Phenylephrine and pseudoephedrine are known to cause anxiety, dizziness, headache, insomnia, nervousness, and restlessness. In addition, pseudoephedrine has been documented to cause tachycardia, palpitations, arrhythmia, blurred vision, and anorexia. It is difficult to define how frequently these side effects can occur. Patients with high blood pressure or other known cardiac conditions should not use pseudoephedrine without guidance from their physician.
The following table is not intended to be a complete list of side effects. You should consult a pharmacist or other healthcare professional for a complete list. Source: DailyMed phenylephrine DailyMed pseudoephedrine.
Phenylephrine and pseudoephedrine have a very similar drug interaction profile due to their adrenergic effects on the alpha and beta receptors.
Alpha-blockers, such as tamsulosin, may diminish the vasoconstrictive properties of both decongestants making them less effective. MAO inhibitors, such as selegiline, and ergot derivatives, such as bromocriptine, may enhance the hypertensive effects of the decongestants. This would be concerning in someone with pre-existing hypertension who may be considering decongestant use. The combination of phenylephrine or pseudoephedrine with either MAO inhibitors or ergot derivatives is contraindicated.
The following list is not meant to be a complete list of all potential drug interactions. Please consult your pharmacist or physician for a complete list and more information. Phenylephrine and pseudoephedrine are available without a prescription and are generally considered to be safe drugs. Due to their effects on the cardiac system, patients with high blood pressure and heart disease should not use these drugs without explicit consent from their physician.
These drugs are intended for short-term use for the relief of acute rhinitis and sinus pressure. Patients who experience these symptoms for longer than seven days, or who develop a fever, should consult a physician.
Phenylephrine is in pregnancy category C which means that studies in animals showed adverse effects to the fetus. When a drug is category C, there may be some situations where the benefit to the pregnant patient outweighs the risk, and phenylephrine should not be used without consent from your physician. Pseudoephedrine is pregnancy category B which means that animal studies have not shown adverse effects to the fetus.
Pseudoephedrine is considered safe to take when pregnant after consulting your physician. Pseudoephedrine should, however, be avoided in the first trimester. Phenylephrine is an over-the-counter nasal decongestant available in 5 mg and 10 mg tablets, as well as an oral solution. It is also available in an injectable form which is only used in an inpatient setting by medical professionals for low blood pressure. Pseudoephedrine is an over-the-counter nasal decongestant available in 30 mg and 60 mg tablets, as well as mg and mg extended-release tablets.
It is also available as an oral solution. Pseudoephedrine purchases must be done at a pharmacy and the purchase information must be logged into a database. Purchase limits are set by state and federal guidelines. Phenylephrine and pseudoephedrine are both adrenergic agonists. Phenylephrine has primarily an affinity to only alpha-adrenergic receptors, while pseudoephedrine has an affinity to both alpha- and beta-adrenergic receptors.
Their side effect profiles are very similar. Studies have shown that pseudoephedrine is a much more effective decongestant than phenylephrine. Anyone experiencing serious side effects from a nasal decongestant should seek urgent medical advice. Insomnia is the most common side effect that people may experience when taking nasal decongestants. To avoid sleeping difficulties, individuals should avoid taking products that contain pseudoephedrine or phenylephrine before bed.
Some cold and flu medications have separate pills for daytime and nighttime use. Nighttime pills typically contain either phenylephrine or pseudoephedrine in addition to an antihistamine, a substance that causes drowsiness in most people. Overuse of topical nasal decongestants can lead to chronic inflammation of the nasal passages.
Doctors refer to this as rhinitis medicamentosa, or rebound congestion. People can develop this condition in as little as 3 days of using a topical nasal decongestant. However, rebound congestion typically occurs after 7—10 days of regular use. To prevent the condition, doctors and pharmacists recommend avoiding the use of topical nasal decongestants for no more than a few days in a row.
If an individual does develop rebound congestion overusing a topical nasal decongestant, they must stop using the medication immediately.
This may result in a temporary worsening of their congestion. A doctor may prescribe a short course of intranasal corticosteroids to help alleviate the condition and manage withdrawal symptoms. Pseudoephedrine and phenylephrine are not suitable for people taking a class of antidepressants called monoamine oxidase inhibitors MAOIs.
Examples of MAOIs include:. The combination of MAOIs with certain classes of drugs — including selective serotonin reuptake inhibitors, serotonin—norepinephrine reuptake inhibitors, and tricyclic antidepressants — in some oral decongestants, can cause serotonin syndrome SS.
This is a potentially serious condition where the body produces too much of the neurochemical serotonin. A person taking MAOIs needs to stop taking them for 14 days before starting a decongestant. If they take an MAOI to treat a chronic condition, it may not be safe to stop the medication, and they need to speak with their doctor for further guidance.
People should also note that nasal decongestants may worsen certain underlying health conditions, such as:. As a general rule, those with any preexisting health condition or taking any type of medication need to consult with a doctor or pharmacist before using nasal decongestants. They may recommend safer alternatives to help alleviate nasal congestion if required. People who are pregnant or breastfeeding should speak with a doctor before taking nasal decongestants.
According to an older review from , exposure to nasal decongestants during the first trimester may cause developmental defects in the growing fetus. In this small study of eight breastfeeding women, a single dose of pseudoephedrine reduced milk production. The following people should not take nasal decongestants unless their doctor confirms it is safe for them to do so:.
If a doctor determines that these decongestants are not safe, they may recommend other treatments to help relieve nasal congestion. Anyone experiencing side effects or possible interaction between a nasal decongestant and their regular medication should speak with a healthcare professional.
Pseudoephedrine and phenylephrine are medications that can help alleviate nasal congestion. These drugs work by constricting blood vessels within the nose and sinuses, which allow people to breathe more easily. Individuals can find phenylephrine in various over-the-counter medications for cold, flu, and allergy symptoms.
The sale of products containing pseudoephedrine is more restricted and varies from location to location. Certain people need to speak with a doctor before they consider taking decongestants.
This includes those taking existing medications, individuals with underlying health conditions, and those who are pregnant or breastfeeding. What are the best nasal decongestants for different ages? If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
There is a large variety of antihistamine and decongestant combination products on the market. Some products are for use in adults only, while others may be used in children. If you have any questions about this, check with your health care professional. Follow your doctor's orders if this medicine was prescribed. Or, follow the directions on the box if you are buying this medicine without a prescription.
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Before you have any skin tests for allergies, tell the doctor in charge that you are taking this medicine.
The results of the test may be affected by the antihistamine in this medicine. When taking antihistamines contained in this combination medicine on a regular basis, make sure your doctor knows if you are taking large amounts of aspirin at the same time as for arthritis or rheumatism. Effects of too much aspirin, such as ringing in the ears, may be covered up by the antihistamine.
The antihistamine in this medicine will add to the effects of alcohol and other CNS depressants medicines that slow down the nervous system, possibly causing drowsiness.
Some examples of CNS depressants are other antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are taking this medicine. The antihistamine in this medicine may cause some people to become drowsy, dizzy, or less alert than they are normally.
Some antihistamines are more likely to cause drowsiness than others loratadine , for example, rarely produces this effect. Make sure you know how you react before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert. The decongestant in this medicine may add to the central nervous system CNS stimulant and other effects of diet aids.
Do not use medicines for diet or appetite control while taking this medicine unless you have checked with your doctor. The decongestant in this medicine may cause some people to be nervous or restless or to have trouble in sleeping. If you have trouble in sleeping, take the last dose of this medicine for each day a few hours before bedtime. If you have any questions about this, check with your doctor. Antihistamines may cause dryness of the mouth, nose, and throat.
Some antihistamines are more likely to cause dryness of the mouth than others loratadine , for example, rarely produces this effect. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute.
However, if your mouth continues to feel dry for more than 2 weeks, check with your dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.
Along with its needed effects, a medicine may cause some unwanted effects.
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