Oral Decongestants: Pseudophedrine
Place in Therapy
Place in Therapy
While antihistamines are used to attenuate the allergic response to environmental triggers and alleviating a wide spectrum of symptoms associated with allergic rhinitis, an additional agent is often needed to reduce congestion. Allergic rhinitis patients experience varying degrees of congestion, and as a result will have differing needs with regards to decongestant use. Phenylephrine and pseudoephedrine are two effective decongestants that can be used orally. The benefit of oral decongestants over topical nasal decongestants is that they do not cause rebound medicamentosa and are suitable for patients experiencing congestion symptoms for longer than a few days.
Single entity pseudoephedrine products are not longer marketed in Canada due to their potential use for illicit drug manufacturing. Pseudoephedrine is usually formulated in combination with 1st and 2nd generation antihistamines, as well as analgesics, such as acetaminophen and ibuprofen in cough and cold formulations. Products containing pseudoephedrine should be avoided in patients with cardiac conditions, hypertension and hyperthyroidism, as well as in pregnant and lactating women, and children under 12 years of age.
1. Diphenhydramine (Systemic). In: Lexi-Drugs (Lexicomp Online). Hudson, OH: Lexi-Comp, Inc; 2014. https://online.lexi.com/lco/action/home. Accessed June 28, 2014.
2. Keith, P. Respiratory Disorders: Allergic Rhinitis. In: e-Therapeutics (Therapeutic Choices). Ottawa, ON: Canadian Pharmacists Association; 2014. http://www.e-therapeutics.ca. Revised June 2014. Accessed June 20, 2014.
While antihistamines are used to attenuate the allergic response to environmental triggers and alleviating a wide spectrum of symptoms associated with allergic rhinitis, an additional agent is often needed to reduce congestion. Allergic rhinitis patients experience varying degrees of congestion, and as a result will have differing needs with regards to decongestant use. Phenylephrine and pseudoephedrine are two effective decongestants that can be used orally. The benefit of oral decongestants over topical nasal decongestants is that they do not cause rebound medicamentosa and are suitable for patients experiencing congestion symptoms for longer than a few days.
Single entity pseudoephedrine products are not longer marketed in Canada due to their potential use for illicit drug manufacturing. Pseudoephedrine is usually formulated in combination with 1st and 2nd generation antihistamines, as well as analgesics, such as acetaminophen and ibuprofen in cough and cold formulations. Products containing pseudoephedrine should be avoided in patients with cardiac conditions, hypertension and hyperthyroidism, as well as in pregnant and lactating women, and children under 12 years of age.
1. Diphenhydramine (Systemic). In: Lexi-Drugs (Lexicomp Online). Hudson, OH: Lexi-Comp, Inc; 2014. https://online.lexi.com/lco/action/home. Accessed June 28, 2014.
2. Keith, P. Respiratory Disorders: Allergic Rhinitis. In: e-Therapeutics (Therapeutic Choices). Ottawa, ON: Canadian Pharmacists Association; 2014. http://www.e-therapeutics.ca. Revised June 2014. Accessed June 20, 2014.