Experiences with

Pseudoephedrine

Pseudoephedrine is a decongestant that helps you breathe more easily if your nose is stuffy or blocked (nasal congestion). This happens when blood vessels in the cavities in your nose (sinuses) become swollen.

Pseudoephedrine works by reducing this swelling and that helps mucus and air flow more freely.

You can get a blocked or stuffy nose when you have:

• a cold
• the flu
• allergies such as hay fever
• a sinus infection (sinusitis)

You can buy pseudoephedrine from pharmacies. It comes as tablets and a liquid that you swallow. You can buy these from a pharmacy in a pack of 12 tablets or 100ml of liquid.

If you need more than this, you'll need a prescription from a doctor.

Pseudoephedrine also comes mixed with other medicines to treat the symptoms of coughs, colds and allergies. These include Benadryl Allergy Relief, Benylin Day & Night and Boots Chesty Cough & Congestion Relief.

Galpseud Plus Linctus is another pseudoephedrine mixture but it comes in a 500ml bottle so you will need a prescription.

Pseudoephedrine mixed with other medicines comes as tablets, capsules and a liquid that you swallow.

Who can take pseudoephedrine

Most adults and children aged 12 years and over can take pseudoephedrine.

You can sometimes give pseudoephedrine to children aged 6 years and over if they have a stuffy nose, but this depends on their symptoms. Ask a pharmacist for advice.

Do not give pseudoephedrine to children under 6 years. This includes cough and cold medicines containing pseudoephedrine. Always check the label.

Pseudoephedrine is not suitable for some people. To make sure it's safe for you, tell a pharmacist or doctor before taking it if you have:

• ever had an allergic reaction to pseudoephedrine or any other medicine
• high blood pressure (hypertension)
• heart disease
• taken medicines for depression known as monoamine oxidase inhibitors (MAOIs) in the last 2 weeks
• diabetes
• an overactive thyroid gland (hyperthyroidism)
• glaucoma (increased pressure in the eye)
• an enlarged prostate (this causes difficulty peeing or needing to pee often)
• liver or kidney problems

Dosage and strength

Pseudoephedrine comes as 60mg tablets or as a liquid containing 30mg in 5ml.

The usual dose is:

• adults and children aged 12 to 17 years – one 60mg tablet or two 5ml spoons (10ml) of liquid up to 4 times a day
• children aged 6 to 11 years – half a tablet (30mg) or one 5ml spoon of liquid up to 4 times a day. This depends on their age and symptoms, so ask a doctor or pharmacist

How to take it

You can take pseudoephedrine tablets and liquid with or without food. Always take your tablets with a drink of water.

Liquid medicines containing pseudoephedrine come with a plastic syringe or spoon to help you measure out the right dose.

If you do not have a syringe or spoon, ask a pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

How long to take it for

You can take pseudoephedrine for a few days, usually up to 5 to 7 days, for the short-term relief of a stuffy or blocked nose.

Only take it for longer than 7 days if a doctor has said it's OK.

Pseudoephedrine should not be given to children aged 6 to 11 years for more than 5 days unless their doctor has said it is OK.

If you forget to take it

If you forget to take a dose, take the next dose when you need it.

Always leave at least 4 hours between doses.

Do not take 2 doses to make up for a missed one.

If you take too much

Taking too much pseudoephedrine can be dangerous. It can make you restless, make your heartbeat faster, and make you feel sick or vomit. You may also have difficulty peeing.

• you take more than the recommended dose of pseudoephedrine

Go to 111.nhs.uk or call 111 .

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the pseudoephedrine packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of pseudoephedrine happen in more than 1 in 100 people. There are things you can do to help cope with them:

Talk to a pharmacist or doctor if the advice does not help and any of these side effects bother you or will not go away.

Serious side effects

Stop taking the medicine and call 111 straight away if:

• you have a fast, irregular or pounding heartbeat (palpitations) that does not stop or comes back
• you suddenly get a high temperature, your skin reddens or lots of pustules (small, fluid or pus-filled bumps) appear on your skin. These are possible symptoms of acute generalised exanthematous pustulosis (AGEP). This may happen within the first 2 days of taking pseudophedrine
• you suddenly feel sick or are suddenly being sick. If this happens, stop taking pseudoephedrine straight away. This could be a sign of very rare but serious conditions that can involve inflammation of the brain or reduced blood supply to the brain

• you have a severe headache that comes on very quickly
• you start feeling confused
• you've had a fit or seizure
• you have changes in your vision

Stop taking pseudoephedrine straight away if you have any of these side effects. These can be signs of very rare but serious conditions that can involve inflammation of the brain or reduced blood supply to the brain.

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to pseudoephedrine.

These are not all the side effects of pseudoephedrine. For a full list, see the leaflet inside your medicine packet.

Pseudoephedrine and pregnancy

Pseudoephedrine is not recommended in pregnancy because it can reduce the blood flow in the placenta and to the baby.

There is some evidence that pseudoephedrine, taken in the first 12 weeks of pregnancy, may be associated with birth defects, although this evidence is not strong.

Pseudoephedrine and breastfeeding

Pseudoephedrine is not usually recommended while breastfeeding.

Although it only seems to pass into breast milk in very small amounts, there is still not enough information about pseudoephedrine and breastfeeding. Until we know more, other medicines might be better.

Pseudoephedrine may also reduce the amount of milk you make, so try to avoid taking it if possible.

If you do need a medicine, speak to you doctor or pharmacist who will be able to advise on other options that are more suitable.

Pseudoephedrine and fertility

There's no evidence to suggest that pseudoephedrine affects fertility in men or women.

Cautions with other medicines

Pseudoephedrine can be affected by other medicines and can also affect the way other medicines work. This can sometimes increase the chances of you having side effects.

Check with a pharmacist or doctor if you're taking:

• antidepressants known as monoamine oxidase inhibitors (MAOIs)
• digoxin, a medicine for heart failure
• tricyclic antidepressants, such as amitriptyline
• ergot alkaloids, such as ergotamine (for migraine)
• medicines for high blood pressure, such as beta blockers or methyldopa

Taking pseudoephedrine with painkillers

Some cough and cold remedies contain pseudoephedrine mixed with painkillers.

If you are taking a cough or cold remedy, check the label before taking any painkillers as it may already contain aspirin, paracetamol, ibuprofen or codeine. Taking both may cause you to have too much.

Ask a pharmacist if you're not sure.

Mixing pseudoephedrine with herbal remedies and supplements

There's not enough information to say whether complementary medicines, herbal remedies and supplements are safe to take with pseudoephedrine. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

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