Pseudoephedrine — what it does and when to use it
Pseudoephedrine is a common oral decongestant used to relieve a blocked nose from colds, sinusitis, or allergies. It shrinks swollen blood vessels in the nose so you can breathe easier. Unlike topical sprays, it works systemically, so effects last longer but side effects can be stronger.
People reach for pseudoephedrine when nasal sprays or antihistamines don’t help. It can be very effective for daytime relief, travel, or when you need to sleep better during a cold — but you should use it carefully and for a short time.
Typical dosing and practical tips
Common dosing for adults is 60 mg every 4–6 hours as needed, with a usual daily maximum of 240 mg. Extended-release tablets often come as 120 mg every 12 hours; follow the package or your doctor’s instructions. For children, dosing depends on age and weight — always check the label and ask a pediatrician. Many countries restrict sales or keep pseudoephedrine behind the counter due to misuse, so you may need to show ID or get a pharmacist’s help.
Use tips: take the last dose well before bedtime to avoid insomnia, and skip it if you’re overly anxious or already have a fast heartbeat. Avoid combining with other stimulants like high-dose caffeine, and don’t exceed the recommended daily dose.
Side effects, risks, and drug interactions
Common side effects include nervousness, restlessness, dizziness, headache, and trouble sleeping. It can raise blood pressure and heart rate, so people with hypertension, heart disease, or severe anxiety should avoid it unless a doctor approves. Also be cautious if you have hyperthyroidism or an enlarged prostate.
Pseudoephedrine can interact with certain medicines. Don’t take it if you’re on MAO inhibitors or within two weeks of stopping them. Tell your doctor if you use antidepressants, stimulants, or blood pressure meds — dose adjustments or safer alternatives may be needed.
Pregnant or breastfeeding? Talk to your provider. Many clinicians avoid routine use in pregnancy unless benefits clearly outweigh risks. For infants and very young children, ask a pediatrician — many decongestants are not recommended under age 4.
Concerned about misuse? Pseudoephedrine can be diverted to make illegal drugs, so sales are controlled in many places. Buy only from licensed pharmacies, store securely, and dispose of unused pills safely.
Safer alternatives include saline nasal rinses, steam inhalation, topical nasal sprays (used short-term to avoid rebound congestion), and treating the underlying cause with antihistamines if allergies are to blame. If congestion is severe or lasts more than a week, see a healthcare provider — you may need a different treatment.
Want quick help choosing an option? Ask a pharmacist about short-term use and check with your doctor if you have heart disease, high blood pressure, pregnancy, or take other medications. Simple choices and short courses keep pseudoephedrine useful and safe.
