Pseudoephedrine

Sounds like 'sue-doh-eff-ED-rin'

Key points about pseudoephedrine

  • Pseudoephedrine is a nasal decongestant that's used for the relief of a blocked or stuffy nose.
  • It's a pharmacist-only medicine, meaning it can only be purchased after a consultation with a pharmacist.
  • Pseudoephedrine isn't suitable for some people. It may cause serious side effects or worsen some existing medical conditions. Your doctor or pharmacist will advise if the medicine is suitable for you.
Teenager on couch with cold symptoms and tissues drinks tea
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Pseudoephedrine is a nasal decongestant used for the relief of a blocked or stuffy nose (nasal congestion). You can get a blocked nose when you have a cold, the flu, hay fever and sinusitis. A stuffy or blocked nose happens when blood vessels in your nasal cavities (sinuses) become swollen. Pseudoephedrine works by reducing this swelling and that helps mucus and air to flow more freely.

In Aotearoa New Zealand pseudoephedrine is found in tablets, eg, Noumed Decongestant and Sudafed Sinus and Nasal Decongestant.

  • Cold and flu medicines containing pseudoephedrine are pharmacist-only medicines, meaning you have to talk with a pharmacist before you purchase it.
  • The pharmacist will advise if the medicine is suitable for you and they will record the sale.
  • Read more about pharmacist-only medicines.

Only use pseudoephedrine for a short time, usually less than 7 days. Using it for longer than this could cause side effects.

Follow the recommended dose as advised or as printed on the pack and don't use more than this amount. Only use pseudoephedrine for a short time, usually less than 7 days. Taking more than the recommended dose or using it for longer than this can cause side effects.

  • Timing: Avoid taking pseudoephedrine a few hours before bedtime. It can keep you awake.
  • Food: You can take pseudoephedrine with or without food.
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it's nearly time for your next dose, just take the next dose at the right time. Don't take double the dose. If you are feeling better, you don’t need to keep taking it.

Pseudoephedrine isn't suitable for everyone. It may cause serious side effects or worsen some existing medical conditions. Your doctor or pharmacist will advise if the medicine is suitable for you.

It's not suitable for:

  • children under 12 years of age
  • people with uncontrolled high blood pressure (hypertension) or with severe heart disease
  • people taking moclobemide or tranylcypromine, or who have taken moclobemide or tranylcypromine within the previous 14 days.

Pseudoephedrine may not be suitable for people with kidney or liver problems, thyroid problems, high blood pressure, diabetes, heart disease, glaucoma and enlarged prostate.

Athletes should take care when using pseudoephedrine. Pseudoephedrine is prohibited in competition by the World Anti-Doping Agency (WADA) in-competition prohibited list. Athletes must stop taking pseudoephedrine at least 24 hours before competition.

Like all medicines, pseudoephedrine can cause side effects.

Side effects What should I do?
  • Feeling sick or nausea
  • Headache
  • Dry mouth
  • Feeling restless, shaky or nervous
  • These effects are quite common when taking pseudoephedrine.
  • Tell your doctor or pharmacist if this continues or gets worse. 
  • Difficulty sleeping
  • Pseudoephedrine can cause sleeplessness, even if taken a few hours before going to bed.
  • Avoid taking a dose near bedtime. 
  • Sudden stomach pain and rectal bleeding
  • Pseudoephedrine can cause reduced blood flow to the colon.
  • Stop taking pseudoephedrine and tell your doctor immediately or phone Healthline 0800 611 116.
  • Severe headache, nausea, vomiting and visual disturbances.
  • Any changes in your vision, including loss of vision or changes in visual clarity
  • Stop taking pseudoephedrine and tell your doctor immediately or phone Healthline 0800 611 116.
  • Small blisters on the skin, with or without fever or red skin
  • This may happen within the first 2 days of taking pseudoephedrine.
  • Stop taking pseudoephedrine and tell your doctor immediately or phone Healthline 0800 611 116.
  • Fast or irregular heart beat
  • Chest pain
  • Shortness of breath
  • Difficulty breathing
  • Stop taking pseudoephedrine and tell your doctor immediately or phone Healthline 0800 611 116.

Read more about medicines and side effects and reporting a reaction you think might be a side effect.

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

Last reviewed: