Pseudoephedrine

Administration

  • Type: Decongestant, sympathomimetic
  • Dosage Forms:
  • Routes of Administration: PO
  • Common Trade Names: Sudafed, Nexafed, Zephrex-D

Adult Dosing

  • Nasal congestion: 60mg PO q4-6h PRN
  • Priapism: 60-120mg PO once

Pediatric Dosing

  • <2y: safety/efficacy not established
  • 2-6y: 5-30mg PO q4-6h PRN
  • 6-12y: 30mg PO q4-6h PRN OR 4mg/kg/day divided q6h
  • >12y: 60mg PO q4-6h PR

Special Populations

Pregnancy Rating

  • Pregnancy Category C, avoid use in first trimester

Lactation risk

  • Excreted in breast milk; irritability reported in nursing infants (limited data)[1]

Renal Dosing

  • Caution with renal impairment

Hepatic Dosing

Contraindications

  • Allergy to class/drug
  • Concomitant or recent (<14d) MAOI use
  • Severe hypertension
  • Severe CAD
  • Caution with:
    • Mild/moderate hypertension, cardiac disease
    • Hyperthyroidism
    • Hyperglycemia, DM
    • Renal impairment
    • Seizure disorder
    • Glaucoma

Adverse Reactions

Serious

  • MI
  • Afib
  • Ischemic colitis

Common

  • Tremor, restlessness, insomnia
  • Nausea/vomiting
  • Hypertension
  • PVCs

Pharmacology

  • Half-life: 3-16h
  • Metabolism: Liver
  • Excretion: Urinary

Mechanism of Action

  • Alpha adrenergic agonist, causes vasoconstriction in nasal/respiratory mucosa. Also stimulates beta adrenergic receptors causing bronchial relaxation

Comments

See Also

References

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