Phenylephrine

A sympathomimetic with alpha-adrenergic action. It produces peripheral vasoconstriction and increased blood pressure without stimulating effects on the central nervous system.

Used as decongestant in topical nasal preparations at low concentration, in association with other drugs, in oral preparations to treat respiratory catarrh (Nice 2000, Kanfer 1993) and in eye drops at concentrations of up to 10% as a mydriatic. It is also used subcutaneously or intramuscularly in severe hypotensive states and in association with topical anesthetics.

Since the last update, we have not found published data on its excretion in breast milk.

The low dose of phenylephrine in nasal, ophthalmic and topical preparations makes its unlikely that it will transfer into breastmilk in significant amounts. It is prudent to press on the tear glands after adminitering eye drops in order to reduce absorption.

Its low oral bioavailability complicates its transfer to the infant’s plasma from ingested breastmilk, except in premature babies and the immediate neonatal period in which there may be increased intestinal permeability.

Nasal and ophthalmic use is authorized in children under one year of age.

Avoid excessive or prolonged oral use and use the minimum sufficient dose.

A similar molecule, pseudoephedrine, can cause a decrease in milk production (Aljazaf 2003).

• Pseudoephedrine (Low Risk probable)

Alternatives

• Loratadine (Very Low Risk)
• Azelastine (Low Risk probable)
• Oxymetazoline (Low Risk probable)
• Cetirizine Hydrochloride (Very Low Risk)