Skip to main content

Cold medication containing oral phenylephrine as a cause of hypertension in children

Abstract

A 5-year-old girl presented hypertension [24-h blood pressure (BP) average 135/80 mmHg, above the 99th BP percentile], as confirmed by ambulatory BP monitoring, following the use of a cold preparation (2.5 ml every 8 h for 4 days) containing phenyephrine (1 mg/ml). There was a clear relationship between the administration of the medication and hypertension, and between normalized BP values (24-h BP average 109/66 mmHg, 90th percentile) and the withdrawal of the medication. Alternative causes of hypertension could not be found. This is the first reported case of children’s hypertension related with oral administration of phenylephrine. The potential risk of medicines containing sympathomimetic drugs should not be underestimated, and cold preparations should be included in the differential diagnosis of the etiology of hypertension in children.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. 1.

    Anonymous (2007) Infant Deaths Associated with Cough and Cold Medications – Two States, 2005. MMWR 56:1-4 (accessed on 13th June 2007). Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5601a1.htm

  2. 2.

    Cantu C, Arauz A, Murillo-Bonilla LM, Lopez M, Barinagarrementeria F (2003) Stroke associated with sympathomimetics contained in over-the-counter cough and cold drugs. Stroke 34:1667–1672

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Clemens CJ, Taylor JA, Almquist JR, Quinn HC, Mehta A, Naylor GS (1997) Is an antihistamine–decongestant combination effective in temporarily relieving symptoms of the common cold in preschool children? J Pediatr 130:463–466

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Fraunfelder FW, Fraunfelder FT, Jensvold B (2002) Adverse systemic effects from pledgets of topical ocular phenylephrine 10%. Am J Ophthalmol 134:624–625

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Minatoguchi S, Ito H, Ishimura K, Suzuki T, Tonai N, Mori M, Hirakawa S, Fujiwara H (1995) Plasma adrenaline modulates alpha 1-adrenoceptor mediated pressor responses and the baroreflex control in patients with borderline hypertension. Blood Press 4:105–112

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, Janecek E, Domecq C, Greenblatt DJ (1981) A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 30:239–245

    PubMed  CAS  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Francisco J. Morales-Olivas.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Morales-Carpi, C., Torres-Chazarra, C., Lurbe, E. et al. Cold medication containing oral phenylephrine as a cause of hypertension in children. Eur J Pediatr 167, 947–948 (2008). https://doi.org/10.1007/s00431-007-0597-6

Download citation

Keywords

  • Adverse drug reactions
  • Ambulatory blood pressure monitoring
  • Cold medication
  • Secondary hypertension