This sheet is about exposure to phenylephrine in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is phenylephrine?
Phenylephrine is a decongestant. Decongestants are often in over-the-counter medications used to treat nasal congestion (“stuffy nose”) caused by colds or allergies. Phenylephrine can be found in different products, including Sudafed PE. Phenylephrine has also been used to treat temporary low blood pressure caused by anesthesia used during surgeries.
Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. If you use a decongestant, it may be best to choose one that has only one active ingredient (not one with many active ingredients). This avoids exposing the pregnancy to other medications that may not be needed. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.
I take phenylephrine. Can it make it harder for me to get pregnant?
It is not known if phenylephrine can make it harder to get pregnant.
Does taking phenylephrine increase the chance for miscarriage?
Miscarriage can occur in any pregnancy. Studies have not been done to see if phenylephrine increases the chance for miscarriage.
Does taking phenylephrine increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Based on the studies reviewed, it is not known if phenylephrine increases the chance for birth defects above the background risk.
Studies involving more than 1,500 people who were pregnant and took phenylephrine in the first trimester did not show an increased chance for birth defects. One study looked at 1,249 people who were pregnant and who took phenylephrine in the first trimester. A slightly higher chance for minor differences of the eyes or ears were reported (small changes that are not birth defects). Studies on other medications that work in the same way (make blood vessels smaller) have raised questions about a small increased chance for birth defects.
Does taking phenylephrine in pregnancy increase the chance of other pregnancy-related problems?
Based on the studies reviewed, it is not known if phenylephrine can cause other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). Because phenylephrine can make blood vessels smaller (constrict), there are theoretical concerns that using this medication could reduce blood flow through the placenta (organ that grows during pregnancy to supply the developing baby with food and oxygen).
Because phenylephrine can constrict blood vessels, using this medication could raise your blood pressure. If you have high blood pressure, talk to your healthcare provider about medications that would be best for you.
Does taking phenylephrine in pregnancy affect future behavior or learning for the child?
Studies have not been done to see if phenylephrine can cause behavior or learning issues for the child.
Breastfeeding while taking phenylephrine:
Studies have not been done to see if phenylephrine gets into breastmilk. Studies in animals have shown that phenylephrine might reduce milk supply. Because there is little information about the use of phenylephrine while breastfeeding, use of nasal sprays or other medication might be preferred.
If a male takes phenylephrine, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?
Studies have not been done to see if phenylephrine could affect fertility or increase the chance of birth defects above the background risk. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
Please click here for references.
OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.