Pseudoephedrine
( d-Isoephedrine ) Pronouncation: (SUE-doe-eh-FED-rin)Class: Arylalkylamine
Trade Names:
Allermed
- Capsules 60 mg
Trade Names:
Cenafed
- Tablets 60 mg
- Liquid 30 mg per 5 mL
Trade Names:
Children's Congestion Relief
- Liquid 30 mg per 5 mL
Trade Names:
Congestion Relief
- Tablets 30 mg
Trade Names:
Children's Silfedrine
- Liquid 30 mg per 5 mL
Trade Names:
Decofed Syrup
- Liquid 30 mg per 5 mL
Trade Names:
Defed-60
- Tablets 60 mg
Trade Names:
Dorcol Children's Decongestant
- Liquid 15 mg per 5 mL
Trade Names:
Dynafed Pseudo
- Tablets 60 mg
Trade Names:
Genaphed
- Tablets 30 mg
Trade Names:
Halofed
- Tablets 30 mg
- Tablets 60 mg
Trade Names:
Mini Thin Pseudo
- Tablets 60 mg
Trade Names:
PediaCare Infant's Decongestant
- Drops 7.5 mg per 0.8 mL
Trade Names:
Pseudo
- Liquid 30 mg per 5 mL
Trade Names:
Pseudo-Gest
- Tablets 30 mg
- Tablets 60 mg
Trade Names:
Seudotabs
- Tablets 30 mg
Trade Names:
Sinustop Pro
- Capsules 60 mg
Trade Names:
Sudafed
- Tablets 30 mg
- Tablets 60 mg
Trade Names:
Sudafed 12 Hour Caplets
- Tablets, extended-release 120 mg
Trade Names:
Sudex
- Tablets 30 mg
Trade Names:
Triaminic Infant Oral Decongestant Drops
- Liquid 7.5 mg per 0.8 mL
Trade Names:
Triaminic AM Decongestant Formula
- Liquid 15 mg per 5 mL
Benylin Decongestant (Canada)
Contac Cold 12 Hour Nondrowsy (Canada)
Eltor 120 (Canada)
Pseudofrin (Canada)
Sudafed Decongestant 12 Hour (Canada)
Sudafed Decongestant Children's (Canada)
Sudafed Decongestant Extra Strength (Canada)
Triaminic Pediatric (Canada)
Pharmacology
Feedback for Pseudoephedrine (d-Isoephedrine)
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Causes vasoconstriction and subsequent shrinkage of nasal mucous membranes by alpha-adrenergic stimulation, promoting nasal drainage.
Pharmacokinetics
Distribution
Distributes into breast milk.
Metabolism
Partially metabolized in the liver.
Elimination
Renal (55% to 75% as unchanged); acidic urine accelerates rate of excretion.
Onset
15 to 30 min.
Peak
30 to 60 min.
Duration
3 to 4 h; 8 to 12 h (extended-release).
Indications and Usage
Relief of nasal or eustachian tube congestion.
Contraindications
Hypersensitivity to sympathomimetic amines; severe hypertension; coronary artery disease; MAOIs therapy; breast-feeding mothers.
Dosage and Administration
Pseudoephedrine SulfateAdults and Children older than 12 yr of age
PO 120 mg sustained-release every 12 h.
Pseudoephedrine HydrochlorideAdults
PO 60 mg every 4 to 6 h or 120 mg sustained-release every 12 h. Not to exceed 240 mg/day.
Children 6 to 12 yr of agePO 30 mg every 4 to 6 h. Not to exceed 120 mg/day.
Children 2 to 5 yr of agePO 15 mg every 4 to 6 h. Not to exceed 60 mg/day.
Children 1 to 2 yr of agePO 7 drops (0.2 mL)/kg every 4 to 6 h. Not to exceed 4 doses/day.
Children 3 to 12 moPO 3 drops/kg every 4 to 6 h. Not to exceed 4 doses/day.
Storage/Stability
Store at room temperature.
Drug Interactions
Furazolidone, guanethidine, methyldopaIncreased BP.
MAOIsSevere headache, hypertension and hyperpyrexia; can cause hypertensive crisis.
Urinary acidifiers (eg, ammonium chloride)Increased elimination of pseudoephedrine.
Urinary alkalinizers (eg, sodium bicarbonate)Decreased elimination of pseudoephedrine.
Laboratory Test Interactions
None well documented.
Adverse Reactions
Cardiovascular
Arrhythmias; CV collapse with hypotension; tachycardia; bradycardia; transient hypertension.
CNS
Nervousness; excitability; dizziness; tremor; insomnia; restlessness; depression.
Dermatologic
Pallor.
GI
Anorexia; nausea; vomiting; dry mouth.
Genitourinary
Difficulty urinating.
Precautions
Pregnancy
Category C .
Lactation
Do not give to breast-feeding mothers.
Children
Use drug only under health care provider's advice in children under 3 mo.
Elderly
Ensure that short-acting product is tolerated before giving sustained-release product.
Special Risk Patients
Use drug with caution in patients with hyperthyroidism, diabetes, CV disease, increased IOP or prostatic hypertrophy. Patients with hypertension should use only under medical advice.
Excessive use
Systemic effects (eg, nervousness, dizziness, sleeplessness) are more common in elderly and infants.
Overdosage
Symptoms
Somnolence; sedation, which may be accompanied by profuse sweating, hypotension or shock; coma. Symptoms in elderly include hallucinations, seizures, CNS depression, and death.
Patient Information
- Advise patient not to exceed recommended dose.
- Instruct patient not to chew or crush sustained-release form.
- Teach patient to use calibrated measuring device to administer liquid and calibrated dropper to administer drops.
- Instruct patient to report the following symptoms to health care provider: Breathing difficulties, hallucinations, seizures (symptoms of overdose); lack of improvement within 7 days; high fever.
- Instruct patient to take sips of water frequently or suck on ice chips, sugarless hard candy or chew sugarless gum if dry mouth occurs.
- Advise patient to avoid taking other OTC medications containing sympathomimetic amines.
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