Phenylephrine and Breastfeeding

Summary of use during lactation

The oral bioavailability of phenylephrine is very low, so the drug is unlikely to reach the infant in large amounts.[1] 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.

Drug levels in milk and infant serum

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Relevant published information in humans was not found as of the revision date. However, animal data indicate that phenylephrine can decrease milk production and pseudoephedrine, a pharmacologically similar vasoconstrictor, decreases milk production in nursing mothers after oral use.[2-4]

Alternative drugs to consider

Oxymetazoline

References

1. Eccles R. Substitution of phenylephrine for pseudoephedrine as a nasal decongeststant. An illogical way to control methamphetamine abuse. Br J Clin Pharmacol 2007;63:10-4.17116124 PubMed
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;58:411-9.1684977 PubMed
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;25:275-86.14550511 PubMed
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;56:18-24.12848771 PubMed