a patient used propylhexedrine alone or with other substances. No specific reversal agent is available; management is symptomatic and supportive.

Specific Populations

Pregnancy

Patients who are pregnant should consult their clinician prior to use.

Lactation

Patients who are breastfeeding should consult their clinician prior to use.

Pediatric Use

Safety and efficacy not established in children <6 years of age.

Common Adverse Effects

Burning, stinging, sneezing, increase in nasal discharge.

Stability

Storage

Intranasal

Inhaler

Inhaler should be tightly closed and stored at 15–30°C.

Inhaler is effective for a minimum of 3 months after first use.

Actions

• A potent α-adrenergic sympathomimetic amine that is structurally related to amphetamine.

• Acts as a local vasoconstrictor by antagonizing α- and β-adrenergic receptors in the mucosa of the respiratory tract; when administered intranasally, decreases swelling and inflammation of the mucous membrane lining the nasal passages.

Advice to Patients

• Advise patients to discontinue propylhexedrine and consult a clinician if nasal congestion persists.

• Inform patients that overuse of the nasal inhaler may cause nasal congestion to worsen or recur.

• Advise patients to avoid contamination of the inhaler. To minimize risk of spreading infections, do not share inhaler with other individuals.

• Advise patients to inform their clinician if they are or plan to become pregnant or plan to breast-feed.

• Advise patients to inform their clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses.

• Inform patients of other important precautionary information.

Additional Information

The American Society of Health-System Pharmacists, Inc. represents that the information provided in the accompanying monograph was formulated with a reasonable standard of care, and in conformity with professional standards in the field. Readers are advised that decisions regarding use of drugs are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and that the information contained in the monograph is provided for informational purposes only. The manufacturer’s labeling should be consulted for more detailed information. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information contained in the monograph is not a substitute for medical care.

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

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