pseudoephedrine hydrochloride

pseudoephedrine hydrochloride

[-ef′ədrēn]

an adrenergic agonist that acts as a vasoconstrictor and decongestant. Also called pseudoephedrine sulfate.

indication It is prescribed for the relief of nasal congestion.

contraindications Known hypersensitivity to sympathomimetic drugs prohibits its use. Interaction with monoamine oxidase inhibitors may cause hypertensive crisis. It is prescribed with caution in patients who have hypertension, glaucoma, heart disease, diabetes, or urinary retention.

adverse effects Among the more serious adverse effects are central nervous system stimulation, headache, tachycardia, and increased blood pressure.

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pseudoephedrine hydrochloride

Contac Non Drowsy (UK), Galsud (UK), Genaphed, Kidkare Decongestant, Meltus Decongestant (UK), Non-Drowsy Sudafed Decongestant (UK), PediaCare Infants' Oral Decongestant Drops, Robidrine (CA), Silfedrine Children's, Sudafed, Sudafed Children's Nasal Decongestant, Sudafed 12 Hour, Sudo-Tab, Sudodrin, SudoGest

Pharmacologic class: Sympathomimetic

Therapeutic class: Decongestant (systemic)

Pregnancy risk category C

Action

Stimulates alpha-adrenergic receptors, causing vasoconstriction of respiratory tract; relaxes bronchial smooth muscle through beta₂-adrenergic stimulation

Availability

pseudoephedrine hydrochloride

Capsules: 60 mg

Capsules (extended-release): 120 mg, 240 mg

Capsules (soft gel): 30 mg

Oral solution: 15 mg/5 ml, 30 mg/5 ml

Syrup: 30 mg/5 ml

Tablets: 30 mg, 60 mg

Tablets (chewable): 15 mg

Tablets (extended-release): 120 mg, 240 mg

pseudoephedrine sulfate

Tablets (extended-release, film-coated): 120 mg

⊘Indications and dosages

➣ Nasal, sinus, or eustachian tube congestion

Adults and children ages 12 and older: 60 mg P.O. q 4 to 6 hours p.r.n. (not to exceed 240 mg/day); or 120 mg (extended-release) q 12 hours or 240 mg (extended-release) q 24 hours

Contraindications

• Hypersensitivity to drug or other sympathomimetics
• Alcohol intolerance (with some liquid products)
• Hypertension
• Severe coronary artery disease
• MAO inhibitor use within past 14 days
• Children younger than age 12 (extended-release forms)

Precautions

Use cautiously in:
• hyperthyroidism, diabetes mellitus, prostatic hypertrophy, ischemic heart disease, glaucoma
• elderly patients (more sensitive to drug's CNS effects)
• pregnant or breastfeeding patients.

Administration

• Give at least 2 hours before bedtime to minimize insomnia.

Route	Onset	Peak	Duration
P.O.	30 min	Unknown	4-8 hr
P.O. (extended)	60 min	Unknown	12 hr

Adverse reactions

CNS: anxiety, nervousness, dizziness, drowsiness, excitability, fear, hallucinations, headache, insomnia, restlessness, asthenia, seizures

CV: palpitations, hypertension, tachycardia, cardiovascular collapse

GI: anorexia, dry mouth

GU: dysuria

Respiratory: respiratory difficulty

Interactions

Drug-drug. Beta-adrenergic blockers: increased pressor effects of pseudoephedrine

MAO inhibitors: hypertensive crisis

Mecamylamine, methyldopa, reserpine: decreased antihypertensive effect of these drugs

Other sympathomimetics: additive effects, greater risk of toxicity

Drug-food. Foods that acidify urine: decreased drug efficacy

Foods that alkalize urine: increased drug efficacy

Patient monitoring

• Monitor vital signs.
• Assess neurologic and cardiovascular status regularly.

Patient teaching

• Advise patient to take at least 2 hours before bedtime to reduce insomnia.
• Tell patient not to crush or break extended-release tablets or capsules.
• Advise patient to discontinue use and consult prescriber if he experiences nervousness, dizziness, or insomnia.
• Tell patient to consult prescriber before taking other over-the-counter products.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and foods mentioned above.