Phenylephrine is one of the ingredients found in most of the over-the-counter (OTC) nasal decongestants. It is also used to manage hypotension during cesarean delivery under spinal anesthesia (1). But is phenylephrine safe while pregnant? Read on as MomJunction answers this and a few other questions regarding the safety of phenylephrine during pregnancy.
Are Phenylephrine-containing Decongestants Safe During Pregnancy?
It is not clearly known if phenylephrine in oral decongestants can cross the placenta and affect the fetus. But its vasoconstricting property might constrict uterine blood vessels, which may cause birth defects. However, when administered intranasally, for localized effect, phenylephrine carries less risk than when given systemically (2).
Some studies state that the use of phenylephrine as a decongestant in the first trimester might slightly increase the risk of birth defects. However, many cohort studies and a Swedish population-based study failed to replicate these results (3).
Another case study supported the hypothesis that the use of phenylephrine as a nasal decongestant in the first trimester increased the risk of endocardial cushion defect (2). However, this study did not find any association of first-trimester exposure to phenylephrine and ear, eye defects, and club foot. The studies concluded that the rise in the risk is relatively small.
There are thus no adequate studies to prove if maternal use of phenylephrine during pregnancy could cause serious birth defects. A medical resource paper by the American Academy of Family Physicians states that decongestants should be used sparingly during pregnancy until further research is done (4). So, always check with your doctor before using a nasal decongestant containing phenylephrine.
Phenylephrine As A Vasopressor During Pregnancy
Phenylephrine (Vazculep) is also used to treat hypotension.
The US Food and Drug Administration (FDA) classified intravenous phenylephrine as a Pregnancy Category C drug. It states that there are no adequate studies to determine the safety of intravenous phenylephrine during pregnancy. So, your doctor would prescribe it only when the potential benefits outweigh the risks (5).
A comparative study done between phenylephrine and ephedrine stated that “from the limited existing data, phenylephrine and ephedrine both are appropriate selections for treating or preventing hypotension induced by the neuraxial blockade in high-risk pregnancies.”
This study further says that both phenylephrine and ephedrine are equally effective, and both could be used to prevent or treat spinal-induced hypotension (1).
What Happens If You Take Too Much Phenylephrine?
Prolonged use or overdosing can worsen or may cause the return of your nasal decongestant (6).
Also, an overdose of phenylephrine can cause a rise in blood pressure and reflex bradycardia. It may also result in symptoms such as irritability, headache, nausea, and vomiting (7).
What Are The Side Effects Of Phenylephrine?
Some of the common side effects of this drug are:
- Loss of appetite
- Tingling and redness under the skin
- Skin rash and itching
The following are some elaborate side effects of phenylephrine.
- Fast pounding and uneven heartbeat
- Dizziness and anxiety
- Weakness, fever, chills and body aches
- High blood pressure, seizures, headache, blurred vision (8)
If you experience side effects, then stop using the drug, and see a doctor.
What Are Some Of The OTC Drugs That Contain Phenylephrine?
Some of the brand names of oral drugs that contain phenylephrine are.
- Contac Cold and Flu (9)
- Tylenol Sinus Plus Headache (10)
- Mucinex Fast-Max Cold and Flu (11)
- Sudafed PE (12)
- Tylenol Cold and Flu Severe Day/Night (13)
- Codral Day and Night (14)
The following are some intranasal drugs that contain phenylephrine.
There are no adequate studies to say if phenylephrine is safe during pregnancy. Always read the labels carefully since several OTC medications might contain this compound. Check with your doctor before using an OTC medicine with phenylephrine.
Did you use phenylephrine during your pregnancy? How did it help you? Do share your experiences with us by commenting in the section below.
This post is for informational purposes only and is not a replacement for a doctor’s consultation. Do not use any medication without talking to your doctor.
2. Wai-Ping Yau, et al., Use of Decongestants During Pregnancy and the Risk of Birth Defects; NCBI (2013)
3. Aida Erebara, et al.; Treating the common cold during pregnancy; NCBI(2008)
4. Jessica Servey, MD, Jennifer Chang, MD; Over-the-Counter Medications in Pregnancy; The American Academy of Family Physicians
5. Prescribing Information-Vazculep; The US Food and Drug Administration
6. Phenylephrine Nasal Spray; Medline Plus; U.S National Library of Medicine
7. A Justification for changing the current wording of the GSL classification of phenylephrine to include a cut-off point for solid dose products containing 10 mg or less of phenylephrine; Medsafe
8. Phenylephrine; Michigan Medicine; University of Michigan
9. Contac cold and flu day- acetaminophen and phenylephrine hydrochloride tablet; Dailymed
10. Tylenol Sinus Plus Headache Day; Dailymed
11. Mucinex Fast- Max Cold and Flu; Dailymed
12. Sudafed PE; Dailymed
13. Tylenol Cold+Flu Severe Day/Night; Dailymed
14. Codral Day & Night; Codral official website
15. Neo-synephrine Extra Strength; Dailymed
16. 4 Way Fast Acting; Dailymed
- 10 Helpful Tips To Get Rid Of A Stuffy Nose During Pregnancy
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