The Basics
What is Phenylephrine?
Used to relieve nasal discomfort caused by colds, allergies, and hay fever. It is also used to relieve sinus congestion and pressure.
Brand names for Phenylephrine
Biorphen
How Phenylephrine is classified
Adrenergic Agents, Adrenergic Alpha-Agonists, Antiglaucoma Agents, Sympathomimetics, Vasoconstrictor Agents, Nasal Decongestants
Phenylephrine During Pregnancy
Phenylephrine pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Phenylephrine while pregnant
Can you take phenylephrine while pregnant? Relevant published information about taking phenylephrine while pregnant was not found as of the revision date.
Taking Phenylephrine While Breastfeeding
What are recommendations for lactation if you're taking Phenylephrine?
The oral bioavailability of phenylephrine is only about 40%,[1] so the drug is unlikely to reach the infant in large amounts. However, intravenous or oral administration of phenylephrine might decrease milk production. Because no information is available on the use of oral phenylephrine during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. Phenylephrine nasal spray or ophthalmic drops are less likely to decrease lactation. To substantially diminish the effect of the drug after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.
Maternal / infant drug levels
The oral bioavailability of phenylephrine is only about 40%,[1] so the drug is unlikely to reach the infant in large amounts. However, intravenous or oral administration of phenylephrine might decrease milk production. Because no information is available on the use of oral phenylephrine during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. Phenylephrine nasal spray or ophthalmic drops are less likely to decrease lactation. To substantially diminish the effect of the drug after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.
Possible effects of Phenylephrine on milk supply
Relevant published information pertaining to this specific aspect of taking phenylephrine while breastfeeding in humans was not found as of the revision date. However, animal data indicate that phenylephrine can decrease milk production[2][3] and pseudoephedrine, a pharmacologically similar vasoconstrictor, decreases milk production in nursing mothers after oral use.[4]
Possible alternatives to Phenylephrine
Oxymetazoline.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Eccles R. Substitution of phenylephrine for pseudoephedrine as a nasal decongeststant. An illogical way to control methamphetamine abuse. Br J Clin Pharmacol. 2007;63:10-4. PMID: 17116124
2. Bruckmaier R, Mayer H, Schams D. Effects of alpha- and beta-adrenergic agonists in intramammary pressure and milk flow in dairy cows. J Dairy Res. 1991;58:411-9. PMID: 1684977
3. Inderwies T, Pfaffl MW, Bruckmaier RM. Milking characteristics and their relation to adrenergic receptor mRNA expression and ligand binding in the mammary gland of dairy cows. Domest Anim Endocrinol. 2003;25:275-86. PMID: 14550511
4. Aljazaf K, Hale TW, Ilett KF et al. Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk. Br J Clin Pharmacol. 2003;56:18-24. PMID: 12848771
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
