Side Effects of pseudoephedrine: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Main Research Findings

Pseudoephedrine is a drug commonly used to relieve nasal congestion and is often found in over-the-counter medications. 2 found that pseudoephedrine, when combined with loratadine, can increase the risk of side effects such as tremors and insomnia compared to loratadine alone. Another study, 7 , indicated that pseudoephedrine might lead to liver toxicity by triggering mitophagy, a process where cells break down their own mitochondria. Additionally, 15 reported a case of acute myocardial infarction in a patient who was taking pseudoephedrine along with methylphenidate, suggesting a potential link between pseudoephedrine and heart problems.

Reason for Side Effects

Pseudoephedrine is a sympathomimetic drug, meaning it stimulates the sympathetic nervous system. This stimulation leads to various effects like increased heart rate, vasoconstriction, and elevated blood pressure. These effects can contribute to side effects, especially in the nervous and cardiovascular systems. 14 and 15 suggest that pseudoephedrine's impact on the urinary and cardiovascular systems could be linked to these effects of vasoconstriction and increased heart rate.

Common Side Effects

Tremors

2 indicates that the combination of loratadine and pseudoephedrine for allergic rhinitis treatment is associated with a higher occurrence of tremors compared to loratadine alone.

Insomnia

2 found cases of insomnia reported by patients taking pseudoephedrine-containing medications for allergic rhinitis. Furthermore, 16 highlights the possibility of insomnia as a side effect of pseudoephedrine-containing cold medications.

Palpitation

2 reports instances of palpitations experienced by patients after taking pseudoephedrine-containing allergic rhinitis medications.

Dry Mouth

2 reports instances of dry mouth experienced by patients after taking pseudoephedrine-containing allergic rhinitis medications.

Anxiety

2 reports instances of anxiety experienced by patients after taking pseudoephedrine-containing allergic rhinitis medications.

Hepatotoxicity

7 suggests that pseudoephedrine might induce mitophagy in hepatocytes, leading to liver toxicity.

Acute Myocardial Infarction

15 reports a case of acute myocardial infarction in a patient taking pseudoephedrine alongside methylphenidate, raising concerns about a potential connection between pseudoephedrine and heart issues.

Urinary Retention

14 reports a case of acute urinary retention in a 3-year-old child, attributed to pseudoephedrine.

Other

8 mentions the possibility of side effects like tachycardia and heart palpitations due to pseudoephedrine. Additionally, 10 highlights that pseudoephedrine may pose a greater risk of adverse reactions for individuals with pre-existing conditions such as hypertension, arrhythmias, insomnia, prostatic hypertrophy, and glaucoma.

Side Effect Management

Tremors

If tremors occur after taking pseudoephedrine, it's essential to consult a doctor. Adjusting the dosage or switching to a different medication might be necessary. 2 suggests that loratadine alone may be associated with a lower risk of tremors compared to the combination of pseudoephedrine and loratadine.

Insomnia

In case of insomnia following pseudoephedrine use, seek advice from a doctor for potential dosage adjustments or changes in the administration schedule. 16 recommends avoiding pseudoephedrine before bedtime. It's also crucial to abstain from caffeine or alcohol before going to sleep.

Palpitation

Should palpitations occur due to pseudoephedrine intake, consult a doctor. Dosage adjustments or a switch to an alternative medication might be needed. 8 suggests that pseudoephedrine might trigger palpitations.

Dry Mouth

If dry mouth occurs due to pseudoephedrine use, ensure sufficient hydration by drinking plenty of fluids.

Anxiety

If anxiety arises as a result of taking pseudoephedrine, consult a doctor to discuss potential dosage adjustments or a switch to a different medication.

Hepatotoxicity

Given the possibility of hepatotoxicity from pseudoephedrine, undergoing liver function tests is recommended. 7 suggests that pseudoephedrine might have an impact on the liver.

Acute Myocardial Infarction

Pseudoephedrine may increase the risk of coronary vasospasm, therefore, individuals with heart conditions should consult a doctor before taking it. 15 suggests that the combination of pseudoephedrine and methylphenidate might lead to acute myocardial infarction.

Urinary Retention

If urinary retention occurs after taking pseudoephedrine, consult a doctor. Dosage adjustments or a switch to a different medication might be necessary. 14 reports a case of acute urinary retention in a child attributed to pseudoephedrine.

Comparison Between Studies

Commonalities in Studies

Several studies have indicated that pseudoephedrine can cause side effects on the nervous system and cardiovascular system. 2 ， 7 ， 15 ， 14

Differences in Studies

Different studies have found varying types and severity of side effects associated with pseudoephedrine. 2 suggests that pseudoephedrine can cause nervous system side effects such as tremors. In contrast, 7 suggests that pseudoephedrine can affect the liver. Additionally, 15 suggests that pseudoephedrine can affect the cardiovascular system. 14 reports that pseudoephedrine may affect the urinary system.

Precautions for Real-Life Application

Pseudoephedrine is widely available over the counter as a cold remedy or allergy medication. When taking pseudoephedrine, you should understand the potential side effects and consult with a doctor or pharmacist before taking it. 16 ， 10

Limitations of Current Research

There is still not enough research on the side effects of pseudoephedrine. In particular, more research is needed on long-term side effects.

Future Research Directions

Research on the long-term side effects of pseudoephedrine is needed. Additionally, more research is necessary to understand the side effects of pseudoephedrine when used in combination with other medications.

Conclusion

Pseudoephedrine is widely used to alleviate symptoms such as allergic rhinitis, but it can cause side effects on the nervous system and cardiovascular system. When taking pseudoephedrine, understanding the potential side effects and consulting a doctor or pharmacist before use is crucial.

Literature analysis of 24 papers
Positive Content
13
Neutral Content
2
Negative Content
9
Article Type
10
0
0
5
24
1.

Cognitive effects of pregabalin in healthy volunteers: a double-blind, placebo-controlled trial.

Author: SalinskyMartin, StorzbachDaniel, MunozSonia

Cognitive dysfunction

This study investigated the cognitive effects of pregabalin, an antiepileptic drug (AED), in healthy volunteers over 12 weeks.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

A comparative study of the side effects between pseudoephedrine in Loratadine plus Pseudoephedrine Sulfate Repetabs Tables and loratadine + pseudoephedrine tablet in treatment of allergic rhinitis in Thai patients.

Author: SupiyaphunPakpoom, ChochaipanichnonLadda, KerekhanjanarongVirachai, SaengpanichSupinda

Allergic rhinitis treatment
Well tolerated
Insomnia
Tremor

This study compared the adverse reactions of loratadine plus pseudoephedrine sulfate Repetabs (LTD+PSE Repetabs) with loratadine plus pseudoephedrine tablets in treating allergic rhinitis. LTD+PSE Repetabs were found to be well tolerated with fewer adverse effects compared to loratadine plus pseudoephedrine tablets, particularly tremor and insomnia.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Pediatric Fatalities Associated With Over-the-Counter Cough and Cold Medications.

Author: HalmoLaurie Seidel, WangGeorge Sam, ReynoldsKate M, Delva-ClarkHeather, Rapp-OlssonMalin, BannerWilliam, BondG Randall, KauffmanRalph E, PalmerRobert B, PaulIan M, GreenJody L, DartRichard C

Fatalities

This study describes fatalities associated with exposures to over-the-counter cough and cold medications in children younger than 12 years old.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Impact of cold and flu medication on obstructive sleep apnoea and its underlying traits: A pilot randomized controlled trial.

Author: Taranto-MontemurroLuigi, SandsScott, AzarbarzinAli, CalianeseNicole, VenaDaniel, HessLauren, KimSang-Wook, WhiteDavid P, WellmanAndrew

OSA treatment
Insomnia

This study aimed to evaluate the effects of a combination of pseudoephedrine, an alpha-1 adrenergic agonist, and diphenhydramine, an antihistaminic-antimuscarinic, on obstructive sleep apnea (OSA). The combination therapy may improve genioglossus muscle activity during sleep and potentially offer a novel treatment option for OSA.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

How can we Preserve Sexual Function after Ablative Surgery for Benign Prostatic Hyperplasia?

Author: MykoniatisIoannis, RenterghemKoenraad Van, SokolakisIoannis

BPE treatment
Ejaculation dysfunction
Erectile dysfunction

This narrative review describes the prevalence, associated pathophysiologic pathways, and potential management methods of sexual dysfunction related to ablative surgical techniques for Benign Prostatic Enlargement (BPE).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Ephedrine-induced mitophagy via oxidative stress in human hepatic stellate cells.

Author: LeeAh Young, JangYoonjeong, HongSeong-Ho, ChangSeung-Hee, ParkSungjin, KimSanghwa, KangKyung-Sun, KimJi-Eun, ChoMyung-Haing

Ephedrine side effects
Liver toxicity

Ephedrine, a component of the herb Ephedra sinica, was found to trigger mitochondrial oxidative stress and depolarization, leading to mitophagy and cell death in LX-2 liver cells. The study suggests that excessive mitophagy may contribute to ephedrine-induced hepatotoxicity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Pseudoephedrine and circadian rhythm interaction on neuromuscular performance.

Author: PallarésJ G, López-SamanesÁ, Fernández-ElíasV E, Aguado-JiménezR, OrtegaJ F, GómezC, VenturaR, SeguraJ, Mora-RodríguezR

Neuromuscular performance enhancement
Doping violation
Side effects

This study analyzed the effects of pseudoephedrine (PSE) provided at different time of day on neuromuscular performance, side effects, and violation of the current doping cut-off threshold.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Chapter 6: Nonallergic rhinitis.

Author: ShahRachna, McGrathKris G

Rhinitis treatment
Side effects

Nonallergic rhinitis is a group of disorders with nasal symptoms similar to allergic rhinitis, but without pruritus. It can be inflammatory (e.g., postinfectious, nasal polyps) or noninflammatory (e.g., idiopathic, medication-induced, hormone-related, systemic disease-related). Treatment options include topical antihistamines, intranasal steroids, intranasal anticholinergics, and oral decongestants.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

The role of pseudoephedrine on daytime somnolence in patients suffering from perennial allergic rhinitis (PAR).

Author: SherkatAmir A, SardanaNiti, SafaeeSahar, LehmanErik B, CraigTimothy J

Nasal congestion
Somnolence

Allergic rhinitis is an inflammatory nasal disease characterized by eosinophil accumulation and release of inflammatory mediators. This inflammation leads to nasal congestion and sleep disturbance, resulting in daytime somnolence.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

14.

Acute urinary retention due to pseudoephedrine hydrochloride in a 3-year-old child.

Author: SoyerTutku, GölIsmail Hakki, EroğluFunda, CetinAsli

PEH overdose
Urinary retention

This case report describes a three-year-old boy who developed acute urinary retention after taking pseudoephedrine hydrochloride (PEH). It emphasizes the importance of recognizing PEH overdose in children and highlights appropriate treatment approaches.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Acute myocardial infarction related to methylphenidate for adult attention deficit disorder.

Author: ThompsonJan, ThompsonJames R

Adult ADHD treatment
Myocardial infarction

Methylphenidate use was associated with coronary vasospasm and acute myocardial infarction in a 27-year-old man, highlighting the potential cardiovascular risks associated with psychostimulant medications.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Translating the evidence on atypical depression into clinical practice.

Author: Hyman RapaportMark

MAOI depression tx
MAOI side effects
tyramine diet risk

This abstract discusses the use of selegiline transdermal system (STS) in treating major depressive disorder (MDD) with atypical symptoms. STS is a second-generation monoamine oxidase inhibitor (MAOI) with a favorable side effect profile compared to first-generation MAOIs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

A randomized controlled trial of cetirizine plus pseudoephedrine versus loratadine plus pseudoephedrine for perennial allergic rhinitis.

Author: ChiangYi-Chi, ShyurShyh-Dar, ChenTien-Ling, HuangLi-Hsin, WenTa-Chzng, LinMao-Tsair, YangHwai-Chih, LiangPei-Hsuan, KaoYu-Hsuan, WangTsung-Chi

Reduced allergic rhinitis symptoms
Side effects

This double-blind, randomized, parallel trial compared the efficacy and safety of cetirizine plus pseudoephedrine (C+P) with loratadine plus pseudoephedrine (L+P) in treating perennial allergic rhinitis. Both medications were effective, with C+P showing slightly better relief of sneezing and nasal congestion and slightly better tolerability.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

18.

Pseudoephedrine enhances performance in 1500-m runners.

Author: HodgesKate, HancockSarah, CurrellKevin, HamiltonBruce, JeukendrupAsker E

Ergogenic aid
Stimulant effect

Pseudoephedrine is an over-the-counter decongestant. While it was once thought to be a stimulant and performance enhancer, it has been removed from the banned substance list and placed on a monitoring program by the International Olympic Committee. The ergogenic effect of pseudoephedrine is not yet established, and this study aims to investigate its impact on 1500-meter running performance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

19.

Colonic toxicity of administered drugs and chemicals.

Author: CappellMitchell S

Colonic hypomotility
Colonic ischemia
Colonic pseudo-obstruction
Hemorrhagic colitis
Inflammatory colitis
Lymphocytic colitis
Neutropenic colitis
Pseudomembranous colitis
Toxic colitis
Yersinia enterocolitis

Medication-induced colonotoxicity, though uncommon, can be serious and requires prompt medication cessation. This review categorizes medications associated with colonotoxicity into various categories, including those associated with ischemia, pseudo-obstruction, colitis, and lymphocytic colitis.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

[Assessment of the clinical efficacy and safety of epinastine plus pseudoephedrine vs loratadine plus pseudoephedrine in perennial allergic rhinitis].

Author: Hernández ColínDante, González DíazSandra Nora, Rodríguez MedinaRicardo, Aguilar AngelesDaniel, González GámezJaime, Becerril AngelesMartin, Orea SolanoModesto, Domínguez HenkelRafael, Segovia AyalaCarlos

Allergic rhinitis treatment
Reduced CNS effects
Side effects

This study reviews the development of medications for the treatment of perennial allergic rhinitis.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Spanish

21.

Elimination of ephedrines in urine following multiple dosing: the consequences for athletes, in relation to doping control.

Author: ChesterNeil, MottramDavid R, ReillyThomas, PowellMark

CNS stimulation

Therapeutic doses of phenylpropanolamine and pseudoephedrine can remain in the urine for 6 and 16 hours, respectively, after the final dose. Athletes should be aware of this when using these medications.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

22.

Oral medications.

Author: AlbretsenJay C

Medication management
Toxicity

This article provides an overview of the pharmacokinetics, mechanism of action, toxicity, clinical signs, and management procedures for several oral medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Intranasal budesonide spray as an adjunct to oral antibiotic therapy for acute sinusitis in children.

Author: YilmazG, VaranB, YilmazT, GürakanB

Acute sinusitis treatment
Hasten symptom resolution

Intranasal budesonide was found to be a useful adjunctive agent in the treatment of acute sinusitis in children. Intranasal budesonide, along with cefaclor, resulted in a significantly higher recovery rate than oral pseudoephedrine and cefaclor. There were no apparent side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

24.

[Evaluation of the efficiency and safety of the loratadine with pseudoephedrine combination drug in treatment of seasonal allergic rhinitis].

Author: ZawiszaE, LipiecA, RapiejkoP

Allergic rhinitis relief
Dry mouth
Insomnia
Nervousness
Sedation

Loratadine/pseudoephedrine combination drug was found to be safe and effective in treating symptoms of seasonal allergic rhinitis. The drug significantly reduced nasal and non-nasal symptoms, with a low incidence of mild side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Polish

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