Pseudoephedrine (Sudafed)

What is pseudoephedrine?

Pseudoephedrine is a decongestant. It’s widely used to relieve a blocked or stuffy nose caused by colds, flu, hay fever or sinusitis. It is sometimes known by brand names like Sudafed, Galpseud, and various own-brand pharmacy decongestants. it is usually available both on prescription and over the counter[1]. 

What is pseudoephedrine used for?

Pseudoephedrine is used to treat nasal congestion. This can be due to illnesses like colds or flu, sinus congestion, or hay fever and other symptoms of allergic rhinitis[1].  

How does pseudoephedrine work?

Pseudoephedrine works by narrowing the blood vessels in the nasal passages. This reduces swelling and congestion, making it easier to breathe, and relieving the uncomfortable feeling of having a blocked or stuffy nose[1]. 

Who can take pseudoephedrine?

Most adults and children over 12 years old can take pseudoephedrine. However, it may not be suitable for people aged 6 to 12 years old, so ask your pharmacist for advice first. Do not give pseudoephedrine to children under 6 years. It may also not be suitable for people who have high blood pressure, heart disease, diabetes, glaucoma, liver or kidney problems, an enlarged prostate, or an overactive thyroid. Likewise, it may not be recommended for people who are taking monoamine oxidase inhibitors (MAOIs) or certain antidepressants[1]. 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

How do you take pseudoephedrine?

Pseudoephedrine is usually taken tablet or capsule form, but can also come as a liquid. If taking tablets or capsules, you should swallow them whole with water. Pseudoephedrine can be taken with or without food. Always follow the instructions on the label or as directed by your healthcare professional[1]. 

What is the typical dosage of pseudoephedrine?

Pseudoephedrine comes as 60mg tablets or capsules and a liquid containing 30mg in 5ml. For adults and children over 12 years old, the typical dose is 60mg (or two 5ml spoonfuls) every 4 to 6 hours. Generally, you should not exceed 240mg in 24 hours, and always follow the dosage instructions provided on the packaging or by your doctor or pharmacist[1]. 

Can you stop taking pseudoephedrine suddenly?

Yes, you can typically stop taking pseudoephedrine once your symptoms improve. It is not intended for long-term use – typically, it should not be taken for more than seven days unless advised by a doctor or pharmacist[1]. 

What should you do if you take too much pseudoephedrine?

Taking too much pseudoephedrine can be harmful, bringing symptoms including restlessness, anxiety, hallucinations, tremors, high blood pressure, a fast or irregular heartbeat, or seizures. If you think you or somebody else has taken too much pseudoephedrine, call 999 or go to A&E immediately[1]. 

What should you do if you forget a dose of pseudoephedrine?

If you forget a dose, you can take it as soon as you remember. But if it is nearly time for your next dose, skip the missed one. Then, you can just continue on your schedule and take the next one. Do not take a double dose to make up for a missed one[1]. 

What medicines should you avoid while taking pseudoephedrine?

You should avoid taking pseudoephedrine alongside several other medicines and substances, including[1]: 

• Other decongestants as they may also contain pseudoephedrine  

• Digoxin, a heart failure medicine 

• Ergot alkaloids for migraine 

• Beta blockers or methyldopa for high blood pressure 

• Monoamine oxidase inhibitors (MAOIs), such as phenelzine 

• Certain antidepressants, such as tricyclic antidepressants 

• Stimulants, including caffeine and some medicines for ADHD 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2].

What are the side effects of pseudoephedrine?

Taking pseudoephedrine can bring mild and common side effects. These can involve having difficulty sleeping, headaches, a dry mouth, or feeling nauseous, nervous, or restless. These usually pass quickly[1]. 

The rarer, but more serious, side effects include[1]: 

• A fast or irregular heartbeat 

• High blood pressure or high temperature 

• A sudden feeling of nausea or vomiting 

• Allergic reactions, such as rash, swelling or difficulty breathing 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about pseudoephedrine

Can I take pseudoephedrine with paracetamol or ibuprofen? 

Yes, it is usually safe to take pseudoephedrine along with paracetamol or ibuprofen for pain or fever relief[1]. 

Can I drive after taking pseudoephedrine? 

Most people can drive after taking pseudoephedrine. However, you should do what is safe. Avoid driving if you feel dizzy, restless or drowsy after taking the medication[1]. 

Can I drink alcohol while taking pseudoephedrine? 

It is best to avoid alcohol while taking pseudoephedrine – it can increase the risk of side effects such as dizziness and make them more severe or unpleasant[1]. 

Is pseudoephedrine addictive? 

Pseudoephedrine is not addictive in the usual sense. However, there is a chance that overuse can lead to rebound congestion, where symptoms return worse than before. For this reason, it’s important only to take pseudoephedrine as and when you need it[1]. 

Can I take pseudoephedrine during pregnancy? 

Pseudoephedrine is not recommended during pregnancy unless advised by a doctor first[1]. 

Can I take pseudoephedrine while breastfeeding? 

Pseudoephedrine may reduce milk supply. As such, it should only be used while breastfeeding if recommended by your doctor[1]. 

How quickly does pseudoephedrine work? 

Pseudoephedrine can start to work within 30 minutes to an hour – it usually provides fast and effective relief from nasal congestion[1]. 

Can I take pseudoephedrine at night? 

If absolutely necessary, you can safely take pseudoephedrine at night. However, it’s best to avoid taking it close to bedtime if possible, as it may cause difficulty sleeping and insomnia[1]. 

Is pseudoephedrine available over the counter? 

Yes, pseudoephedrine is available over the counter, as well as on prescription. You may need to speak to a pharmacist before buying it from certain outlets[1]. 

What should I do if I feel worse while taking pseudoephedrine? 

If you are taking pseudoephedrine and your symptoms get worse or do not improve after a few days, you should pause taking it and speak to your doctor or pharmacist for advice[1]. 

For the official NHS guide to pseudoephedrine, visit their website.