6 Sudafed PE Side Effects You Should Know About

If you have a stuffy nose (nasal congestion), you may be thinking about picking something up from your local drugstore to help you feel better. Sudafed PE (phenylephrine) tablets are a convenient option to temporarily relieve both nasal congestion and pressure. It’s available as an over-the-counter (OTC) medication.

But don’t confuse Sudafed PE with Sudafed (pseudoephedrine) that’s kept behind the pharmacy counter. They work in a similar way, but don’t include the same active ingredient.  

Sudafed PE tightens the blood vessels in your nose. This helps lessen swelling and mucus build-up, which soothes the congestion and pressure you feel in your sinuses. But it can also cause some unwanted side effects. Let’s take a look at some of the Sudafed PE side effects you should know about, and what you can do to manage them. 

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1. Anxiety

Sudafed PE may make you feel unusual nervousness or anxiety. That’s because decongestants can have a stimulant effect on your brain. This can make you feel nervous or agitated in some cases. 

If you feel like your heart is racing, that could also be a sign of anxiety. But it might also be a different side effect related to your heart — which we’ll discuss later.

If you notice you’re feeling anxious after taking Sudafed PE, it’s best to stop taking it and talk to your healthcare provider or pharmacist. They can help you find an alternative medication you can take for congestion. 

2. Headache

Headaches are another possible side effect of Sudafed PE. Keep in mind that the same illnesses that can cause congestion (like a cold or the flu) can cause headaches, too. And decongestants can also cause another type of headache — known as a rebound headache — if they’re taken too often.

There are several tips to get rid of a headache. Getting plenty of sleep and drinking enough water are important to help treat headaches. An OTC pain reliever, like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), may also help. Keep in mind that many combination OTC cold medications may already have a pain reliever in them. So be sure to read the label and talk to your pharmacist before taking anything else. 

If your headache is severe, or you also have a stiff neck or feel worse when lying down, seek emergency medical care. This could be a sign something more serious is going on.

3. Dizziness

Dizziness is not a common side effect of Sudafed PE, but it may happen in some cases. If you experience dizziness after taking Sudafed PE, stop taking it and contact your healthcare provider. They’ll be able to help determine what’s going on and if treatment is needed.

If your dizziness is severe or you’re also having sudden trouble with your vision or lose consciousness, you should seek emergency medical care.

4. Insomnia

Insomnia (difficulty sleeping) is another possible Sudafed PE side effect. Like anxiety, this can happen due to its stimulant effects. Think of it as being similar to trying to sleep after having too much caffeine. 

One way to prevent insomnia is to avoid taking Sudafed PE within four hours of bedtime. If your nasal symptoms are worse at night or you’re still having trouble sleeping after taking Sudafed PE earlier in the day, you can discuss alternative options with your healthcare provider or pharmacist.   

5. Nausea

Nausea is a common side effect of many medications, and that includes Sudafed PE. But as with a headache, it could also be related to whatever’s causing your congestion. Nausea is a possible symptom of infection with the flu, common cold, or COVID-19. 

Taking Sudafed PE with food may help with nausea. But if it gets worse or becomes troubling, contact your healthcare provider. They may recommend nausea medication or other options to manage it. They may also suggest a different treatment option for your congestion.

6. Fast heartbeat

It’s possible for Sudafed PE to cause a fast heartbeat. And it may cause high blood pressure, too. While it mostly works in your nose, Sudafed PE can tighten blood vessels throughout your body. This can result in more pressure on your heart, which causes your blood pressure and heart rate to go up. 

If you have a history of heart problems, talk to your healthcare provider before taking an OTC decongestant. They may not be the best choice for you. If you’re taking Sudafed PE and think it’s affecting your heart, stop taking it and contact your provider. But if your heart is racing and you also have other symptoms, like chest pain or trouble breathing, seek medical care right away. 

When should I contact my healthcare provider about Sudafed PE side effects?

Sudafed PE is only intended for short-term treatment (1 week or less), and each dose only lasts about four hours. So most Sudafed PE side effects usually don’t last very long either, and will go away once you stop taking it. 

If you experience side effects that are troublesome, stop taking Sudafed PE and contact your healthcare provider or pharmacist. You should also reach out if your symptoms aren’t better after a week. Seek emergency medical care if you have chest pain, difficulty breathing, or severe dizziness. This could be a sign something more serious is going on.  

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Written by:

Brian Leonard, PharmD, BCACP, BCGP

Brian Leonard earned his doctorate in pharmacy from the University of Florida College of Pharmacy and is board certified in Ambulatory Care and Geriatric Pharmacy.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Jonathan Hoosein, PharmD/MBA Candidate

Jonathan Hoosein is a PharmD and MBA candidate at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences. Throughout his professional career, Jonathan has gained experience in various areas of pharmacy including community, hospital, and managed care — all of which has improved his skills in directing patient care.

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