Indications
Pseudoephedrine is a decongestant used to relieve a blocked or stuffy nose and sinus congestion caused by colds, flu, sinusitis and hay fever (allergic rhinitis). It is often combined with an antihistamine such as Fexofenadine or Loratadine to treat both the allergy symptoms and the nasal blockage.
How It Works
Pseudoephedrine stimulates alpha receptors on the small blood vessels lining the nose and sinuses, making them narrow. This reduces swelling of the nasal lining, opens the airways and helps mucus drain.
Dosage and Administration
For adults and children over 12 years, the usual dose of the plain tablet is 60 mg every 4 to 6 hours, no more than 240 mg in 24 hours. Extended-release combination tablets are usually taken once or twice daily as directed on the label, and must be swallowed whole, not crushed or chewed. Take the last dose a few hours before bedtime to avoid sleeplessness. Do not use for more than 7 days without medical advice. For children under 12, use only as directed by a doctor.
Interactions
Do not take pseudoephedrine with, or within 14 days of stopping, an MAO inhibitor (such as Selegiline, Moclobemide or Linezolid), as a dangerous rise in blood pressure can occur. Avoid other decongestants and stimulants (such as Phenylephrine, Ephedrine or high-caffeine products). It may reduce the effect of blood pressure medicines, and can increase heart rhythm problems with Digoxin or some antidepressants. Antacids may increase its absorption.
Contraindications
Do not take it if you have severe or uncontrolled high blood pressure, severe coronary heart disease, are taking or recently took an MAO inhibitor, or are allergic to pseudoephedrine. It is generally avoided in severe kidney disease, overactive thyroid, closed-angle glaucoma and phaeochromocytoma (an adrenal tumour).
Side Effects
Common side effects include:
- Difficulty sleeping, restlessness and nervousness
- Fast heartbeat or palpitations
- Headache, dizziness and dry mouth
- Loss of appetite and nausea
- Difficulty passing urine, especially in men with an enlarged prostate
Get urgent medical help if you have chest pain, a very fast or irregular heartbeat, a sudden severe headache, confusion, seizures, hallucinations, sudden abdominal pain or bleeding from the back passage, or signs of a serious allergic reaction.
Pregnancy and Lactation
Avoid in the first three months of pregnancy and use later in pregnancy only if a doctor advises it. Small amounts pass into breast milk, and it may reduce milk supply, so it is best avoided while breastfeeding unless a doctor recommends it.
Precautions and Warnings
Use with care and ask a doctor first if you have high blood pressure, heart disease, diabetes, an overactive thyroid, glaucoma, an enlarged prostate or kidney problems. Older people may be more sensitive to side effects. Do not take more than one product containing a decongestant at the same time.
Overdose
Overdose can cause severe agitation, very high blood pressure, fast or irregular heartbeat, hallucinations, seizures and difficulty passing urine. Seek emergency medical care straight away.
Therapeutic Class
Nasal decongestant; sympathomimetic (alpha-adrenergic agonist).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.