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Phenylephrine and related decongestants: Pediatric poisoning

Shan Yin, MD, MPH
Section Editor
Michele M Burns, MD, MPH
Deputy Editor
James F Wiley, II, MD, MPH


Phenylephrine and alpha1 adrenergic agonists are common ingredients in over-the-counter (OTC) cough and cold preparations. Phenylephrine is also available as nasal drops. Following overdose in children, these agents have the potential to cause serious toxicity including agitation, hypertension, and cardiac arrhythmias.

This topic will discuss the clinical features, diagnosis, and management of poisoning caused by phenylephrine and related decongestants. Poisoning caused by OTC cough and cold preparations and the use of cough and cold medications in children are discussed separately. (See "Over-the-counter cough and cold preparations: Approach to pediatric poisoning" and "The common cold in children: Management and prevention".)


Pediatric exposures to phenylephrine and related decongestants primarily occur in one of two ways:

Exploratory ingestion of over-the-counter (OTC) cough and cold medications by a young child (see "Over-the-counter cough and cold preparations: Approach to pediatric poisoning", section on 'Epidemiology')

Intentional ingestion of dextromethorphan-containing preparations for recreational use (see "Dextromethorphan abuse and poisoning: Clinical features and diagnosis", section on 'Pharmacology and cellular toxicology')

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Literature review current through: Nov 2017. | This topic last updated: Dec 04, 2017.
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