Brands, Medical Use, Clinical Data
- Adrenergic Agents
- Vasoconstrictor Agents
- Bronchodilator Agents
- Central Nervous System Agents
- Capsule (sustained-release)
- Tablet (extended-release)
- Oral liquid
- Nasal spray
Brands / Synonyms
Afrinol; Allegra D; Allegra D-12 Hour; Allegra-D; Allegra-D 24 Hour; Atuss DS Suspension; Balminil Decongestant Syrup; Benylin Decongestant; Besan; Cenafed; Chlorphen MAL DEX HBR Pseudoeph; Chlorphen MAL Pseudoeph; Clarinex-D; Corzall; Corzall Liquid; D-Isoephedrine; D-Pseudoephedrine; Decofed; Dihydro; Dimetapp Decongestant; Dimetapp Decongestant Pediatric Drops; Drixoral N.D.; Drixoral Nasal Decongestant; Efidac 24 Pseudoephedrine Hcl; Efidac/24; Eltor 120; Exall; Exefen; Genaphed; Isoephedrine; Maxenal; Myfedrine; Myphetane DX; Novafed; Pedia Care; Pseudo; Pseudo 60's; Pseudo-12; Pseudodine C; Pseudoefedrina [Inn-Spanish]; Pseudoephedrine D-Form; Pseudoephedrine Ephedrine; Pseudoephedrine Hcl; Pseudoephedrinum [Inn-Latin]; Psi-Ephedrin; Psi-Ephedrine; Robidrine; Semprex-D; Sudafed; Sudafed 12 Hour; Sudafed Decongestant; Sudafed Decongestant 12 Hour; Sudafed Decongestant Extra Strength; Trans-Ephedrine; Triacin-C; Triaminic; Triaminic AM Decongestant Formula; Triaminic Infant Oral Decongestant Drops
For the treatment of nasal congestion, sinus congestion, Eustachian tube congestion, and vasomotor rhinitis, and as an adjunct to other agents in the optimum treatment of allergic rhinitis, croup, sinusitis, otitis media, and tracheobronchitis. Also used as first-line therapy of priapism.
Pseudoephedrine is a sympathomimetic agent, structurally similar to ephedrine, used to relieve nasal and sinus congestion and reduce air-travel-related otalgia in adults. The salts pseudoephedrine hydrochloride and pseudoephedrine sulfate are found in many over-the-counter preparations either as single-ingredient preparations, or more commonly in combination with antihistamines and/or paracetamol/ibuprofen. Unlike antihistamines, which modify the systemic histamine-mediated allergic response, pseudoephedrine only serves to relieve nasal congestion commonly associated with colds or allergies. The advantage of oral pseudoephedrine over topical nasal preparations, such as oxymetazoline, is that it does not cause rebound congestion (rhinitis medicamentosa).
Mechanism of Action
Pseudoephedrine acts directly on both alpha- and, to a lesser degree, beta-adrenergic receptors. Through direct action on alpha-adrenergic receptors in the mucosa of the respiratory tract, pseudoephedrine produces vasoconstriction. Pseudoephedrine relaxes bronchial smooth muscle by stimulating beta2-adrenergic receptors. Like ephedrine, pseudoephedrine releasing norepinephrine from its storage sites, an indirect effect.
Pseudoephedrine is readily and almost completely absorbed from the GI tract and there is no evidence of first-pass metabolism.
Common adverse reactions include nervousness, restlessness, and insomnia. Rare adverse reactions include difficult/painful urination, dizziness/lightheadedness, heart palpitations, headache, increased sweating, nausea/vomiting, trembling, troubled breathing, unusual paleness, and weakness.
Biotrnasformation / Drug Metabolism
Patients with severe hypertension, severe coronary artery disease, and patients on MAO inhibitor therapy. Also
contraindicated in patients with hypersensitivity or idiosyncrasy to sympathomimetic amines which may be manifested
by insomnia, dizziness, weakness, tremor or arrhythmias.
Children under 12: Should not be used by children under 12 years.
Nursing Mothers: Contraindicated because of the higher than usual risk for infants from sympathomimetic
MAO inhibitors and beta adrenergic blockers increase the effects of pseudoephedrine. Sympathomimetics may reduce
the antihypertensive effects of methyldopa, mecamylamine, reserpine and veratrum alkaloids.