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

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.