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
    • URI

    References
    1. https://reference.medscape.com/drug/sudafed-nexafed-pseudoephedrine-343412#6
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