What Is Pseudoephedrine?

Sudafed

blister packs of Sudafed pills
Sudafed tablets. E+ / Getty Images

Pseudoephedrine is an over-the-counter (OTC) medication typically used to treat nasal congestion, sinus congestion, and a runny nose. These symptoms may be caused by multiple conditions such as the common cold, sinusitis or allergies. Pseudoephedrine only treats symptoms; it is not a cure for viral or bacterial illness. 

Some doctors have prescribed pseudoephedrine to treat fluid in the ear, but the effectiveness of this application is generally poor. 

Common Brand Names

  • Biofed
  • Cenafed
  • Contac 12-Hour
  • Decofed
  • Dimetapp Decongestant
  • Drixoral
  • Efidac 24
  • Sudafed
  • Suphedrin

You should note that Sudafed PE is actually made with phenylephrine, which is similar to, but not the same as pseudoephedrine.

Indications

The most common indication for pseudoephedrine is as a decongestant, for conditions such as nasal congestion, sinus congestion, and eustachian tube congestion. It works by shrinking swollen nasal membranes, reducing edema (tissue swelling) and hyperemia (increased blood flow to nasal tissues).

You can take pseudoephedrine if:

  • You have a runny nose, nasal congestion, sinus congestion, or severe symptoms related to allergies.
  • You are healthy and have never had an allergic reaction to pseudoephedrine or another medication that contains pseudoephedrine.
  • If you have health problems, take other medications on a regular basis, or if you are pregnant, you should check with your doctor and pharmacist before taking pseudoephedrine.

How It Is Taken

Pseudoephedrine comes in different forms, including tablets, extended-release tablets, and liquid. It is available over-the-counter in both children and adult formulas, so make sure that the formula you buy is age-appropriate.

Extended-release tablets should never be cut, crushed or chewed. Because pseudoephedrine can cause you to become nervous or excited, it is best taken in the morning or afternoon so it doesn't interfere with sleep. Follow the directions on the bottle carefully before giving or taking pseudoephedrine, and contact your doctor or pharmacist with any questions.

Side Effects

Pseudoephedrine is also classified as an alpha-adrenoceptor and beta-adrenoceptor agonist. Alpha and beta refer to the types of nerve receptors that control the constriction of smooth muscles, such as those in blood vessels. By activating these receptors, pseudoephedrine causes vasoconstriction (the narrowing of blood vessels.

Because these receptors are not only located in nasal passages, pseudoephedrine can cause the constriction of other smooth muscles, stimulates the heart rate, slowing parts of the digestive tract, and

Common side effects include:

  • Restlessness
  • Nausea
  • Anxiety
  • Weakness
  • Headache
  • Insomnia
  • Flushing
  • Trembling
  • Itching

If overused, pseudoephedrine can cause vomiting, arrhythmia (irregular heartbeat), dyspnea (shortness of breath), tachycardia (rapid heartbeat), bradycardia (slow heartbeat), seizures, and hallucinations.

Call your doctor or seek emergency care if you experience any of these symptoms.

Contraindications

Pseudoephedrine is contraindicated for use in certain people in whom treatment may pose health risks. It should never be used if:

  • You have had an allergic reaction to it in the past.
  • You are taking any medications in a class called MAO inhibitors, such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate).
  • If you have been off one of the previously listed or other MAO inhibitors for more than 14 days, it is safe to take pseudoephedrine.
  • This medication should be used cautiously in people who have a history of high blood pressure, thyroid disease, heart disease, an enlarged prostate gland, or diabetes.
  • Newborns should not be given pseudoephedrine, nor should women who are breastfeeding.

Notify your doctor and pharmacist if you have any of these conditions.

Prescribing Laws

On March 9, 2006, President George W. Bush signed the Combat Methamphetamine Epidemic Act of 2005, which was incorporated into the Patriot Act. Methamphetamines are highly addictive street drugs that are "cooked" in illegal labs using OTC pseudoephedrine and other household ingredients.(Pseudoephedrine can be chemically altered to make methamphetamine.) These can then be swallowed, inhaled, injected, or smoked to get the stimulant high.

Under the law, you do not need a prescription to purchase pseudoephedrine. However, you must present a driver's license or other government-issued ID to register and track the purchase.

You should not worry about providing this information unless you are buying mass quantities of pseudoephedrine, as it takes between 700 and 1,000 pills to make a half a gram to one gram methamphetamine.

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