- Headache
- Nausea, Vomiting
- Loss of appetite
- Cardiac effects
- CNS stimulation
- Other effects
- Cerebral Hemorrhage
- Cerebrovascular Accident
- Systemic Decongestants
- Pseudoephedrine (Sudafed)
- Available as prescription and over-the-counter in U.S.
- U.S. pharmacies keep this behind counter due to Methamphetamine production-related use
- Combined with Antihistamines that are suffixed with "-D"
- Dosing
- Adults: 60 mg PO q6h
- Child (30 mg/5ml elixir) - NOT recommended
- Ages 6-12 years: 30 mg (5 ml) per dose
- Ages 2-5 years: 15 mg (2.5 ml) per dose
-
Phenylephrine (Sudafed PE)
- Available in U.S. OTC products at 10 mg
- Combined with Antihistamines that are suffixed with "-PE"
- Likely add nothing to Antihistamine efficacy (see below)
- No more effective than Placebo for congestion at this dose systemically
- FDA has as of 2023, labeled oral Phenylephrine as ineffective
- Poor absorption (low Bioavailability) compared with systemic Pseudoephedrine
- In contrast, Intranasal Phenylephrine (Intranasal Neo-Synephrine) is effective
- Hatton (2007) Ann Pharmacother 41(3):381-90 [PubMed]
- Nexafed
- Pseudophedrine preparation that turns to thick gel when tablet is disolved
- Designed to curb diversion of pseudophedrine to Methamphetamine production
- Will require prescription in some U.S. states and quantity that can be sold is limited
- (2013) Prescr Lett 20(2): 9
- Alternative agents (Topical)
- Nasal Saline
- Limited use of Topical Decongestant (3 days only)
- Oxymetazoline (Afrin)
- Never use in young children ("One Pill Can Kill")
- Intranasal Phenylephrine (Intranasal Neo-Synephrine)
- Effective Decongestant, unlike oral Phenylephrine
- Safe for short-term use, even in younger patients
- Oxymetazoline (Afrin)