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)

Renal Dosing

• Caution with renal impairment

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

See Also

• URI