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RESPIRATORY SYSTEM › NASAL PREPARATIONS › NASAL DECONGESTANTS FOR SYSTEMIC USE › Sympathomimetics
pseudoephedrine, combinations
R01BA52
Forms & Strengths
- Oral tablets: 30 mg, 60 mg, 120 mg (extended-release)
- Oral liquid: 15 mg/5 mL
- Combination products: pseudoephedrine with antihistamines (e.g., cetirizine, fexofenadine, loratadine) or analgesics (e.g., ibuprofen, acetaminophen)
Adult Dosing
- Immediate-release: 60 mg orally every 4 to 6 hours as needed; maximum 240 mg daily
- Extended-release: 120 mg orally every 12 hours or 240 mg orally every 24 hours
Pediatric Dosing
- Children 6 to 12 years: Immediate-release 30 mg orally every 4 to 6 hours as needed; maximum 120 mg daily
- Children 2 to 5 years: Immediate-release 15 mg orally every 4 to 6 hours as needed; maximum 60 mg daily
- Children under 2 years: Not recommended due to potential for severe toxicity and lack of efficacy
Indications
- Temporary relief of nasal congestion due to the common cold, sinusitis, or upper respiratory allergies
- Eustachian tube congestion
Mechanism of Action
- Sympathomimetic amine that stimulates alpha- and beta-adrenergic receptors
- Causes vasoconstriction of the nasal mucous membranes, reducing tissue hyperemia, edema, and nasal congestion
Contraindications
- Hypersensitivity to pseudoephedrine or any component of the formulation
- Concurrent use of or within 14 days of monoamine oxidase inhibitors (MAOIs)
- Severe hypertension or severe coronary artery disease
Adverse Reactions
- Cardiovascular: Tachycardia, palpitations, elevated blood pressure
- Nervous system: Insomnia, dizziness, nervousness, restlessness, headache
- Gastrointestinal: Nausea, dry mouth
- Genitourinary: Urinary retention in patients with prostatic hyperplasia
Drug Interactions
- MAOIs: Risk of hypertensive crisis
- Sympathomimetic agents: Increased risk of cardiovascular and central nervous system adverse effects
- Antihypertensive agents (e.g., beta-blockers, methyldopa): May decrease the efficacy of blood pressure-lowering medications
- Tricyclic antidepressants: May potentiate pressor response
Curated Content: Needs Vetting Before Put to Clinical Use