Pseudoephedrine (Sudafed) is a decongestant and vasoconstrictor used in a vast range of cold and flu remedies, cough mixtures and nose drops. Its main use is to ease congestion in the nose and sinuses, but it may also be used to assist in clearing the Eustachian tube (between nose and middle ear). Strangely, it also can be used to treat priapism (a persistently erect penis) and may be of use in some people who have urinary incontinence.
It is used illegally and inappropriately as a stimulant to keep people awake and increase alertness. It can also be used as the base substance from which more potent stimulants such as amphetamines can be manufactured. It is a banned substance for elite sportspeople.
It must be used with caution in pregnancy, breastfeeding, high blood pressure, an enlarged prostate gland and bladder problems. It must not be taken by those suffering from uncontrolled blood pressure or angina.
Side effects are common and include sleeplessness and rapid heart rate. Less common side effects may include hallucinations, palpitations, sweating, flushing, difficulty in passing urine and chest pain. There is a severe interaction with MAOI and it may also interact with other decongestants and medications used to treat high blood pressure. An overdose is serious as it may cause irritability, convulsions, palpitations, high blood pressure, angina and difficulty in passing urine.
Pseudoephedrine is one of the most widely used medications in the world. It is safe and effective if taken in recommended dose but should not be used to combat drowsiness.