Pseudoephedrine
Mechanism :
Pseudoephedrine is an orally effective nasal decongestant with peripheral effects similar to epinephrine and central effects similar to, but less intense than, amphetamines. It has the potential for excitatory side effects. At the recommended oral dosage, it has little or no pressor effect in normotensive adults. Patients have not been reported to experience the rebound congestion sometimes experienced with frequent, repeated use of topical decongestants.
Indication :
- Common cold
- Allergic rhinitis
- Vasomotor rhinitis
Contraindications :
Contraindicated in sensitivity to pseudoephedrine or any of the other components. Patients receiving or having received MAO inhibitors in the preceding 2 weeks; known hypersensitivity to pressor amines. Patients with severe hypertension or severe coronary artery disease.
Dosing :
<2 years:
Safety and efficacy not established.
2-6 years:
5-30 mg PO every 4-6 hours as and when required.
6-12 years:
30 mg PO every 4-6 hours or 4 mg/kg/day in 6 hourly divided doses; Maximum dose: 120 mg/day.
>12 years:
60 mg PO every 6 hours as and when required.
Adverse Effect :
Headache, dizziness, insomnia, tremor, confusion, CNS stimulation, muscular weakness, dry mouth, nausea, vomiting, difficulty in micturition, palpitations, tightness in the chest, syncope. Fixed drug eruption has been reported and rarely hallucinations.
Interaction :
Antidepressants, Appetite Suppressants, Amphetamine, and MAOIs: May cause a rise in blood pressure.
Antihypertensive agents e.g. Bretylium, Methyldopa and Guanethidine: May have effect partially reversed by pseudoephedrine.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function. Use with caution |
| <10 | Dose as in normal renal function. Use with caution |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely dialysability. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
No dose adjustment recommended.