Side Effects of phenylephrine: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Major Research Findings

Phenylephrine is a drug that selectively activates α1-adrenergic receptors. 12 Phenylephrine exhibits a variety of pharmacological effects, including vasoconstriction and increased cardiac contractility. However, phenylephrine can cause a variety of side effects such as hypertension, increased heart rate, arrhythmias, dyspnea, gastrointestinal symptoms, and neurological symptoms. 24 4 7 8 3 20 11 9 15 16 10 1 The side effects of phenylephrine vary depending on the dosage, method of administration, age of the patient, and other diseases.

Reasons for Side Effects

Phenylephrine constricts blood vessels by activating α1-adrenergic receptors. This vasoconstriction can lead to increased blood pressure and increased heart rate. Phenylephrine also has an effect of increasing the contractility of the heart. This action can increase the burden on the heart and cause arrhythmias. In addition, phenylephrine can act on the central nervous system, causing neurological symptoms such as headache, dizziness, anxiety, and insomnia. 24

Common Side Effects

Hypertension

Phenylephrine can cause an increase in blood pressure because it constricts blood vessels. 24 13 19

Increased Heart Rate

Phenylephrine can increase heart rate because it increases cardiac contractility. 24

Arrhythmias

Phenylephrine can cause arrhythmias because it increases the burden on the heart. 24

Dyspnea

Phenylephrine can cause dyspnea because it constricts bronchi. 24

Gastrointestinal Symptoms

Phenylephrine can cause gastrointestinal symptoms such as nausea, vomiting, and abdominal pain because it inhibits the function of the gastrointestinal system. 24

Neurological Symptoms

Phenylephrine can cause neurological symptoms such as headache, dizziness, anxiety, and insomnia because it acts on the central nervous system. 24 13

Countermeasures for Side Effects

Countermeasures for Hypertension

If you experience symptoms of hypertension, it is important to take antihypertensive drugs as directed by your doctor. 24

Countermeasures for Increased Heart Rate

If your heart rate increases, it is important to take beta-blockers as directed by your doctor. 24

Countermeasures for Arrhythmias

If you develop arrhythmias, it is important to take antiarrhythmic drugs as directed by your doctor. 24

Countermeasures for Dyspnea

If you experience symptoms of dyspnea, it is important to take bronchodilators as directed by your doctor. 24

Countermeasures for Gastrointestinal Symptoms

If you experience gastrointestinal symptoms, it is important to take antiemetics and digestive drugs as directed by your doctor. 24

Countermeasures for Neurological Symptoms

If you experience neurological symptoms, it is important to take analgesics and tranquilizers as directed by your doctor. 24

Comparison between Studies

Commonalities between Studies

Many studies have shown that phenylephrine can cause side effects such as hypertension, increased heart rate, and arrhythmias. 24 13 19 4 7 8 3 20 11 9 15 16 10 1

Differences between Studies

The incidence and severity of side effects of phenylephrine vary depending on the study. This is because the age of the subjects, the type of disease, the dosage, and the method of administration differ among studies.

Precautions Regarding Application in Real Life

Phenylephrine can cause side effects such as hypertension and increased heart rate. Therefore, you must follow your doctor's instructions carefully when taking phenylephrine. If you feel unwell while taking phenylephrine, consult your doctor immediately.

Limitations of Current Research

Research on the side effects of phenylephrine is not yet sufficient. Therefore, not all of the side effects of phenylephrine are known.

Directions for Future Research

Further research is needed to further investigate the side effects of phenylephrine. In particular, it is important to clarify the incidence, severity, and risk factors for side effects of phenylephrine.

Conclusion

Phenylephrine is a drug that selectively activates α1-adrenergic receptors and exhibits a variety of pharmacological effects. However, phenylephrine can cause a variety of side effects such as hypertension, increased heart rate, arrhythmias, dyspnea, gastrointestinal symptoms, and neurological symptoms. When taking phenylephrine, be sure to follow your doctor's instructions and consult your doctor immediately if you feel unwell.

Literature analysis of 24 papers
Positive Content
15
Neutral Content
3
Negative Content
6
Article Type
2
0
0
3
23
1.

Oxytocin infusion for maintenance of uterine tone under prophylactic phenylephrine infusion for prevention of post-spinal hypotension in cesarean delivery: a prospective randomised double-blinded dose-finding study.

Author: JinXiao-Qin, ShenYao-Hua, FuFan, YuJuan, XiaoFei, HuangXiao-Dong

Uterine atony prevention
Oxytocin dose increase

This study aimed to determine the effective doses of oxytocin for co-infusion with prophylactic phenylephrine during cesarean delivery to prevent uterine atony. The study found that phenylephrine increased the dose requirement of oxytocin.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

SENP1 Protects Against Pressure Overload-Induced Cardiac Remodeling and Dysfunction Via Inhibiting STAT3 Signaling.

Author: YangDan, FanDi, GuoZhen, LiuFang-Yuan, WangMing-Yu, AnPeng, YangZheng, TangQi-Zhu

Cardiac remodeling prevention
SENP1 blocker side effects

SENP1, a sentrin/small ubiquitin-like modifier-specific protease, plays a protective role against pressure overload-induced cardiac remodeling and dysfunction by inhibiting STAT3 signaling. Cardiac-specific SENP1 knockdown exacerbated cardiac hypertrophy and dysfunction, while overexpression attenuated remodeling.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

The influence of drop size of cyclopentolate, phenylephrine and tropicamide on pupil dilatation and systemic side effects in infants.

Author: ElibolO, AlçelikT, YükselN, CaglarY

Pupil dilatation
Reduced side effects
Increased blood pressure

Microdrops of mydriatic agents were found to be equally effective as standard drops in dilating pupils, but with fewer systemic side effects, particularly regarding blood pressure.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Effect of a new herbal composition comprised of red clover and hop extract on human endothelial cell damage and vasorelaxant activity.

Author: JeonSe Yeong, KimMi Ran, LeeEun Ok, JeonByeong Hwa, LeeJeong Jun, LeeYoung Chul

Cardiovascular disease prevention

Red clover and hop extract combination (RHEC) exhibited binding affinity toward estrogen receptors and showed potential in protecting endothelial function against oxidative stress and estrogen depletion.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

An overview of emergency pharmacotherapy for priapism.

Author: GrahamBobo A, WaelAlmajed, JackConlon, RohanMorenas A, WayneHellstrom J G

Priapism treatment

Priapism is a painful condition where an erection lasts longer than 4 hours. It's a medical emergency that can lead to permanent damage if not treated quickly. This article reviews the different ways to treat priapism, with a focus on medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Fatal necrotising enterocolitis due to mydriatic eye drops.

Author: OzgunUygur, DemetTerek, OzgeKoroglu A, ZaferDokumcu, MuratSezak, MehmetYalaz, NilgunKultursay

Retinopathy of prematurity
Necrotizing enterocolitis

Topical application of cyclopentolate and phenylephrine for ROP screening can lead to serious side effects, including fatal necrotizing enterocolitis.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Cardiopulmonary arrest following administration of Cyclomydril eyedrops for outpatient retinopathy of prematurity screening.

Author: LeeJung M, KodsiSylvia R, GaffarMajida A, RubinSteven E

Cardiopulmonary arrest

Eyedrops used to dilate the pupils can be absorbed into the body, leading to serious side effects, particularly in infants. This report describes a case where a young infant experienced a cardiopulmonary arrest after receiving eyedrops.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

The Pharmacological Effects of Phenylephrine are Indirect, Mediated by Noradrenaline Release from the Cytoplasm.

Author: Al-KhrasaniMahmoud, KaradiDavid A, GalambosAnna R, SperlaghBeata, ViziE Sylvester

Phenylephrine (PE), an α1-adrenoceptor agonist, has unexpected effects that may be due to its ability to release noradrenaline in a calcium-independent manner, potentially contributing to side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Safety of Phenylephrine in Antihypotensive Treatment during Spinal Anesthesia for Cesarean Section.

Author: AnusorntanawatRatikorn, UerpairojkitKetchada, ThongthaweepornNutnicha, CharuluxanananSomrat

Bradycardia
Fetal acidosis
Hypotension

This study aims to investigate the incidence of serious bradycardia and identify risk factors associated with phenylephrine-induced bradycardia and other side effects after phenylephrine administration for hypotension following spinal anesthesia in cesarean section.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Pharmacological characterization of N1-(2-methoxyphenyl)-N4-hexylpiperazine as a multi-target antagonist of α1A/α1D-adrenoceptors and 5-HT1A receptors that blocks prostate contraction and cell growth.

Author: Chagas-SilvaFernanda, Nascimento-VianaJéssica Barbosa, RomeiroLuiz Antonio S, BarberatoLuana C, NoëlFrançois, SilvaClaudia Lucia Martins

BPH treatment

This study investigates the pharmacological characteristics of N1-(2-methoxyphenyl)-N4-hexylpiperazine (LDT66) as a potential treatment for benign prostatic hyperplasia (BPH).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Priapism: What cause: mental illness, psychotropic medications or poly-substance abuse?

Author: KhanQaiser S, TuckerPhebe, LokhandeAkshay

priapism

Priapism is a serious medical condition that can be caused by various factors, including medications, substance abuse, and pre-existing medical conditions. This case report highlights the importance of considering all potential causes of priapism, especially in patients with a history of mental health conditions and substance abuse. It emphasizes the need for clinicians to be aware of the potential side effects of medications and their interactions, particularly in patients with multiple comorbid conditions.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Vasoplegia During Cardiopulmonary Bypass: Current Literature and Rescue Therapy Options.

Author: OrtolevaJamel, ShapetonAlexander, VannemanMathew, DaliaAdam A

Vasoplegia Syndrome

This review discusses vasoplegia syndrome, a condition characterized by low blood pressure, during and after cardiac surgery. It explores the incidence, outcomes, and potential treatment options, emphasizing the use of pharmacologic rescue agents in cases refractory to standard catecholamine agents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Stress cardiomyopathy (Takotsubo syndrome) in patients who received adrenergic agonist drugs: A pharmacovigilance study using the Japanese Adverse Drug Event Report (JADER) database.

Author: SatoKenichiro, IwataAtsushi, KuriharaMasanori, ManoTatsuo, TodaTatsushi

TTS treatment

This review examines the contribution of treatment with sympathomimetic drugs to the development of Takotsubo syndrome (TTS), also known as stress cardiomyopathy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Efficacy of fixed-dose phenylephrine bolus for treating post-spinal hypotension: Comparison between pre-eclamptics and normotensives.

Author: SalhotraRashmi, TyagiAsha, RautelaRajesh Singh, ChauhanJainendra, DolmaLhamo, SharmaAnkit, BatraPrerna, SrivastavaHimsweta

Safe and effective treatment of post-spinal hypotension

A 50 μg fixed bolus of phenylephrine was found to be safe and effective in treating post-spinal hypotension in both pre-eclamptic and normotensive parturients. The efficacy of phenylephrine was comparable in both groups.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

The effect of mydriatic solutions on cognitive function.

Author: DersuInci Irak, SpencerHorace T, GrigorianPaula A, EvansMegan, HarperRichard

Cognitive function

This study investigates the potential impact of mydriatic drops, used to dilate pupils, on cognitive function, including memory, concentration, and orientation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Does fish oil or folic acid prevent vascular changes in female progeny caused by maternal exposure to fluoxetine?

Author: HigashiCarolina M, MatsumotoAndressa K, GameiroJuliana G, MouraKawane F, HigachiLuciana, OliveiraLeticia C, BarbosaDécio S, MoreiraEstefânia G, CeravoloGraziela S

Prevented antidepressant side effects

This study investigated the effects of maternal exposure to fluoxetine, fish oil, and folic acid during pregnancy and lactation on aortic reactivity and nitric oxide metabolites in rats.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

A Case Report of Hypertensive Emergency and Intracranial Hemorrhage Due to Intracavernosal Phenylephrine.

Author: PalagiriRaga Deepak Reddy, ChatterjeeKshitij, JillellaAnusha, HammondDrayton A

Priapism resolution
Hypertensive emergency
Intracranial hemorrhage

Phenylephrine, a drug used to treat priapism, can cause dangerous increases in blood pressure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Reduction in oral mucositis severity using a topical vasoconstrictor: A case report of three bone marrow transplant patients.

Author: Graul-ConroyAmanda, Hoover-ReganMargo, DeSantesKenneth B, SondelPaul M, CallanderNatalie S, LongoWalter L, FahlWilliam E

Oral mucositis prevention

Orotopically applied adrenergic vasoconstrictors prevented up to 100% of radiation-induced oral mucositis in two preclinical animal models.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

22.

Atrial arrhythmia after newborn eye exam, to caffeine or not to caffeine?

Author: AhmadA, MondalT, KleinB

Retinopathy screening
Atrial arrhythmias
Caffeine interaction

This report describes two cases of atrial arrhythmias after neonatal eye exam that improved with conservative management. Both patients were receiving caffeine at the time of events.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Management of mydriasis and pain in cataract and intraocular lens surgery: review of current medications and future directions.

Author: GrobSeanna R, Gonzalez-GonzalezLuis A, DalyMary K

Inflammation control
Mydriasis
Pain control

This article reviews current medications commonly used for intraoperative mydriasis, pain, and inflammation control during cataract and intraocular lens replacement surgery. It highlights a new combination of ketorolac and phenylephrine that demonstrates potential for streamlining the surgical process.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Severe hypertension and pulmonary edema associated with systemic absorption of topical phenylephrine in a child during retinal surgery.

Author: AbdelhalimAshraf A, MostafaMohamed, AbdulmomenAhmed, OthmanEssam A

Pupil dilation
Hypertension
Pulmonary edema

Topical phenylephrine solutions are widely used to promote pupil dilation in eye procedures. This study reports a case of severe hypertension and acute pulmonary edema in a child during retinal surgery after possible systemic absorption of topical phenylephrine eyedrops.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

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