pseudoephedrine
Sudafed (pseudoephedrine) is a non-drowsy decongestant taken by mouth to treat nasal and sinus congestion from allergies and the common cold. It's available in a short-acting version that's taken once every 4 to 6 hours. It also comes in longer-acting versions that are taken every 12 or 24 hours, depending on the dose. Side effects of Sudafed (pseudoephedrine) include anxiety and headache. This medication might also keep you awake at night if you take it too close to bedtime. Sudafed (pseudoephedrine) is an OTC medication, but it's restricted, so you can only purchase it at the pharmacy counter.
What is Sudafed (pseudoephedrine)?
What is Sudafed (pseudoephedrine) used for?
Short-term relief of nasal and sinus congestion and pressure
How Sudafed (pseudoephedrine) works
Sudafed (pseudoephedrine) is a decongestant. It works by squeezing the blood vessels around your nose and sinuses, which helps to clear your congestion and pressure.
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What are the side effects of Sudafed (pseudoephedrine)?
Common Side Effects
- Sweating
- Nervousness
- Excitability
- Difficulty sleeping
- Low appetite
- Difficulty urinating
Other Side Effects
- Nausea
- Vomiting
- Weakness
- Muscle tremor
- Blurred vision
Serious Side Effects
- High blood pressure or fast heart rate: chest pain, blurry vision, headache, fatigue
Source: DailyMed
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The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart palpitations—rapid, pounding, or irregular heartbeat
- Increase in blood pressure
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Anxiety, nervousness
- Headache
- Trouble sleeping
Pros and cons of Sudafed (pseudoephedrine)
Pros
Works well to treat congestion
Available in longer-acting versions that last 12 hours or 24 hours
Children's oral liquids can be taken by kids as young as 4 years old
Available as lower-cost generics
Cons
Several products have different age cut-offs for use in children, so can be confusing
Might make it hard for some people to sleep
Can raise blood pressure and heart rate
Not recommended during pregnancy
Pharmacist tips for Sudafed (pseudoephedrine)
Don't take Sudafed (pseudoephedrine) close to bedtime because it can cause difficulty falling asleep.
Stop using Sudafed (pseudoephedrine) and contact your provider if you experience nervousness, dizziness, or trouble sleeping. These might be serious side effects of Sudafed (pseudoephedrine) and your provider might recommend a different medication to ease your congestion.
Let your provider know if your nasal congestion doesn't get better within a week of starting Sudafed (pseudoephedrine) or if any other new symptoms that appear. These might be signs of a more serious medical condition that your provider needs to check out.
Sudafed (pseudoephedrine) interacts with several medications. Don't start any new medications while taking Sudafed (pseudoephedrine), especially other decongestants, without talking to your provider or pharmacist first. Many combination OTC cold and flu medications already contain pseudoephedrine. Taking too much Sudafed (pseudoephedrine) or other decongestants can raise your risk of overdose and severe side effects, including high blood pressure, fast heart rate, or even death.
Sudafed (pseudoephedrine) shouldn't be taken with a monoamine oxidase inhibitor (MAOI), such as selegiline. This combination can raise your risk for severe side effects (e.g., dangerously high blood pressure). If you're currently taking an MAOI or have taken one in the last 14 days, don't use Sudafed (pseudoephedrine) and contact your provider for other options to treat your congestion symptoms.
It's best to avoid or limit caffeine while taking Sudafed (pseudoephedrine) because this combination can raise your risk for side effects (e.g., fast heart rate, high blood pressure, difficulty sleeping).
Don't split or cut the extended-release tablets. These tablets have a special coating that allows the medication to be slowly released in your body over time. Splitting the tablet will ruin the special coating. This might cause too much medication to be released all at once and lead to side effects, such as irregular heart beats, chest pain, and nervousness.
More tips for Sudafed (pseudoephedrine) 15 mg/5 mL oral liquid only:
Make sure to only use a medication dose cup or syringe from the pharmacy to measure out your dose. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose.
Store the liquid at room temperature in the original bottle it came in from the pharmacy.
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Frequently asked questions about Sudafed (pseudoephedrine)
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What are the risks and warnings for Sudafed (pseudoephedrine)?
Sudafed (pseudoephedrine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Fast heart rate and high blood pressure
Risk factors: Heart problems | High blood pressure
Sudafed (pseudoephedrine) can raise your heart rate and blood pressure, even at recommended doses. If you have a history of heart problems or high blood pressure, ask your provider if Sudafed (pseudoephedrine) is safe for you before using it. If you get severe headaches, nosebleeds, difficulty breathing, irregular heartbeat, or chest pain while taking Sudafed (pseudoephedrine), stop taking it and get medical attention right away.
Worsening of medical conditions
Risk factors: Heart disease or high blood pressure | Thyroid problems | Diabetes | Urinary problems
Don't take Sudafed (pseudoephedrine) if you have any of the risk factors listed above unless your provider said it is safe to do so. Taking Sudafed (pseudoephedrine) can worsen your condition(s) and cause serious side effects. Make sure your provider knows about all medical conditions you have or have had in the past before starting Sudafed (pseudoephedrine).
Accidental overdose
Sudafed (pseudoephedrine) is a decongestant, which is in many other over-the-counter products. Using more than one medication containing a decongestant can lead to an accidental overdose and cause serious side effects, including high blood pressure, high heart rate, difficulty breathing, dizziness, seizures, hallucinations (seeing things that aren't real), or even death. Tell your provider or pharmacist about the medications you take before starting Sudafed (pseudoephedrine) to make sure it's safe for you. Don't start any new medications while taking Sudafed (pseudoephedrine) without talking to your provider or pharmacist. To prevent an accidental overdose, read package labels carefully. If you're not sure if a product has a decongestant, ask your pharmacist. If you or your loved one experiences an accidental overdose, get medical help right away or contact a poison control center at 1-800-222-1222.
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Sudafed (pseudoephedrine) dosage forms
Typical dosing for Sudafed (pseudoephedrine)
Sudafed (pseudoephedrine) comes in different formulations made by different manufacturers. Make sure to check the dosing for your specific product on the manufacturer's label before you take it.
Some examples of directions for Sudafed (pseudoephedrine) include:
Pseudoephedrine 30 mg or 60 mg immediate-release pill (Sudafed, SudoGest, generic):
Adults and children age 12 years and up: The typical dose is 60 mg by mouth every 4 to 6 hours. Don't take more than 240 mg in 24 hours.
Children ages 6 to under 12 years: The typical dose is 30 mg by mouth every 4 to 6 hours. Don't take more than 120 mg in 24 hours.
Children under 6 years of age: Don't use. Contact your child's provider.
Pseudoephedrine 120 mg extended-release tablet (Sudafed Sinus Congestion 12 hour, SudoGest 12 hour, generic):
Adults and children age 12 years and up: The typical dose is 120 mg by mouth every 12 hours. Don't take more than 240 mg in 24 hours.
Children under 12 years of age: Don't use. Contact your child's provider.
Pseudoephedrine 240 mg extended-release tablet (Sudafed Sinus Congestion 24 hour):
Adults and children age 12 years and up: The typical dose is 240 mg by mouth once daily. Don't take more than 240 mg in 24 hours.
Children under 12 years of age: Don't use. Contact your child's provider.
Pseudoephedrine liquid (Children's Sudafed):
Each 5 mL of liquid contains 15 mg of pseudoephedrine.
Children ages 6 to under 12 years old: The typical dose is 30 mg by mouth every 4 to 6 hours. Don't take more than 120 mg per day.
Children ages 4 to under 6 years old: The typical dose is 15 mg by mouth every 4 to 6 hours. Don't take more than 60 mg per day.
Children ages less than 4 years old: Don't use. Contact your child's provider.
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How much does Sudafed (pseudoephedrine) cost?
Sudafed (pseudoephedrine) contraindications
Currently take or have taken an MAOI in the last 14 days
What are alternatives to Sudafed (pseudoephedrine)?
Short-term relief of nasal and sinus congestion and pressure
Short-term relief of nasal and sinus congestion and pressure
Short-term relief of nasal and sinus congestion and pressure
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References
Best studies we foundAmerisource Bergen. (2021). PSEUDOEPHEDRINE HYDROCHLORIDE tablet, film coated, extended release [package insert]. DailyMed.
Food and Drug Administration. (2017). Legal requirements for the sale and purchase of drug products containing pseudoephedrine, ephedrine, and phenylpropanolamine.
Głowacka, K., et al. (2021). Pseudoephedrine—Benefits and risks. International Journal of Molecular Sciences.
Johnson & Johnson Consumer Inc. (2023). CHILDRENS SUDAFED NASAL DECONGESTANT- pseudoephedrine hydrochloride solution [package insert]. DailyMed.
Johnson & Johnson Consumer Inc. (2023). SUDAFED SINUS CONGESTION 12 HOUR- pseudoephedrine hydrochloride tablet, film coated, extended release [package insert]. DailyMed.
Johnson & Johnson Consumer Inc. (2023). SUDAFED SINUS CONGESTION 24 HOUR- pseudoephedrine hydrochloride tablet, film coated, extended release [package insert]. DailyMed.
Johnson & Johnson Consumer Inc. (2023). SUDAFED SINUS CONGESTION- pseudoephedrine hydrochloride tablet, film coated [package insert]. DailyMed.
Johnson & Johnson Consumer Inc. (2023). SUDAFED SINUS CONGESTION- pseudoephedrine hydrochloride tablet, film coated [package insert]. DailyMed.
Kanfer, I., et al. (1993). Pharmacokinetics of oral decongestants. Pharmacotherapy.
Major Pharmaceuticals. (2022). SUDOGEST 12 HOUR- pseudoephedrine hcl tablet, film coated, extended release [package insert]. DailyMed.
Major Pharmaceuticals. (2023). SUDOGEST- pseudoephedrine hcl tablet, film coated [package insert]. DailyMed.
Rugby Laboratories. (2022). NASAL DECONGESTANT- pseudoephedrine hcl tablet [package insert]. DailyMed.
Salerno, S. M., et al. (2005). Effect of oral pseudoephedrine on blood pressure and heart rate: A meta-analysis. Archives of Internal Medicine.
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