Definition: what is pseudoephedrine?

Pseudoephedrine is a vasoconstrictor, i.e. a substance reducing the diameter of blood vessels employed for unblock the nose. It can be administered orally and always combined with paracetamol or ibuprofen to relieve symptoms such as headache and fever. Its use is exclusively reserved for adults and children over 15 years old.

In what drugs is it found?

In combination with paracetamol or ibuprofen, pseudoephedrine is present in the following medicines:

• Actived colds®
• Active cold day and night®
• Dolirhume®
• Dolirhumepro®
• Humex colds®
• Nurofen colds®
• Rhinadvil colds®
• Rhinadvil cold caps®

What are the effects of pseudoephedrine?

Pseudoephedrine induces a narrowing of blood vessels to curb mucus production at the level of the nasal mucosa. This allows to relieve the feeling of stuffy nose in the context of a cold or the flu. This molecule is therefore qualified as both a vasoconstrictor and a decongestant.

Is it available without a prescription?

All drugs containing pseudoephedrine are available in pharmacies without a prescription. Note that if prescribed by a doctor, they are not reimbursed by health insurance.

What is the maximum dose?

According to trade specialties, pseudoephedrine is dosed at 30 mg or 60 mg per tablet can be administered at a rate of one to two per dose. Knowing that these tablets should not be taken more than 3 times a day, the maximum daily dose of pseudoephedrine is set at 180 mg. It is essential to follow the recommended intake methods given on the package leaflet in order to avoid any overdose of pseudoephedrine, ibuprofen or paracetamol exposing to serious risks.

What are the dangers of pseudoephedrine?

The most common side effects seen with pseudoephedrine are dry mouth, nausea, dizziness, nervousness, restlessness and insomnia. Likewise, headaches, hallucinations, drowsiness and seizures are possible. Of the skin rashes, itching, allergies even exceptionally anaphylactic shock were also listed. This molecule can cause inflammation of the colon by reduced blood supply, angle-closure glaucoma and optic nerve damage. Immediate discontinuation of treatment is strongly recommended in the event of abdominal pain, emission of blood from the anus or impaired vision. Pseudoephedrine-based drugs also expose people to cardiovascular adverse effects such as high blood pressure, heart palpitations. Other rare but much more severe manifestations may occur: myocardial infarction, transient ischemic attack (transient obstruction of a blood vessel by a clot) even a hemorrhagic stroke leading to necrosis of the affected area. These phenomena have mainly been reported in the event of overdose. In order to limit the occurrence of adverse effects, the drug should be initiated at the lowest effective dose and for the shortest possible period. The maximum duration of treatment is 4-5 days. If symptoms do not improve, medical consultation is required. Moreover, vigilance is required in some athletes since pseudoephedrine is on the list of substances prohibited in competition.

What are the contraindications of pseudoephedrine?

Pseudoephedrine has many contraindications:

• allergy to one of the components of the drug
• risk of urinary retention
• risk of glaucoma closed angle
• severe coronary insufficiency
• high blood pressure severe or unbalanced
• history of seizures
• history of stroke or presence of risk factors that may be responsible for a stroke
• child under 15
• feeding with milk

In addition, pseudoephedrine is strictly contraindicated in association with certain drugs, like other vasoconstrictors (oral and nasal), midodrine (Gutron®), methyphenidate (Ritaline®), iproniazid (Marsilid®). It is recommended to communicate your medical history and current treatments to your doctor or pharmacist before taking pseudoephedrine. Pseudoephedrine drugs are not contraindicated during pregnancy but very strongly discouraged.

Sources:
– Public drug database
-ANSM