The need-to-know information for Pseudoephedrine


Pearls and Fun Nuggets

1. Pseudoephedrine is used as a first-line prophylactic for recurrent priapismūüė¨Erection is largely a parasympathetic¬†response, so the sympathetic action of pseudoephedrine may serve to relieve this condition. Treatment for¬†urinary incontinence¬†is an¬†off-label use¬†(“unlabeled use”) for these medications.[9]

2. It’s related to the illicit manufacture of methamphetamine ūüíäIts membership in the amphetamine¬†class has made pseudoephedrine a sought-after¬†chemical precursor¬†in the¬†illicit manufacture¬†of¬†methamphetamine¬†and¬†methcathinone. As a result of the increasing regulatory restrictions on the sale and distribution of pseudoephedrine, many pharmaceutical firms have reformulated, or are in the process of reformulating medications to use alternative, but less effective,[18]¬†decongestants, such as¬†phenylephrine.

3. Pseudoephedrine was on the International Olympic Committee’s list of banned substances until 2004 ūüŹą Romanian gymnast Andreea Raducan was stripped of her gold medal at the 2000 Sydney Olympics after testing positive.¬† She took two pills given to her by the team coach for a cold.

4. You ever watch Breaking Bad? ūüďļ In the pilot episode of Breaking Bad, Walter White first synthesizes methamphetamine through the¬†Nagai¬†route, using¬†red phosphorus¬†and¬†iodine¬†to reduce pseudoephedrine.

Patient Perspectives

“I have been suffering from a post cold congested sinus and took two caplets of Panadol Sinus which has 30 mg of pseudoephedrine hydrochloride and 10 minutes later my heart beats went crazy… glad that was during the day since I also suffer from Restless Leg Syndrome at night… but it helped my sinus congestion”


“I have taken Sudafed (pseudoephedrine) for many years, and have found it to be the only OTC medicine that really dries up nasal congestion. Nowadays, “Sudafed,” the brand name, is being sold with other ingredients, because pseudoephedrine can be used for illegal purposes in drug manufacture. When buying it at the pharmacy counter, one must show ID, so their name can be entered on a registry; a person can’t buy frequent or large quantities of the medication. But if you get the real thing, it really works.”


¬†“I’ve had plugged ears from sinus congestion for two weeks. I took two doses every four hours of two tablets each and the congestion has finally cleared but I didn’t realize that it would make for a sleepless jittery night and now a jittery morning with no appetite and mild nausea. Next time I would start with one tablet and see if that helps and make sure I had plenty of time before going to sleep.”

Brandon Simpson, PA-C
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