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Prescription medication · Alpha-1 Agonist

phenylephrine

Also sold as Neo-Synephrine. This medicine temporarily relieves symptoms from a cold.

Data updated 2026-05-15

3,669
FDA reportsLightly reported
2
InteractionsFew interactions
10
Recall records

What the data shows

phenylephrine (Neo-Synephrine) is a prescription Alpha-1 Agonist, among the least-reported drugs the FDA tracks (3,669 FDA reports), with 2 documented drug interactions.

Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.

phenylephrine (Neo-Synephrine) is a prescription Alpha-1 Agonist. This medicine temporarily relieves symptoms from a cold.

Phenylephrine is a medicine that helps relieve cold and flu symptoms. It can reduce fever and relieve pain.

Drug Pricing (NADAC)

Generic Price

$0.05/unit

Generic Available

Yes (24 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

View Alternatives → Compare with Another Drug → Full Side Effects Report →

What it does

This medicine temporarily relieves symptoms from a cold.

Common side effects

No common side effects listed.

Key warnings

Do not take more medicine than directed, as overdose can be dangerous.

The sections below are summarized in plain English from phenylephrine's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.

How It Works

Phenylephrine works by narrowing blood vessels in your nose and sinuses. This helps to reduce congestion and makes it easier to breathe. It also helps to reduce inflammation and pain.

How to Take It

Adults and children 12 years and over should take 30 mL every 4 hours. Do not take more than 6 doses (180 mL) in 24 hours. Only use the provided dosing cup to measure your dose. Do not use any other measuring device.

This is a plain-language summary of phenylephrine's FDA labeling, not individualized dosing advice. Ask a pharmacist or prescriber before changing how you take this medication.

Pregnancy & Breastfeeding

It is not known if this medicine will harm your unborn baby. Talk to your doctor before taking this medicine if you are pregnant or breastfeeding.

This is a plain-language summary of phenylephrine's FDA labeling, not individualized advice. Ask a pharmacist or prescriber about pregnancy or breastfeeding on this medication.

Missed Dose

If you miss a dose, take it as soon as you remember. Do not take a double dose to make up for the missed dose.

This is a plain-language summary of phenylephrine's FDA labeling, not individualized advice. Ask a pharmacist or prescriber what to do about your specific missed dose.

Storage

Store at room temperature away from moisture and heat.

Side Effects (from patient reports)

Based on 3,669 FDA adverse event reports.

Most-reported reactions

Adverse reactions in FAERS for phenylephrine, by number of reports

reports

What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.

Source FDA Adverse Event Reporting System (FAERS) As of 2025

Reports over time

Adverse-event reports filed for phenylephrine each year to the FDA Adverse Event Reporting System (FAERS).

-50005001,0001,500 20042007201020132016201920222025 959

Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.

Where phenylephrine sits

phenylephrine has more FDA adverse-event reports than 21% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.

fewest reports most reports

Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is phenylephrine; the line is the median (50th percentile).

FDA Adverse Event Report Analysis

Detailed analysis of 3,669 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

3,669

Reports Mentioning Death

1,539

41.9% of reports — not proof of cause

Hospitalization Reports

1,983

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 2,480 (83%)
Male 495 (17%)

Age Distribution

0–17 71
18–44 1,351
45–64 412
65–74 188
75+ 290

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
2 PEMPHIGUS 948
3 JOINT SWELLING 920
5 PAIN 902
6 RHEUMATOID ARTHRITIS 872
7 PERICARDITIS 868
8 SYSTEMIC LUPUS ERYTHEMATOSUS 867
9 INFUSION RELATED REACTION 846
10 WOUND 843
11 GLOSSODYNIA 836
12 SYNOVITIS 833
13 ARTHROPATHY 822
14 CONDITION AGGRAVATED 822
15 MATERNAL EXPOSURE DURING PREGNANCY 806
16 TYPE 2 DIABETES MELLITUS 804
17 HEPATIC ENZYME INCREASED 791

Reactions in Death Reports

FOLLICULITIS 642
HYPOAESTHESIA 641
TYPE 2 DIABETES MELLITUS 641
PEMPHIGUS 626
SYNOVITIS 625
SYSTEMIC LUPUS ERYTHEMATOSUS 622
INFUSION RELATED REACTION 609
WOUND 600
GLOSSODYNIA 598
CONDITION AGGRAVATED 596

Reactions in Hospitalization Reports

CONDITION AGGRAVATED 672
PAIN 653
MOBILITY DECREASED 650
JOINT SWELLING 649
FOLLICULITIS 634
HYPOAESTHESIA 630
SYNOVITIS 619
TYPE 2 DIABETES MELLITUS 619
WOUND 617
ARTHROPATHY 608

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Do not take more medicine than directed, as overdose can be dangerous. Do not use this medicine in children under 12 years of age.

Known Drug Interactions

Excessive reduction of blood glucose (additive effect) [See Warnings and Precautions (5.14)] ; CNS depressant agents (including opioids, alcohol, sedatives, hypnotics) Use with caution Increased CNS depression Dietary supplements containing sympathomimetics Contraindicated Antidepressants including but not limited to: • Other MAOIs (e.g., linezolid, intravenous methylene blue, selective MAOIs) • Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) • Tricyclic antidepressants • Amoxapine, bupropion, maprotiline, nefazodone, trazodone,...

Mechanism: Tranylcypromine blocks the enzyme that normally processes phenylephrine, leading to an extreme and unsafe increase in blood pressure.

What to do: Do not use these medicines together. Always check with your pharmacist before taking any over-the-counter cold or allergy medicines while on tranylcypromine.

Terazosin has been used concomitantly in at least 50 patients on the following drugs or drug classes: analgesic/anti-inflammatory (e.g., acetaminophen, aspirin, codeine, ibuprofen, indomethacin); antibiotics (e.g., erythromycin, trimethoprim and sulfamethoxazole); anticholinergic/sympathomimetics (e.g., phenylephrine hydrochloride, phenylpropanolamine hydrochloride, pseudoephedrine hydrochloride); antigout (e.g., allopurinol); antihistamines (e.g., chlorpheniramine); cardiovascular agents (e.g., atenolol, hydrochlorothiazide, methyclothiazide, propranolol); corticosteroids;...

Mechanism: These drugs work against each other because one relaxes blood vessels to lower blood pressure while the other narrows them to raise it. This can make your blood pressure medicine less effective.

What to do: Talk to your doctor before using these together, as your blood pressure may need to be checked more often. They may suggest a different decongestant that does not affect blood pressure.

This is a plain-language summary of interactions documented in FDA labeling, not individualized advice. Ask a pharmacist or prescriber before combining medications.

Common Questions

How often can I take this medicine?
Adults and children 12 and over can take it every 4 hours as needed.
Can children under 12 take this medicine?
No, do not give this medicine to children under 12 years old.
What should I use to measure the dose?
Only use the dosing cup that comes with the medicine.
Can I take more than the recommended dose?
No, do not take more than the recommended dose. Overdose can be dangerous.
What do I do if I miss a dose?
Take the missed dose as soon as you remember.
Can I take this medicine if I am pregnant?
Talk to your doctor before taking this medicine if you are pregnant.
How should I store this medicine?
Store it at room temperature away from moisture and heat.
What does this medicine treat?
It treats cold and flu symptoms like aches, pains, headache, congestion, sore throat, cough, and fever.
How does this medicine work?
It narrows blood vessels to reduce congestion.
Can I use a regular spoon to measure the dose?
No, only use the dosing cup that comes with the medicine to ensure you measure the correct amount.
Does phenylephrine interact with other medications?
Yes, phenylephrine has 2 known drug interactions. Notable interactions include tranylcypromine, terazosin. Always inform your doctor about all medications you are taking.
What drug class is phenylephrine?
phenylephrine belongs to the Alpha-1 Agonist drug class. It requires a prescription (Rx). This medicine temporarily relieves symptoms from a cold.
Is phenylephrine safe during pregnancy?
It is not known if this medicine will harm your unborn baby. Talk to your doctor before taking this medicine if you are pregnant or breastfeeding. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has phenylephrine been recalled?
There are 10 recalls associated with phenylephrine products. cGMP deviations. Check the recalls section below for full details and affected products.

Active Recalls

Class II April 1, 2026

cGMP deviations.

Wells Pharma of Houston LLC

Class II November 20, 2025

Incorrect Product Formulation

Fagron Compounding Services

Class II September 17, 2025

CGMP Deviations

Park Avenue Compounding

Class III July 9, 2025

Sub-Potent Drug: Subpotent assay results during stability testing.

Imprimis NJOF, LLC

Class III February 24, 2025

Sub-Potent Drug: The stability batch showed a subpotent result, which does not meet the product specifications of 90.0-110.0% of the label claim.

Imprimis NJOF, LLC

Class II February 29, 2024

Lack of Assurance of Sterility: Firm did not perform process validation.

SSM Health Care St. Louis DBA SSM St. Clare Health Center

Class I December 28, 2023

Superpotent Drug: semi-automated IV bag filling system can malfunction and provide a double dose of drug product to IV bags.

Denver Solutions, LLC DBA Leiters Health

Class I December 28, 2023

Superpotent Drug: semi-automated IV bag filling system can malfunction and provide a double dose of drug product to IV bags.

Denver Solutions, LLC DBA Leiters Health

Class III November 10, 2023

Labeling: Label Mix-Up: The label of a dropper bottle mistakenly states the container is a 0.5mL single-use syringe instead of a 5 mL dropper

Fagron Compounding Services

Class II May 29, 2013

Lack of Assurance of Sterility: FDA inspection findings resulted in concerns regarding quality control processes

Lowlite Investments, Inc. D/B/A Olympia Pharmacy

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What the FDA Data Shows for phenylephrine

The FDA label for phenylephrine (sold under brand names such as Neo-Synephrine) classifies it as a prescription-only medication in the Alpha-1 Agonist class. This medicine temporarily relieves symptoms from a cold. Labeling covers dosing, contraindications, and monitoring requirements derived from clinical trials.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 3,669 voluntary reports. The database also lists 2 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.05.

Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 10 recall records on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice, always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: March 27, 2024

Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled and last refreshed May 2026. See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a correction.

All federal data sources used on this page