Pseudoephedrine

Pseudoephedrine Brand Names

Contac Cold 12 Hour | Dimetapp Decongestant | Drixoral | ElixSure Cold | ElixSure Congestion | Entex | Genaphed | KidKare | Myfedrine | NASAL Decongestant | Nasofed | Nexafed | PediaCare Infants’ Decongestant | Pseudo-Time | Silfedrine | Sudafed | Sudafed 12 Hour | Sudafed 24 Hour | Sudafed Children’s | Sudafed Children’s Nasal Decongestant | Sudafed Congestion | Sudafed Sinus Congestion | Sudogest | Sudogest 12 Hour | Sudogest Children’s | Tylenol Children’s Simply Stuffy | Zephrex-D

What is Pseudoephedrine

Pseudoephedrine is an orally administered sympathomimetic agent with structural similarity to ephedrine.

Compared to ephedrine, pseudoephedrine has practically no bronchodilatory properties and is ineffective in relieving bronchospasm.

Pseudoephedrine most commonly is used to relieve nasal and sinus congestion in adults and children 4 years of age and older. Oral decongestant use produces little or no rebound congestion, unlike topically applied sympathomimetics.

Pseudoephedrine is effective in reducing air-travel-related otalgia in adults; however, children and infants do not appear to benefit.

Pseudoephedrine and phenylephrine appear to have a lower propensity to cause hypertension and potential sequelae (e.g., hemorrhagic stroke, hypertensive crisis) than ephedrine or phenylpropanolamine.

Well-controlled hypertensive patients receiving pseudoephedrine at recommended doses do not appear at high risk for significant elevations in blood pressure, however, increased blood pressure (especially systolic hypertension) has been reported in some patients.

Pseudoephedrine is commonly diverted for use as a substrate for the illegal synthesis of amphetamine and methamphetamine.

The U.S. Comprehensive Methamphetamine Control Act of 1996 requires retailers to report bulk sales (more than 24 grams) of pseudoephedrine, as well as all distributions of pseudoephedrine to non-regulated parties by postal, private, or commercial carrier to the DEA on a monthly basis (regardless of the size of the shipment).

The Combat Methamphetamine Epidemic Act of 2005 governs the sale and purchase of all OTC products containing pseudoephedrine, ephedrine, or phenylpropanolamine in the U.S. Retailers must keep pseudoephedrine-containing products in locked cabinets or behind counters prior to purchase, enter individual product purchases and amounts into a log and maintain it for at least 2 years following each sale, require photo identification and verify customer-required entries into the log, and ensure daily and monthly allowable limits on purchases are not exceeded (review Patriot Act Title VII for more information on legal requirements).

Pseudoephedrine was approved by the FDA in June 1959.

Indications

1. allergic rhinitis
2. common cold
3. eustachian tube congestion
4. nasal congestion
5. otalgia prophylaxis
6. urinary incontinence

For the temporary relief of the symptoms of sinus and nasal congestion due to the common cold, allergic rhinitis or other upper respiratory allergies or conditions, including eustachian tube congestion

Side Effects

1. abdominal pain
2. acute generalized exanthematous pustulosis (AGEP)
3. angina
4. anxiety
5. arrhythmia exacerbation
6. bowel ischemia
7. colitis
8. contact dermatitis
9. dizziness
10. erythema
11. hallucinations
12. headache
13. hypertension
14. insomnia
15. myocardial infarction
16. nausea
17. ocular hypertension
18. palpitations
19. photophobia
20. premature ventricular contractions (PVCs)
21. psychosis
22. rash
23. restlessness
24. seizures
25. sinus tachycardia
26. stroke
27. supraventricular tachycardia (SVT)
28. urinary retention
29. urticaria

Monitoring Parameters

• laboratory monitoring not necessary

Contraindications

• acute myocardial infarction
• angina
• breast-feeding
• bronchitis
• cardiac arrhythmias
• cardiac disease
• cardiomyopathy
• children
• closed-angle glaucoma
• coronary artery disease
• diabetes mellitus
• dysphagia
• emphysema
• geriatric
• GI obstruction
• heart failure
• hypertension
• hyperthyroidism
• infants
• MAOI therapy
• phenylketonuria
• pregnancy
• renal failure
• renal impairment
• substance abuse
• tachycardia
• urinary retention

Interactions

• Acarbose
• Acebutolol
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetazolamide
• Aclidinium; Formoterol
• Albiglutide
• Albuterol
• Albuterol; Ipratropium
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Alkalinizing Agents
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-blockers
• Alpha-glucosidase Inhibitors
• Aluminum Hydroxide
• Aluminum Hydroxide; Magnesium Carbonate
• Aluminum Hydroxide; Magnesium Hydroxide
• Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
• Aluminum Hydroxide; Magnesium Trisilicate
• Amiloride; Hydrochlorothiazide, HCTZ
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Ammonium Chloride
• Amoxapine
• Angiotensin II receptor antagonists
• Angiotensin-converting enzyme inhibitors
• Arformoterol
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Atenolol
• Atenolol; Chlorthalidone
• Atomoxetine
• Atropine
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Atropine; Edrophonium
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azilsartan; Chlorthalidone
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Benazepril
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Beta-blockers
• Betaxolol
• Bethanechol
• Bisoprolol
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bosentan
• Bretylium
• Brimonidine; Timolol
• Bromocriptine
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Phenylephrine
• Budesonide; Formoterol
• Bumetanide
• Bupropion
• Bupropion; Naltrexone
• Caffeine
• Caffeine; Ergotamine
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Calcium-channel blockers
• Canagliflozin
• Canagliflozin; Metformin
• Candesartan; Hydrochlorothiazide, HCTZ
• Captopril
• Captopril; Hydrochlorothiazide, HCTZ
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Phenylephrine
• Cardiac glycosides
• Carteolol
• Carvedilol
• Chlophedianol; Guaifenesin; Phenylephrine
• Chlorothiazide
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Phenylephrine
• Chlorthalidone
• Chlorthalidone; Clonidine
• Clevidipine
• Clonidine
• Cocaine
• Codeine; Phenylephrine; Promethazine
• Colchicine
• Colchicine; Probenecid
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin; Phenylephrine
• Digitoxin
• Digoxin
• Dihydroergotamine
• Diltiazem
• Dipeptidyl Peptidase-4 Inhibitors
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Phenylephrine
• Dopamine
• Dorzolamide; Timolol
• Dronabinol
• Droxidopa
• Dulaglutide
• Dyphylline
• Dyphylline; Guaifenesin
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enalapril, Enalaprilat
• Enalapril; Felodipine
• Enalapril; Hydrochlorothiazide, HCTZ
• Ephedrine
• Epoprostenol
• Eprosartan; Hydrochlorothiazide, HCTZ
• Ergoloid Mesylates
• Ergonovine
• Ergot alkaloids
• Ergotamine
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Esmolol
• Ethacrynic Acid
• Exenatide
• Felodipine
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Formoterol
• Formoterol; Mometasone
• Fosinopril
• Fosinopril; Hydrochlorothiazide, HCTZ
• Furosemide
• Ginger, Zingiber officinale
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide; Metformin
• Glyburide; Metformin
• Glycopyrrolate; Formoterol
• Green Tea
• Guaifenesin; Phenylephrine
• Guanabenz
• Halogenated Anesthetics
• Haloperidol
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone; Phenylephrine
• Iloprost
• Incretin Mimetics
• Indacaterol
• Indacaterol; Glycopyrrolate
• Indapamide
• Insulin Degludec; Liraglutide
• Insulin Glargine; Lixisenatide
• Insulins
• Iobenguane I 131
• Isocarboxazid
• Isradipine
• Labetalol
• Levalbuterol
• Levobetaxolol
• Levobunolol
• Levothyroxine
• Levothyroxine; Liothyronine (Porcine)
• Levothyroxine; Liothyronine (Synthetic)
• Linagliptin; Metformin
• Linezolid
• Liothyronine
• Liraglutide
• Lisinopril
• Lixisenatide
• Loop diuretics
• Macitentan
• Maprotiline
• Mecamylamine
• Meglitinides
• Metaproterenol
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methazolamide
• Methyclothiazide
• Methyldopa
• Methylergonovine
• Methysergide
• Metolazone
• Metoprolol
• Midodrine
• Miglitol
• Moexipril
• Monoamine oxidase inhibitors
• Nabilone
• Nadolol
• Nebivolol
• Nebivolol; Valsartan
• Nicardipine
• Nicotine
• Nifedipine
• Nimodipine
• Nisoldipine
• Nitrates
• Norepinephrine
• Ozanimod
• Penbutolol
• Pergolide
• Perindopril
• Perindopril; Amlodipine
• Phenelzine
• Phenylephrine
• Phenylephrine; Promethazine
• Pindolol
• Pioglitazone
• Pirbuterol
• Potassium-sparing diuretics
• Pramlintide
• Procarbazine
• Propranolol
• Quinapril
• Racepinephrine
• Ramipril
• Rasagiline
• Reserpine
• Riociguat
• Rosiglitazone
• Safinamide
• Salmeterol
• Selegiline
• Selexipag
• Semaglutide
• SGLT2 Inhibitors
• Sibutramine
• Solriamfetol
• Sotalol
• St. John’s Wort, Hypericum perforatum
• Sulfonylureas
• Terbutaline
• Theophylline, Aminophylline
• Thiazide diuretics
• Thiazolidinediones
• Thyroid hormones
• Timolol
• Torsemide
• Trandolapril
• Trandolapril; Verapamil
• Tranylcypromine
• Treprostinil
• Tricyclic antidepressants
• Umeclidinium; Vilanterol
• Vasodilators
• Vasopressors
• Verapamil
• Yohimbine