From the Guidelines
Daily use of pseudoephedrine is not recommended due to the risk of severe side effects, including irregular heartbeat, severe high blood pressure, and psychological effects. The use of pseudoephedrine can cause several side effects that range from mild to severe, including nervousness, anxiety, restlessness, insomnia, headache, increased heart rate, elevated blood pressure, and dry mouth 1. Some people may experience dizziness, difficulty urinating, and gastrointestinal issues like nausea or constipation. Pseudoephedrine works by stimulating alpha-adrenergic receptors, causing blood vessel constriction, which explains many of its cardiovascular side effects 1. The medication can also cross the blood-brain barrier, affecting the central nervous system and causing stimulant effects. Key points to consider when using pseudoephedrine include:
- Common side effects: nervousness, anxiety, restlessness, insomnia, headache, increased heart rate, elevated blood pressure, and dry mouth
- Serious side effects: irregular heartbeat, severe high blood pressure, and psychological effects including paranoia or hallucinations
- Contraindications: hypertension, heart disease, diabetes, thyroid disorders, or glaucoma
- Alternative treatments: consult with a healthcare provider about safer alternatives for long-term use, such as intranasal corticosteroids or oral antihistamines 1. It is essential to weigh the benefits and risks of pseudoephedrine use, especially in patients with certain medical conditions, and to consider alternative treatments for long-term nasal congestion relief.
From the Research
Side Effects of Daily Pseudoephedrine Use
- Cardiovascular effects: Pseudoephedrine can cause increases in mean arterial pressure and heart rate, although these effects may not be statistically significant in medically controlled hypertensive patients 2.
- Neurological effects: Pseudoephedrine can cause mild disturbances in sleeping pattern and urinary retention in some male subjects 2.
- Central nervous system stimulant properties: Pseudoephedrine has CNS stimulant properties, which can lead to non-medical use as an appetite reducer, an agent to eliminate drowsiness and fatigue, and to improve concentration 3.
- Rebound congestion: Topical decongestants, including pseudoephedrine, can produce rebound congestion in patients with allergic rhinitis 4.
- Unpredictable severe adverse events: Pseudoephedrine can cause unpredictable severe cardiovascular and neurological adverse events, even at low doses and in the absence of pre-existing pathology 5.
Special Considerations
- Hypertensive patients: Pseudoephedrine should be used with caution in patients with hypertension, as it can cause increases in blood pressure 2.
- Patients under 15: Pseudoephedrine should not be used in patients under the age of 15 due to the risk of severe adverse events 5.
- Allergic rhinitis: Pseudoephedrine should be used with caution in patients with allergic rhinitis, as it can produce rebound congestion 4.