Over-the-counter sympathomimetics: A risk factor for cardiac arrhythmias in pregnancy

More than 170 over-the-counter (OTC) preparations contain a sympathomimetic agent as the active ingredient. Nonprescription medicines are consumed com monly in our society. Phenylpropanolamine, an alpha-adrenergic agonist as w ell as a popular decongestant, is consumed at a massive volume of 5 billion doses annually, Over-the-counter sympathomimetics have been reported to ca use hypertension and arrhythmias, Despite the ability to cause these potent ially serious adverse effects and the high-volume consumption of these agen ts, the medical literature until recently has been scant in reporting adver se events. We report symptomatic ventricular arrhythmia and presyncope in a 36-year-old pregnant woman who consumed relatively high doses of two OTC c old remedies simultaneously. Increased physician awareness of the potential side effects associated with OTC sympathomimetics as well as improved leve l of patient education are needed. Finally, we support the calls for more p rominent warning labels on some selected OTC preparations, including OTC sy mpathomimetics.