Pseudoephedrine

Benjamin Clanner-Engelshofen is a freelance writer in the medical department. He studied biochemistry and pharmacy in Munich and Cambridge / Boston (USA) and noticed early on that he particularly enjoyed the interface between medicine and science. That is why he went on to study human medicine.

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The active ingredient pseudoephedrine is used as a cold remedy. It makes the mucous membrane in the nose swell. The active ingredient naturally found in some plants is chemically closely related to stimulants such as amphetamine and methamphetamine. Here you can read everything you need to know about pseudoephedrine: effect, use and side effects.

This is how pseudoephedrine works

The function of the involuntary nervous system of the human body can be divided into two different parts. The sympathetic nervous system, also known as the “sympathetic nervous system”, activates the body: the heart beats faster, the bronchi of the lungs and the pupils dilate, the body is geared towards performance. The antagonist is the "parasympathetic nervous system", which specifically promotes regeneration of the body: digestion is stimulated and the heartbeat slows down.

The active ingredient pseudoephedrine ensures that the stress hormone noradrenaline - a messenger substance of the sympathetic nervous system - is increasingly released by nerve cells and only absorbed again with a delay. This increases and extends its effect - the sympathetic nervous system is stimulated. In therapeutic doses, the effect of pseudoephedrine is limited to the mucous membranes of the nasopharynx and the bronchi. The stimulation of the sympathetic nervous system causes the blood vessels to contract (and thus the swelling of the nasal mucous membrane) and the bronchial tubes to widen, which improves breathing.

Uptake, breakdown and excretion of pseudoephedrine

Medicines contain the active ingredient as pseudoephedrine hydrochloride or sulfate. In this salt form, it is quickly and completely absorbed into the blood through the intestinal wall after it has been taken up through the mouth. It reaches the mucous membranes and the lungs via the blood. The highest blood levels can be measured after two hours.

The active ingredient is partially broken down in the liver, which in part results in other effective metabolic products. It is excreted through the kidneys with the urine. About five to eight hours after ingestion, half of the active ingredient has left the body.

When is pseudoephedrine used?

Drugs containing pseudoephedrine are used for the symptomatic treatment of:

  • Runny nose and cold with a stuffy nose

It should only be used for a short time (over a few days). With prolonged use, the body gets used to the active ingredient and its effectiveness decreases.

This is how pseudoephedrine is used

Pseudoephedrine is usually offered in combination preparations together with other active ingredients:

In combination with pain relievers such as ibuprofen and acetylsalicylic acid (ASA), the active ingredient is mainly used for colds. Combination preparations with antiallergic active ingredients such as triprolidine, desloratadine or cetirizine are used to treat allergies such as hay fever.

Usually 30 to 60 milligrams of pseudoephedrine are added per single dose, up to 120 milligrams in the case of tablets with delayed release of active ingredients ("sustained release tablets").

The tablets or drinking granules are taken throughout the day regardless of meals. A total daily amount of 240 milligrams of pseudoephedrine should not be exceeded.

What are the side effects of pseudoephedrine?

The occurrence of adverse drug reactions (ADRs) is dose-dependent with pseudoephedrine. Side effects due to activation of the sympathetic nervous system occur to a greater extent, especially with high doses. Such pseudoephedrine side effects are loss of appetite, increased blood pressure, palpitations, insomnia, urinary retention and skin reactions such as rashes, redness and itching.

What should be considered when taking pseudoephedrine?

The combination with other active ingredients that stimulate the sympathetic nervous system can lead to serious side effects, which mainly affect the cardiovascular system. These active ingredients include agents for the treatment of asthmatic complaints (especially in the form of tablets, less than inhalation), agents for depression (antidepressants), stimulants for the treatment of ADHD or narcolepsy (amphetamine and methylphenidate) and drugs.

Pseudoephedrine can make high blood pressure drugs less effective.

Since the active ingredient pseudoephedrine can cross the placental barrier and is also excreted in breast milk, it should not be used during pregnancy and breastfeeding. In pregnant women, pseudoephedrine can also reduce the blood flow to the placenta, which endangers the child.

Pseudoephedrine can be used in children aged twelve and over.

Elderly people and patients with impaired liver or kidney function should not take the active ingredient.

How to get pseudoephedrine medication

Combination preparations with the active ingredient pseudoephedrine are only available in pharmacies and do not require a prescription, provided that the other active ingredient is also available without a prescription. This applies to pain relievers and older antiallergic agents. Preparations in which pseudoephedrine is combined with newer antiallergic active ingredients require a prescription.

How long has pseudoephedrine been known?

The active ingredient pseudoephedrine was discovered by the Japanese chemist Nagayoshi Nagai in 1885 together with the chemically very similar active ingredient ephedrine. In the mid-1920s, the active ingredients were then marketed as a remedy for asthma by the pharmaceutical company Merck. Compared to pseudoephedrine, ephedrine has a stronger effect on the cardiovascular system and the central nervous system, which is why it is often misused as a drug.This is one of the reasons why pseudoephedrine is used for cold remedies rather than ephedrine.

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