What are the Common Phenylephrine Side Effects?

Melanie Smeltzer

Phenylephrine is a medication that is generally used as a decongestant for those suffering from a cold, allergies, or sinus irritation. Although it is well tolerated by many, some may experience side effects. Phenylephrine side effects can be mild, and may include nasal irritation or stomach upsets. This drug, however, is known to cause a number of severe side effects such as high blood pressure, allergic reactions, and chest pain.

Nasal irritation is a possible side effect when taking phenylephrine.
Nasal irritation is a possible side effect when taking phenylephrine.

Some of the most common phenylephrine side effects are usually moderate and short-lived. As this medication can be taken as a nasal spray, it can potentially cause dryness, or a stinging or burning sensation in the nasal passages. Other mild phenylephrine side effects can include stomach problems, dizziness, excitability, and restlessness or sleep disturbances.

Most people who take phenylephrine hydrochloride do not experience side effects, although some may.
Most people who take phenylephrine hydrochloride do not experience side effects, although some may.

Although it is generally thought to be uncommon, some will experience more severe phenylephrine side effects. Allergic reactions are not unusual, and may present themselves in the form of a noticeable swelling in the extremities, nose, or throat. This reaction may also cause difficulty in breathing or painful skin rashes. In addition to rashes, this drug might also cause excessive bruising of the skin or bleeding.

Children are more likely to experience negative reactions to phenylephrine.
Children are more likely to experience negative reactions to phenylephrine.

For those with heart conditions, prostatic hyperplasia, or epilepsy, phenylephrine side effects can be especially problematic. As this drug may cause chest pain, an increase of blood pressure, and a decrease of heart rate, those with chronically elevated blood pressure are discouraged from taking this medication. In addition, phenylephrine may cause a worsening of symptoms for those suffering from prostatic hyperplasia. This drug is also known to interact negatively with anticonvulsant medications, and may cause seizures in epileptic patients.

Phenylephrine taken as a nasal spray can cause dryness and a burning sensation in the nasal passages.
Phenylephrine taken as a nasal spray can cause dryness and a burning sensation in the nasal passages.

Other severe reactions may include fainting as well as a tingling sensation in the feet or hands. Changes in mood, behavior, or mental state are rare but possible, as is a decrease in the frequency of urination. In some cases, the patient may also experience a distinct tremor or weakness in the extremities.

Phenylephrine may cause sleep disturbances in some users.
Phenylephrine may cause sleep disturbances in some users.

Though severe side effects are more common in those with certain medical conditions, those who are otherwise healthy may be affected. Small children are also more likely to develop negative reactions as their bodies quickly absorb the medication, which may lead to an overdose. Children who develop reactions may present symptoms such as trembling, an increase in heart rate, pale skin, or sweating. This drug is not recommended for children below the age of four years old.

Decongestant nasal spray may cause mild nose bleeding as a side effect.
Decongestant nasal spray may cause mild nose bleeding as a side effect.

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