Sympathomimetic decongestant
Pseudoephedrine hydrochloride
Brand names: Sudafed
Adult dose
Dose: 60mg PO QDS (max 240mg/24h)
Route: PO
Frequency: QDS
Clinical pearls
- Nasal congestion; OTC restricted (pharmacy supervision)
- MHRA 2024 alert: PRES/RCVS — avoid in uncontrolled hypertension
Contraindications
- Severe hypertension
- Severe coronary artery disease
- Concurrent MAOI / within 14 days
- Closed-angle glaucoma
- Phaeochromocytoma
- Hyperthyroidism
Side effects
- Hypertension
- Tachycardia
- Insomnia
- Anxiety
- Posterior reversible encephalopathy syndrome (MHRA 2024)
Interactions
- MAOIs
- TCAs
- Sympathomimetics
- Linezolid
Monitoring
- BP
- Symptoms
Reference: BNF; MHRA; NICE CKS; https://bnf.nice.org.uk/drugs/pseudoephedrine-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Adult Upper Airway Obstruction (Stridor) · DAS 2015 unanticipated difficult airway; RCEM
- Epistaxis Management · ENT-UK / NICE
- Acute Otitis Media · NICE NG91 2018
- Tonsillitis and Sore Throat · NICE NG84 2018
- Benign Paroxysmal Positional Vertigo · NICE CG124 / AAO-HNS Guidelines
- Acute Rhinosinusitis · NICE NG79 2017 / EPOS 2020