Pseudoephedrine (Oral Route)

Pseudoephedrine is a nasal decongestant that works by making the blood vessels narrow to reduce swelling and congestion.

Overview

Pseudoephedrine is a non-prescription (over-the-counter) medication that helps treat a stuffy nose. It belongs to a category of medications known as nasal decongestants. It narrows the blood vessels in the nose that bring on congestion when symptoms develop.

This medicine is available in the form of tablets as well as extended release tablets. Standard tablets are taken 4-6 times daily as needed. Extended release tablets, on the other hand, are taken once or twice daily with a full glass of water.

Don’t chew, split, or break the extended release tablets. Make sure to swallow them whole.

Pseudoephedrine is also available as a solution (oral suspension) and chewable tablets for children’s dosage.

Pseudoephedrine can cause side effects like a pounding, fast heartbeat, ringing in ears, and dizziness. Don’t use heavy machines or drive until you understand how this medicine affects you.

Conditions Treated

  • Stuffy nose

Type of Medicine

  • Nasal decongestant

Side Effects

Alongside its useful effects, Pseudoephedrine can cause various adverse effects. While not all of the effects below can occur, some of them may require medical attention.

See your physician at once if you develop any of these effects while using Pseudoephedrine:

  • Rare/more common with large doses:
  • Slow/irregular heartbeat
  • Convulsions (seizures)
  • Troubled breathing or shortness of breath
  • Hallucinations (feeling, hearing, or seeing things that aren’t there)

Symptoms of overdose:

  • Irregular heartbeat (continuing)
  • Convulsions (seizures)
  • Fast breathing
  • Unusual excitement, nervousness, or restlessness
  • Rise in blood pressure
  • Hallucinations (feeling, hearing, or seeing things that aren’t there)
  • Troubled breathing or shortness of breathing (continuing or severe)
  • Fast or slow heartbeat (continuing or severe)

Some Pseudoephedrine side effects can occur that normally don’t need medical care. These effects may disappear during treatment as you adjust to Pseudoephedrine. Please check with your physician if you have questions about any of these effects, if they are bothersome, or if they persist.

More common:

  • Restlessness
  • Trouble sleeping
  • Nervousness
  • Less common:
  • Dizziness or lightheadedness
  • Difficult/painful urination
  • Nausea or vomiting
  • Increased sweating
  • Fast/pounding heartbeat
  • Headache
  • Trembling
  • Weakness
  • Unusual paleness

This isn’t a comprehensive list of possible Pseudoephedrine side effects. If you develop other effects not outlined above, please check with your physician and pharmacist.

Dosage

Pseudoephedrine is available as a standard tablet, a solution (liquid), a 12-hour long-acting (extended release) tablet, and a 24-hour extended release tablet to be taken orally (by mouth).

The standard tablets and solution are normally taken every four to six hours. It’s advised that you take the 12-hour extended release tablet every 12 hours, i.e. twice in 24 hours. The 24-hour extended release tablet is usually taken only once daily.

To help prevent problems with sleeping, take the final daily dose several hours before you go to bed. Carefully follow the instructions on the prescription or package label, and ask your pharmacist and doctor to explain whatever you don’t understand. Please take the medication exactly as prescribed. Don’t take it more often than directed on the package label or by your doctor or take less or more of it.

Pseudoephedrine comes together with other medications or alone. Ask your pharmacist or doctor for advice about which medication is suitable for your symptoms. Be sure to carefully check over-the-counter cold and cough medications before using two or more medications at once. These medications may contain similar active ingredients and using them together may cause you to overdose. This can be particularly important if you’ll be giving your child cold and cough medications.

Nonprescription cold and cough combination medications, including medications containing Pseudoephedrine, can trigger serious effects or cause death in young children. Don’t give over-the-counter Pseudoephedrine medications to infants younger than 4. If you’re giving these medications to children aged 4 to 11, observe caution and follow the package directions. Don’t give extended release tablets of this medication to children younger than 12.

If you’re giving a combination product that has Pseudoephedrine or Pseudoephedrine alone to a child, carefully read the label of the package to ensure it’s the right medication for a child of that age. Don’t give children Pseudoephedrine medications that are meant for adults.

Before you give any Pseudoephedrine medicine to a child, check the label on the package to see how much medicine the child should get. Check the chart and give the amount that matches the child's age. Ask the pediatrician if you do not know how much medicine to give your child.

If you’re taking the Pseudoephedrine solution, don’t measure your dose with a household spoon. Use the cap or measuring spoon that is provided with the medicine or use a specially made spoon for measuring medicine.

If your symptoms don’t improve within a week or you suffer a fever, stop using Pseudoephedrine and contact your doctor.

Don’t chew, break, or crush extended release tablets; swallow them whole.

Interactions

Before using Pseudoephedrine, report all medicines you’re using to your doctor, including over-the-counter and prescription medicines. Also let your doctor know if you using vitamins or complementary therapies like herbal products since these can interact with medicines as well.

If you’re using more than one drug, there could be an interaction between the drugs. Your healthcare professional may decide to give you medications which interact with one another if the needed effects outweigh the risks. In such cases, your medicine doses may need to be changed or you may need to be closely monitored.

Pseudoephedrine may interact with the following medicines:

  • Tricyclic antidepressants
  • Oxytocin
  • Digoxin (for heart conditions)
  • Medicines to suppress or stimulate appetite
  • The antibiotic furazolidone
  • Methysergide or ergotamine (for migraine)
  • Medicines for treating high blood pressure, including beta and alpha blockers, methyldopa, and guanethidine
  • Medicines for treating asthma and congestion, including other medicines that contain Pseudoephedrine
  • (MAOIs)Monoamine oxidase inhibitors, used for treating depression

These aren’t all the possible Pseudoephedrine interactions. Therefore, make sure to tell your healthcare professional about all products you’re taking before using Pseudoephedrine.

If you’ve got any question or want to talk about anything to do with your medication, consult your local pharmacist.

Warnings

Before using Pseudoephedrine, let your pharmacist and doctor know if you have allergies to it, or have any other kinds of allergies. Also let your doctor know if you have adverse reactions to other decongestants, including ephedrine and phenylephrine. Pseudoephedrine may have inactive ingredients, which may trigger allergies or other issues. For more information, speak to your pharmacist.

If you suffer from any of these medical conditions, please consult your pharmacist and doctor before using Pseudoephedrine: glaucoma (an eye condition), diabetes, heart problems (for example heart attack, heart failure, chest pain), high blood pressure, fast/irregular heartbeat, kidney disease, hyperthyroidism (overactive thyroid), or difficulty with urination (like due to an enlarged prostate).

This medication can cause dizziness. So, don’t use machinery, drive, or carry out any tasks that require attention until you’re certain that you can do these tasks safely. Limit your consumption of alcoholic drinks.

Don’t use Pseudoephedrine if you’re using a monoamine oxidase inhibitor like Selegiline (Zelpar, Emsam, Eldepryl), Phenelzine (Nardil), Tranylcypromine (Parnate), and Isocarboxazid (Marplan), or if you’ve stopped using one of these drugs within the last two weeks.

Liquid products may have alcohol, sugar, or aspartame. It’s advised that you take care if you have liver disease, diabetes, phenylketonuria, alcohol dependence, or any other problem that requires limiting or avoiding these things in your diet. Consult your pharmacist or doctor about using this medication carefully.

If you have very serious narrowing of the stomach, intestine, or esophagus, you shouldn’t use the 240 mg extended release Pseudoephedrine tablet due to the danger of blockage.

Before having an operation, tell your dentist or doctor about all products you’re using (such as nonprescription and prescription products, as well as herbal products).

The elderly may be more vulnerable to this medication’s effects, especially fast/irregular heartbeat, problems with urination, dizziness, confusion, or trouble with sleeping. Therefore, seniors should take Pseudoephedrine cautiously as their chances of suffering side effects are higher.

Children could also be more vulnerable to this medication’s effects, especially restlessness.

The safety of this medication hasn’t been determined during pregnancy. Talk to your doctor/pharmacist if you have any questions or doubts about this.

It’s wise to restrict the use of any medication while you’re pregnant whenever possible. Your doctor, however, may decide that a medication’s benefits outweigh its risks in specific situations and after a thorough assessment of your particular health situation.

If you’ve got any concerns or doubts about using this medication during pregnancy, discuss this with your pharmacist and doctor.

Pseudoephedrine isn’t safe to use if you’re nursing an infant because it gets into breast milk.

It’s advisable to limit the use of this medicine while you’re breastfeeding whenever possible. Your doctor, however, may decide that this medication has more benefits than risks in specific situations after a thorough evaluation of your particular health situation.

If you’ve got any concerns or doubts about breastfeeding while taking this medication, talk to your pharmacist and doctor.

Storage

Keep Pseudoephedrine at room temperature.

Protect Pseudoephedrine from moisture and light.

Keep Pseudoephedrine out of children’s reach.

Don’t dispose of Pseudoephedrine in the toilet or down the sink or in household trash.

Discuss with your local pharmacist how to properly dispose of medications that have expired or those no longer needed.

Summary

Pseudoephedrine and related nasal decongestants are generally safe for everyone, but of course, there are a few exceptions. Don’t take Pseudoephedrine without your physician’s approval if you suffer from any of the conditions below:

  • Heart disease
  • Diabetes
  • High blood pressure
  • Prostate problems
  • Thyroid disease

Also, don’t take this drug without your physician’s permission if you’re pregnant, want to get pregnant, or if you’re breastfeeding.

Additionally, don’t take Pseudoephedrine if you’ve taken a monoamine oxidase (MAO) inhibitor like Selegiline (Zelpar, Emsam, Eldepryl), Phenelzine (Nardil), Tranylcypromine (Parnate), and Isocarboxazid (Marplan) in the last two weeks. A toxic drug reaction may occur, resulting in serious side effects. Don’t take Pseudoephedrine if you take diet pills, other stimulants (e.g. ADHD medications), or caffeine pills as well. Taking a decongestant together with a stimulant can heighten your risk for serious side effects.

Ask your pharmacist or doctor before taking any cold or cough medication. Pseudoephedrine or similar decongestants come in many combination medications. Taking certain substances together may cause you to receive too much of a particular drug. Take a look at the label to find out if a medication has Pseudoephedrine or other decongestant.

If you’re using the 24-hour sustained-release Pseudoephedrine tablet, you may spot something like the same tablet in your feces. Don’t worry. This is simply the empty shell of the tablet, and it doesn’t mean that you didn’t receive your full dose of medication.

Don’t give this medication to children younger than 4. Always consult your doctor before giving your child a cold or cough medicine. Misuse of cold and cough medicines can cause death in very young children.

If you’ve got any questions about Pseudoephedrine, please ask your pharmacist and doctor.

 

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