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