Pseudoephedrine Hydrochloride

Indications

Pseudoephedrine Hydrochloride is used for: Nasal congestion

Adult Dose

Oral Nasal congestion Adult: 1 tablet (60 mg) every 4-6 hr. Max: 4 tab in 24 hr.

Child Dose

Oral Nasal congestion Children : 6 - 12 years of age: 1/2 tablet (30 mg) 3-4 times daily. 2 - 5 years of age: 1/4 tablet (15 mg) every 3-4 times daily.

Renal Dose

Administration

May be taken with or without food.

Contra Indications

Hypersensitivity, Severe hypertension and coronary artery disease, Concurrent use of Mono Amine Oxidase Inhibitor (MAOI) drugs.

Precautions

Hyperthyroidism; ischaemic heart disease, arrhythmia or tachycardia; occlusive vascular disorders e.g. arteriosclerosis, hypertension or aneurysms; DM and closed-angle glaucoma; renal impairment, prostatic enlargement. Pregnancy; lactation. Lactation: Concentrated in breast milk, Mfr contraindicates (AAP Committee states compatible with nursing)

Pregnancy-Lactation

Pregnancy Avoid, during first trimester; may be associated with possible risk of gastroschisis, small intestinal atresia, and hemifacial microsomia due to pseudoephedrine’s vasoconstrictive effects; magnitude of risk unknown Fetal tachycardia reported following maternal use of extended release formulation for multiple days Lactation Excreted in breast milk; irritability reported in nursing infants (limited data); milk production may be decreased in some women

Interactions

Increased risk of hypertension and arrhythmias if given with cardiac glycosides, quinidine or TCAs. Increased risk of vasoconstrictor effects if given with ergot alkaloids or oxytocin. Co-admin with MAOIs may cause hypertensive crisis. Anaesthetics e.g. cyclopropane, halothane and other halogenated anaesthestics; antihypertensive agents.

Adverse Effects

Side effects of Pseudoephedrine Hydrochloride : Anginal pain; rebound congestion and rhinorrhoea; fear, anxiety, restlessness, tremor, insomnia, confusion, irritability and psychotic states; reduced appetite, nausea, vomiting; gangrene; cerebral haemorrhage and pulmonary oedema; reflex bradycardia, tachycardia and cardiac arrhythmias, palpitations and cardiac arrest, hypotension and dizziness, fainting and flushing. Tissue necrosis and sloughing; myocardial and arterial necrosis.

Mechanism of Action

Pseudoephedrine is both an alpha-and beta-adrenergic receptor agonist. It causes vasoconstriction via direct stimulation of alpha-adrenergic receptors of the respiratory mucosa. It also directly stimulates beta-adrenergic receptors causing bronchial relaxation, increased heart rate and contractility.