Why is pseudoephedrine (PSE) included in influenza (flu) products?

From the Guidelines

Pseudoephedrine is included in flu products because it effectively relieves nasal and sinus congestion, a common symptom of the flu and colds, by narrowing blood vessels in the nasal passages, which reduces swelling and mucus production, allowing for easier breathing. This medication works as a decongestant and is particularly helpful when congestion is severe and interfering with daily activities or sleep. Common over-the-counter products containing pseudoephedrine include Sudafed, Advil Cold and Sinus, and Claritin-D, typically dosed at 30-60mg every 4-6 hours for adults (not exceeding 240mg daily) 1. It's essential to note that pseudoephedrine is kept behind pharmacy counters due to its potential misuse in manufacturing illegal substances, and purchase requires ID and signature. Side effects may include insomnia, nervousness, and increased blood pressure, so it should be used with caution by those with heart conditions, high blood pressure, diabetes, or thyroid disorders 1. Unlike antihistamines which target allergy symptoms, pseudoephedrine specifically addresses congestion by acting on the sympathetic nervous system to constrict blood vessels.

Some key points to consider when using pseudoephedrine include:

• It is effective in relieving nasal and sinus congestion
• It should be used with caution in patients with certain medical conditions, such as heart conditions, high blood pressure, diabetes, or thyroid disorders
• It can cause side effects, such as insomnia, nervousness, and increased blood pressure
• It is kept behind pharmacy counters due to its potential misuse in manufacturing illegal substances

Overall, pseudoephedrine is a useful medication for relieving nasal and sinus congestion, but it should be used responsibly and with caution.

From the Research

Pseudoephedrine in Flu Products

Pseudoephedrine is commonly found in flu products due to its effectiveness as a decongestant. The following points highlight its use and effects:

• Pseudoephedrine is used to treat nasal congestion associated with the common cold and flu 2.
• It works by reducing nasal airway resistance, making it easier to breathe 2.
• Studies have shown that pseudoephedrine is safe and effective in treating nasal congestion, with minimal side effects 2, 3, 4.
• However, its use should be carefully considered in certain populations, such as children under 15 and patients with hypertension, due to potential risks 5, 6.

Benefits and Risks

The benefits and risks of pseudoephedrine are:

• Benefits: effective decongestant, relieving nasal congestion and sinus pressure 2, 6.
• Risks: potential for cardiovascular and neurological adverse events, especially in certain populations 5, 6.
• Pseudoephedrine can also be misused as a stimulant or appetite suppressant, highlighting the need for regulated distribution 6.

Effects on Blood Pressure and Heart Rate

Pseudoephedrine can have the following effects on blood pressure and heart rate:

• Increases systolic blood pressure and heart rate, although the effect is generally small 3.
• No significant effect on diastolic blood pressure 3.
• Therapeutic doses of pseudoephedrine do not appear to adversely affect blood pressure control in patients with controlled hypertension 4.