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.

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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. Instead of pseudoephedrine, Sudafed PE contains phenylephrine.

While pseudoephedrine is considered a more effective decongestant, it is also a stronger amphetamine and 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

Active Ingredient

Sudafed PE pills are round, red, film-coated, and embossed with "44453" on one side. Each pill contains 10 milligrams of 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 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

Adults and children over 12 can take one Sudafed PE pill every four hours. 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.

Do not take more than six doses of Sudafed PED within 24 hours. Children under the age of 12 should not take Sudafed PE unless directed to do so by a healthcare provider.

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.

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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.
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  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.

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