Pseudoephedrine: Difference between revisions

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{{MedTemplate

| generic = Pseudoephedrine

| generic = Pseudoephedrine (hydrochloride; sulfate)

| brand = Sudafed

| brand = Sudafed (IR, 12-hour, 24-hour); many combination products including Claritin-D, Allegra-D, Zyrtec-D, Mucinex-D

| classes = ~~Stimulant~~, ~~Decongestant~~

| structure =

| mechanism = Indirect sympathomimetic

| classes = [[:Category:Decongestants|Decongestant]], [[:Category:Sympathomimetics|Sympathomimetic (indirect-acting)]]

| uses = <vote slug="nasal-congestion-cold-use">Nasal congestion from common cold (OTC, FDA)</vote>, <vote slug="allergic-rhinitis-congestion-use">Allergic rhinitis nasal congestion (OTC, FDA)</vote>, <vote slug="sinusitis-congestion-use">Acute sinusitis nasal congestion (OTC, FDA)</vote>, <vote slug="eustachian-tube-congestion-use">Eustachian tube congestion (off-label)</vote>

| starting_dose = IR: 60 mg PO every 4-6 hours. 12-hour ER: 120 mg PO every 12 hours. 24-hour ER: 240 mg PO once daily. Pediatric: weight-based

| preparations = IR tablets 30, 60 mg; 12-hour ER tablets 120 mg; 24-hour ER tablets 240 mg; oral liquid; multiple combination products with antihistamines, NSAIDs, or expectorants

| fda_max = 240 mg/day

| pill_id =

| routes = Oral

| onset = 30-60 minutes

| duration = 4-6 hours (IR); 12-24 hours (ER)

| halflife = 9-16 hours (pH-dependent: acidic urine shortens, alkaline urine substantially extends)<ref name="sudafed-monograph">FDA OTC Monograph for Nasal Decongestants. https://www.accessdata.fda.gov/scripts/cder/ob/ (reference for the IR and ER pseudoephedrine formulations)</ref>

| bioavailability = ~90% (oral, low first-pass)<ref name="sudafed-monograph" />

| pregnancy = Some controversial signal for first-trimester gastroschisis association in observational studies; limited use is generally considered acceptable after the first trimester.{{citation needed}}

| legal = '''[[USLegal:Behind-the-counter|Behind-the-counter]] in US''' under the Combat Methamphetamine Epidemic Act 2005: purchase restricted to ≤3.6 g/day and ≤9 g/30 days, with photo ID, logbook signature, and quantity logging required. Several states schedule higher than federal

| mechanism = <vote slug="pseudoephedrine-mech-claim">Indirect-acting sympathomimetic. Taken up by adrenergic nerve terminals where it displaces stored norepinephrine into the synaptic cleft via vesicular monoamine transporter activity. Peripheral α1- and β-adrenergic receptor stimulation produces vasoconstriction in nasal mucosa (the decongestant effect, the principal clinical action). Central sympathomimetic effects (mild insomnia, restlessness, anxiety) are substantially less than amphetamines because pseudoephedrine penetrates the CNS poorly compared to amphetamine-class agents.</vote> Cardiovascular adverse effects (elevated blood pressure, tachycardia, occasional arrhythmia) are the principal safety concern; avoid in uncontrolled hypertension and severe coronary artery disease. Urinary retention in benign prostatic hyperplasia is a common counseling point<ref name="sudafed-monograph" />.

}}

~~[[Category:Psychostimulants]]~~

== References ==

[[Category:Decongestants]]

[[Category:Sympathomimetics]]

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