Possible Cardiovascular Effects Secondary to Topical Ophthalmic 2.5% Phenylephrine

Severe cardiovascular effects, such as increased blood pressure and cerebrovascular accidents, are rare systemic adverse reactions following topical ophthalmic 10% phenylephrine use. A marked increase in blood pressure in low-weight premature neonates, infants, and adult patients with idiopathic orthostatic hypotension has been reported with 2.5% phenylephrine. The National Registry of Drug-Induced Ocular Side Effects has received 14 additional cases of possible cardiovascular reactions secondary to 2.5% topical ophthalmic phenylephrine.