Phenylephrine When Pregnant: Safety Profile, Side Effects And Risks

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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, a few other studies did not find anything to this effect (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). But it did not find any association of first-trimester exposure to phenylephrine and ear, eye defects, and club foot in the baby.

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).

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
  • Insomnia
  • 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.


MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

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