From the FDA Drug Label
Directions adults and children 12 years and over • take 2 tablets every 4 to 6 hours • do not take more than 8 tablets in 24 hours The patient can be given pseudoephedrine as a one-time dose of 2 tablets as a hospitalist, considering the patient is likely an adult.
- Dose: 2 tablets
- Frequency: Every 4 to 6 hours
- Maximum daily dose: 8 tablets in 24 hours 1
From the Research
For a patient with sore throat and nasal congestion, I recommend acetaminophen (Tylenol) 650 mg orally as a one-time PRN dose for symptomatic relief, as it has been shown to be effective in reducing pain and fever 2. Alternatively, ibuprofen (Motrin) 400-600 mg orally can be given if there are no contraindications such as renal impairment, active GI bleeding, or NSAID allergy. For nasal congestion, consider adding pseudoephedrine 60 mg orally (if no hypertension or cardiovascular concerns) or oxymetazoline nasal spray 2-3 sprays in each nostril (limited to 3 days use to prevent rebound congestion), as pseudoephedrine has been shown to be effective in reducing nasal congestion in several studies, including a study published in 2005 3 and 2006 4. However, it's essential to note that pseudoephedrine should be used with caution, especially in patients with cardiovascular concerns, as highlighted in a study published in 2015 5. Ensure adequate hydration and consider saline nasal spray for additional congestion relief. These medications work by reducing inflammation, blocking pain signals, and constricting blood vessels in the nasal passages to reduce swelling and congestion. If symptoms persist beyond 3-5 days or if fever develops, further evaluation may be warranted to rule out bacterial infection requiring antibiotics. Some key points to consider when treating patients with sore throat and nasal congestion include:
- Informing patients about the self-limited nature of the common cold to manage expectations and limit antibiotic use 2
- Avoiding over-the-counter purchases that may not be effective
- Counseling patients about the importance of good hand hygiene to prevent transmission of cold viruses 2
- Considering the use of zinc, nasal decongestants with or without antihistamines, and ipratropium for cough in adults 2
- Using acetylcysteine, honey (for children one year and older), nasal saline irrigation, intranasal ipratropium, and topical application of ointment containing camphor, menthol, and eucalyptus oils in children 2