An Overview of Sudafed PE for Cold and Flu

Sudafed PE is an over-the-counter (OTC) nasal decongestant used to relieve congestion of the sinuses and upper respiratory tract. Decongestants work by narrowing the blood vessels of the nose and decreasing swelling and inflammation of mucosal tissues. When the swelling is decreased, it opens the air passages and allows accumulated mucus to drain.

This article discusses the types of Sudafed PE and how they are used. It also covers the ingredients, dosages, and possible side effects.

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How Sudafed PE Differs From Sudafed

Sudafed PE is so-named because its active ingredient is different from that of regular Sudafed. Regular Sudafed ingredients include pseudoephedrine while Sudafed PE contains phenylephrine hydrochloride (HCI).

The pseudoephedrine in Sudafed is considered a more effective decongestant than phenylephrine; it's also a stronger amphetamine. Because of this, pseudoephedrine is frequently used in the manufacture of the street drug methamphetamine (also known as "meth" or "crystal meth"). Therefore, Sudafed is not available over the counter. Federal regulations dictate that it be obtained from behind the pharmacist or service counter.

Sudafed PE Uses

Sudafed PE is used to relieve stuffy nose and sinus pain and pressure caused by the following conditions:

  • Common cold and flu
  • Allergies, including hay fever
  • Non-allergic rhinitis
  • Bronchitis
  • Sinus infection (sinusitis)
  • Allergic asthma
  • Respiratory syncytial virus (RSV) in adults or children over 12

Types of Sudafed PE

Different products are used to treat different symptoms and conditions.

Sudafed PE Sinus Congestion

This is considered a maximum strength sinus decongestant that can relieve sinus pressure and nasal congestion. Tablets contain phenylephrine HCl decongestant. It should not make you drowsy.

Sudafed PE Sinus Congestion Day + Night

These decongestants tablets provide ease sinus and nasal congestion and sinus pressure. In addition to phenylephrine, they contain diphenhydramine HCl, an antihistamine that can relieve allergy symptoms. It may cause drowsiness.

Sudafed PE  Sinus Pressure + Pain

Along with phenylephrine, this product contains acetaminophen to provide pain relief in addition to treating sinus congestion and pressure. It should not make you sleepy.

Sudafed PE for Head Congestion + Pain Relief

With ibuprofen and phenylephrine HCl, this formula helps with head congestion, sinus pressure, headache, and pain. 

Sudafed PE Head Congestion + Mucus

Containing acetaminophen for pain relief and the decongestant phenylephrine HCI, it helps relieve sinus pressure and congestion, headache, chest and nasal congestion, and excess mucus.

Sudafed PE Head Congestion + Flu Severe

This formula works to treat a range of cold and flu symptoms, including cough, sinus pressure, sinus congestion, sinus headache, sore throat, and chest congestion

Children’s Sudafed PE Nasal Decongestant, Berry Liquid

Alcohol-free and sugar-free, this non-drowsy flavored medication for children contains phenylephrine HCl to relieve nasal congestion and sinus pressure.

Children’s Sudafed PE Cough + Cold, Grape Liquid

Also a non-drowsy flavored liquid medication, this is a decongestant and cough suppressant that eases nasal congestion, cough, and stuffy nose.

Active Ingredient

Sudafed PE pills are round, red, film-coated, and embossed with "44453" on one side. Children's medication comes in a liquid. For all Sudafed PE products, the active ingredient is phenylephrine HCl.

Phenylephrine is part of a class of drugs known as vasopressors that work by reducing inflamed blood vessels in the nose and upper respiratory tract.

In addition to Sudafed PE, phenylephrine can be found in many generic OTC products, including children’s cough syrups, nose drops, and hemorrhoid preparations.

While phenylephrine can help relieve congestion, it does not treat the underlying causes of the symptoms.

Side Effects

Sudafed PE is effective in alleviating congestion, but some people may experience side effects. Most Sudafed PE side effects are mild to moderate and tend to resolve on their own.

The most commonly reported side effects of Sudafed PE include:

  • Headaches
  • Mild upset stomach
  • Nausea
  • Dizziness or lightheadedness
  • Jitteriness
  • Cold feet (from reduced blood circulation)

Contraindications and Considerations

Do not use Sudafed PE if you are taking a monoamine oxidase inhibitor (MAOI) or have done so in the past two weeks. MAOIs are used to treat depression, bipolar disorder, anxiety, and other mood disorders.

MAOIs that may interact with Sudafed PE include:

  • Emsam (selegiline)
  • Marplan (isocarboxazid)
  • Nardil (phenelzine)
  • Parnate (tranylcypromine)

Dosage and Directions

Adult Sudafed PE comes in tablets of 10 milligrams (mg). The pill should be swallowed whole. You should not crush or chew the pill as this interferes with how rapidly the drug is absorbed into the system.

Sudafed PE Dosage: How Much Do I Take?
Age  Dosage of Phenylephrine
Adults and children over 12 years old 10 mg (one tablet) every four hours Do not exceed 60 mg in 24 hours
Children 6-11 5 mg in 10 milliliters (mL) dose of children's formula every 4 hours
Children 4-5 2.5 mg in 5 mL dose of children's formula every 4 hours
Children under 4 Do not use

Stop treatment and call your practitioner if you experience irregular or fast heartbeat, vomiting, difficulty urinating, or severe shaking. In very rare instances, seizures, panic, confusion, and abnormal thoughts and behavior have been known to occur after taking Sudafed PE.

Men with an enlarged prostate gland may also want to avoid Sudafed PE as it can cause urinary difficulty. If you have prostate hyperplasia or any problem with your prostate gland, speak with your practitioner about alternative nasal decongestants.

If your symptoms do not improve within seven days or are accompanied by fever, stop taking Sudafed PE and call your healthcare provider.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DrugBank. Pseudoephedrine. DrugBank Version 5.1.5

  2. International Narcotics Control Board (INCB). List of Precursors and Chemicals Frequently Used in the Illicit Manufacture of Narcotic Drugs and Psychotropic Substances under International Control.


  4. Richards E, Maani CV. Phenylephrine. NCBI StatPearls. PMID: 30521222.

  5. Know Your OTCs. Phenylephrine. CHPA Educational Foundation.

  6. Kaiser Permanente. Sudafed PE 10 Mg Tablet. Kaiser Permanente Drug Encyclopedia.

Additional Reading

By Kristina Duda, RN
Kristina Duda, BSN, RN, CPN, has been working in healthcare since 2002. She specializes in pediatrics and disease and infection prevention.