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Revision as of 11:53, 6 December 2011 editBeetstra (talk | contribs)Edit filter managers, Administrators172,031 edits Saving copy of the {{drugbox}} taken from revid 464345940 of page Pseudoephedrine for the Chem/Drugbox validation project (updated: '').		Latest revision as of 02:31, 27 December 2024 edit ChemicalBear (talk | contribs)Extended confirmed users663 edits Updated broken Anchor and added another linkTag: Visual edit
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			{{Short description|Pharmaceutical drug}}
	{{ambox | text = This page contains a copy of the infobox ({{tl|drugbox}}) taken from revid of page ] with values updated to verified values.}}
			{{redirect|Sudafed|Sudafed PE|Phenylephrine}}
	{{drugbox
			{{Use dmy dates|date=September 2023}}
	| Verifiedfields = changed
			{{cs1 config|name-list-style=vanc|display-authors=6}}
	| verifiedrevid = 408972025
			{{Infobox drug
	| IUPAC_name = (S,S)-2-methylamino-1-phenylpropan-1-ol
			| Watchedfields = changed
	| image = (+)-Pseudoephedrin.svg
			| verifiedrevid = 464375838
	| width = 175
	| image2 = Pseudoephedrine-3d-CPK.png		| image = Pseudoephedrine S,S ephedrine comparison.png
			| width = 200px
			| image2 = (1S,2S)-Pseudoephedrine molecule ball.png
			| width2 = 200px
			<!-- Clinical data -->| pronounce = {{IPAc-en|ˌ|s|uː|d|oʊ|.|ᵻ|ˈ|f|ɛ|d|r|ɪ|n|,_|-|ˈ|ɛ|f|ᵻ|d|r|iː|n}}
	<!--Clinical data-->
	| tradename = Afrinol, Sudafed, Sinutab(UK)		| tradename = Afrinol, Sudafed, Sinutab, others
	| Drugs.com = {{drugs.com|monograph|pseudoephedrine}}		| Drugs.com = {{drugs.com|monograph|pseudoephedrine}}
	| MedlinePlus = a682619		| MedlinePlus = a682619
			| licence_EU = yes
			| INN_EMA = pseudoephedrine sulfate
			| DailyMedID = Pseudoephedrine
	| pregnancy_AU = B2		| pregnancy_AU = B2
			| pregnancy_AU_comment =
	| pregnancy_US = C
			| pregnancy_category =
			| routes_of_administration = ]<ref name="GłowackaWiela-Hojeńska2021" /><ref name="Eccles2007" />
			| class = ]; ]; ]
			| ATCvet =
			| ATC_prefix = R01
			| ATC_suffix = BA02
			| ATC_supplemental = <!-- Legal status -->
	| legal_AU = S3		| legal_AU = S3
			| legal_AU_comment = Largely tracked nationwide via “Project STOP” to avoid purchases in large quantities.<ref>{{cite web |url=https://www.guild.org.au/__data/assets/pdf_file/0011/5015/project-stop.pdf |title=Project STOP A Pharmacy Guild Initiative, May 2016 |date=18 May 2016 |publisher=The Pharmacy Guild of Australia }}</ref> Use of Project STOP is mandatory in all states and territories except Victoria and Tasmania<ref>{{cite web |url=https://www.aic.gov.au/sites/default/files/2020-05/tandi509.pdf | access-date=11 July 2024 |title=Trends & issues in crime and criminal justice No. 509, March 2016 |date=7 March 2016 |publisher=Australian Institute of Criminology }}</ref><ref>{{cite web | title=Project STOP mandatory for pharmacists in NSW from next month | website=Pulse.IT | date=24 February 2016 | url=https://www.pulseit.news/australian-digital-health/project-stop-mandatory-for-pharmacists-in-nsw-from-next-month/ | access-date=11 July 2024}}</ref>
	| legal_CA = S3
			| legal_BR = D1
			| legal_BR_comment = <ref>{{cite web |author=Anvisa |author-link=Brazilian Health Regulatory Agency |date=31 March 2023 |title=RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial |trans-title=Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control|url=https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |url-status=live |archive-url=https://web.archive.org/web/20230803143925/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |archive-date=3 August 2023 |access-date=15 August 2023 |publisher=] |language=pt-BR |publication-date=4 April 2023}}</ref>
			| legal_CA = OTC
			| legal_CA_comment = Removed from the {{abbr|NDS|National Drug Schedule}} in 2024, for both combination and single ingredient preparations, on 1 Mar & 10 Jun 2024, respectively.<ref>{{cite web | title=Background on Update to {{abbr|NAPRA|National Association of Pharmacy Regulatory Authorities}} {{abbr|NHP|Natural Health Products}} Policy | website=napra.ca | date=10 June 2024 | url=https://www.napra.ca/national-drug-schedules/national-drug-schedules-policies/ | access-date=11 July 2024}}</ref>
			| legal_DE = <!-- Anlage I, II, III or Unscheduled -->
			| legal_DE_comment =
			| legal_NZ = <!-- Class A, B, C -->
			| legal_NZ_comment =
	| legal_UK = P		| legal_UK = P
			| legal_UK_comment =
	| legal_US = OTC		| legal_US = OTC
			| legal_US_comment =
	| routes_of_administration = oral
			| legal_EU =
			| legal_EU_comment =
			| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV -->
			| legal_UN_comment =
			| legal_status = <!-- For countries not listed above -->
			<!-- Pharmacokinetic data -->| bioavailability = ~100%<ref name="BruntonLazoParker2006">{{cite book| veditors = Brunton LL, Lazo JS, Parker K | title = Goodman & Gilman's The Pharmacological Basis of Therapeutics | edition = 11th | year = 2006 | publisher = McGraw-Hill Medical Publishing Division | location = New York | isbn = 0-07-142280-3}}</ref>
	<!--Pharmacokinetic data-->
			| protein_bound = 21–29% ({{Abbrlink|AGP|alpha-1-acid glycoprotein}}, {{Abbrlink|HSA|Human serum albumin}})<ref name="VolppHolzgrabe2019">{{cite journal | vauthors = Volpp M, Holzgrabe U | title = Determination of plasma protein binding for sympathomimetic drugs by means of ultrafiltration | journal = Eur J Pharm Sci | volume = 127 | issue = | pages = 175–184 | date = January 2019 | pmid = 30391401 | doi = 10.1016/j.ejps.2018.10.027 | url = }}</ref><ref name="Schmidt2023">{{cite thesis | vauthors = Schmidt S | title=Lang-etablierte Arzneistoffe genauer unter die Lupe genommen: Enantioselektive Proteinbindung und Stabilitätsstudien | trans-title = A closer look at long-established drugs: enantioselective protein binding and stability studies | language = de | publisher= Universität Würzburg | date=2023 | doi=10.25972/opus-34594 | page=}}</ref>
	| bioavailability = ~100%<ref name="goodman-gilman">{{Citebook | editor = Laurence L Brunton | title = Goodman & Gilman's The Pharmacological Basis of Therapeutics | edition = 11th | year = 2006 | publisher = McGraw-Hill Medical Publishing Division | location = New York | isbn = 0-07-142280-3}}</ref>
			| metabolism = Not extensively ]<ref name="ChuaBenrimojTriggs1989" /><ref name="GłowackaWiela-Hojeńska2021" /><ref name="Eccles2007" />
	| metabolism = ] (10–30%)
	| elimination_half-life = 4.3-8 hours<ref name="goodman-gilman" />		| metabolites = • ]<ref name="GłowackaWiela-Hojeńska2021" />
	| excretion = 43-96% ]<ref name="goodman-gilman" />		| onset = 30{{nbsp}}minutes<ref name="GłowackaWiela-Hojeńska2021" />
			| elimination_half-life = 5.4{{nbsp}}hours (range 3–16{{nbsp}}hours dependent on ] ])<ref name="Eccles2007" /><ref name="GłowackaWiela-Hojeńska2021" /><ref name="ChuaBenrimojTriggs1989" />
			| duration_of_action = 4–12{{nbsp}}hours<ref name="GłowackaWiela-Hojeńska2021" /><ref name="Aaron1990">{{cite journal | vauthors = Aaron CK | title = Sympathomimetics | journal = Emerg Med Clin North Am | volume = 8 | issue = 3 | pages = 513–526 | date = August 1990 | pmid = 2201518 | doi = 10.1016/S0733-8627(20)30256-X| url = }}</ref>
			| excretion = ]: 43–96% (unchanged)<ref name="GłowackaWiela-Hojeńska2021" /><ref name="ChuaBenrimojTriggs1989" /><ref name="Eccles2007" /><ref name="BruntonLazoParker2006" />
	<!--Identifiers-->		<!-- Identifiers -->| CAS_number_Ref = {{cascite|correct|??}}
	| CASNo_Ref = {{cascite|correct|CAS}}
	| CAS_number_Ref = {{cascite|correct|??}}
	| CAS_number = 90-82-4		| CAS_number = 90-82-4
	| ATC_prefix = R01		| CAS_supplemental =
	| ATC_suffix = BA02
	| PubChem = 7028		| PubChem = 7028
			| IUPHAR_ligand =
	| DrugBank_Ref = {{drugbankcite|correct|drugbank}}		| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
	| DrugBank = DB00852		| DrugBank = DB00852
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	| KEGG_Ref = {{keggcite|correct|kegg}}		| KEGG_Ref = {{keggcite|correct|kegg}}
	| KEGG = D08449		| KEGG = D08449
	| ChEBI_Ref = {{ebicite|changed|EBI}}		| ChEBI_Ref = {{ebicite|correct|EBI}}
	| ChEBI = 51209		| ChEBI = 51209
	| ChEMBL_Ref = {{ebicite|correct|EBI}}		| ChEMBL_Ref = {{ebicite|correct|EBI}}
	| ChEMBL = 1590		| ChEMBL = 1590
			| NIAID_ChemDB =
			| PDB_ligand =
			| synonyms = PSE; PDE; (+)-ψ-Ephedrine; ψ-Ephedrine; d-Isoephedrine; (1''S'',2''S'')-Pseudoephedrine; d-Pseudoephedrine; (+)-Pseudoephedrine; <small>L</small>(+)-Pseudoephedrine; Isoephedrine; (1''S'',2''S'')-α,''N''-Dimethyl-β-hydroxyphenethylamine; (1''S'',2''S'')-''N''-Methyl-β-hydroxyamphetamine
	<!--Chemical data-->		<!-- Chemical data -->| IUPAC_name = (1''S'',2''S'')-2-(methylamino)-1-phenylpropan-1-ol
	| C=10 | H=15 | N=1 | O=1		| C = 10
			| H = 15
	| molecular_weight = 165.23
			| N = 1
	| smiles = O(c1ccccc1)(NC)C
			| O = 1
	| InChI = 1/C10H15NO/c1-8(11-2)10(12)9-6-4-3-5-7-9/h3-8,10-12H,1-2H3/t8-,10+/m0/s1
			| SMILES = O(c1ccccc1)(NC)C
	| StdInChI_Ref = {{stdinchicite|correct|chemspider}}		| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
	| StdInChI = 1S/C10H15NO/c1-8(11-2)10(12)9-6-4-3-5-7-9/h3-8,10-12H,1-2H3/t8-,10+/m0/s1		| StdInChI = 1S/C10H15NO/c1-8(11-2)10(12)9-6-4-3-5-7-9/h3-8,10-12H,1-2H3/t8-,10+/m0/s1
			| StdInChI_comment =
	| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}		| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
	| StdInChIKey = KWGRBVOPPLSCSI-WCBMZHEXSA-N		| StdInChIKey = KWGRBVOPPLSCSI-WCBMZHEXSA-N
			<!-- Physical data -->| density =
			| density_notes =
			| melting_point =
			| melting_high =
			| melting_notes =
			| boiling_point =
			| boiling_notes =
			| solubility =
			| sol_units =
			| specific_rotation =
	}}		}}
			<!-- Definition and medical uses -->
			'''Pseudoephedrine''', sold under the brand name '''Sudafed''' among others, is a ] medication which is used as a ] to treat ].<ref name="GłowackaWiela-Hojeńska2021">{{cite journal | vauthors = Głowacka K, Wiela-Hojeńska A | title = Pseudoephedrine—Benefits and Risks | journal = Int J Mol Sci | volume = 22 | issue = 10 | pages = 5146 | date = May 2021 | pmid = 34067981 | pmc = 8152226 | doi = 10.3390/ijms22105146 | doi-access = free | url = }}</ref><ref name="LaccourreyeWernerGiroud2015">{{cite journal | vauthors = Laccourreye O, Werner A, Giroud JP, Couloigner V, Bonfils P, Bondon-Guitton E | title = Benefits, limits and danger of ephedrine and pseudoephedrine as nasal decongestants | journal = Eur Ann Otorhinolaryngol Head Neck Dis | volume = 132 | issue = 1 | pages = 31–34 | date = February 2015 | pmid = 25532441 | doi = 10.1016/j.anorl.2014.11.001 | url = }}</ref><ref name="Eccles2007">{{cite journal | vauthors = Eccles R | title = Substitution of phenylephrine for pseudoephedrine as a nasal decongeststant. An illogical way to control methamphetamine abuse | journal = British Journal of Clinical Pharmacology | volume = 63 | issue = 1 | pages = 10–14 | date = January 2007 | pmid = 17116124 | pmc = 2000711 | doi = 10.1111/j.1365-2125.2006.02833.x }}</ref> It has also been used ] for certain other indications, like treatment of ].<ref name="FreemanKaufmann2007" /><ref name="VanBerkelFuller2015" /><ref name="Fedorowski2019" /> At higher doses, it may produce various additional effects including ],<ref name="SchifanoChiappiniMiuli2021" /><ref name="GłowackaWiela-Hojeńska2021" /> ],<ref name="MunafòFraraPerico2021" /> and ] effects.<ref name="TrinhKimRitsma2015" /><ref name="GheorghievHosseiniMoran2018" /> In relation to this, non-medical use of pseudoephedrine has been encountered.<ref name="SchifanoChiappiniMiuli2021" /><ref name="GłowackaWiela-Hojeńska2021" /><ref name="MunafòFraraPerico2021" /><ref name="TrinhKimRitsma2015" /><ref name="GheorghievHosseiniMoran2018" /> The medication is taken ].<ref name="GłowackaWiela-Hojeńska2021" /><ref name="Eccles2007" />
			<!-- Side effects and mechanism of action -->
			Side effects of pseudoephedrine include ], elevated ], increased ], ], ], ], and ], among others.<ref name="TavernerLatte2007">{{cite journal | vauthors = Taverner D, Latte J | veditors = Latte GJ | title = Nasal decongestants for the common cold | journal = Cochrane Database Syst Rev | volume = | issue = 1 | pages = CD001953 | date = January 2007 | pmid = 17253470 | doi = 10.1002/14651858.CD001953.pub3 | url = }}</ref><ref name="Eccles2007" /><ref name="GłowackaWiela-Hojeńska2021" /><ref name="SalernoJackson2005" /> Rarely, pseudoephedrine has been associated with serious ]s like ] and ].<ref name="MunafòFraraPerico2021" /><ref name="CantuArauzMurillo-Bonilla2003" /><ref name="VanBerkelFuller2015" /> Some people may be more sensitive to its ] effects.<ref name="SalernoJackson2005" /><ref name="GłowackaWiela-Hojeńska2021" /> Pseudoephedrine acts as a ], thereby indirectly activating ]s.<ref name="RothmanVuPartilla2003" /><ref name="Eccles2007" /><ref name="ODonnell1995" /><ref name="GłowackaWiela-Hojeńska2021" /> As such, it is an indirectly acting ].<ref name="RothmanVuPartilla2003" /><ref name="Eccles2007" /><ref name="ODonnell1995" /><ref name="GłowackaWiela-Hojeńska2021" /> Pseudoephedrine significantly crosses into the ], but has some ] due to its ].<ref name="ODonnell1995" /><ref name="BouchardWeberGeiger2002" /> Chemically, pseudoephedrine is a ] and is closely related to ], ], and ].<ref name="GłowackaWiela-Hojeńska2021" /><ref name="LaccourreyeWernerGiroud2015" /><ref name="Eccles2007" /> It is the (1''S'',2''S'')-] of ].<ref name="PubChem" />
			<!-- History, society, and culture -->
			Along with ephedrine, pseudoephedrine occurs ] in ], which has been used for thousands of years in ].<ref name="LaccourreyeWernerGiroud2015" /><ref name="AbourashedEl-AlfyKhan2003">{{cite journal | vauthors = Abourashed EA, El-Alfy AT, Khan IA, Walker L | title = Ephedra in perspective--a current review | journal = Phytother Res | volume = 17 | issue = 7 | pages = 703–712 | date = August 2003 | pmid = 12916063 | doi = 10.1002/ptr.1337 | url = }}</ref> It was first ] from ephedra in 1889.<ref name="AbourashedEl-AlfyKhan2003" /><ref name="LaccourreyeWernerGiroud2015" /><ref name="ChenKao1926">{{cite journal | vauthors = Chen KK, Kao CH | title=Ephedrine and Pseudoephedrine, their Isolation, Constitution, Isomerism, Properties, Derivatives and Synthesis. (with a Bibliography) **The expense of this work has been defrayed by a part of a grant from the Committee on Therapeutic Research, Council on Pharmacy and Chemistry, American Medical Association. | journal=The Journal of the American Pharmaceutical Association (1912) | volume=15 | issue=8 | date=1926 | doi=10.1002/jps.3080150804 | pages=625–639}}</ref> Subsequent to its ] in the 1920s, pseudoephedrine was introduced for medical use as a decongestant.<ref name="LaccourreyeWernerGiroud2015" /> Pseudoephedrine is widely available ] (OTC) in both single-drug and ] ].<ref name="Drugs@FDA" /><ref name="SalernoJackson2005" /><ref name="LaccourreyeWernerGiroud2015" /><ref name="Eccles2007" /> Availability of pseudoephedrine has been restricted starting in 2005 as it can be used to synthesize ].<ref name="LaccourreyeWernerGiroud2015" /><ref name="Eccles2007" /> ] has replaced pseudoephedrine in many over-the-counter ] decongestant products.<ref name="Eccles2007" /> However, oral phenylephrine appears to be ineffective as a decongestant.<ref name="Hatton2022">{{cite journal |vauthors=Hatton RC, Hendeles L |date=March 2022 |title=Why Is Oral Phenylephrine on the Market After Compelling Evidence of Its Ineffectiveness as a Decongestant? |journal=Ann Pharmacother |volume=56 |issue=11 |pages=1275–1278 |doi=10.1177/10600280221081526 |pmid=35337187 |s2cid=247712448}}</ref><ref name="HendelesHatton2006">{{cite journal | vauthors = Hendeles L, Hatton RC | title = Oral phenylephrine: an ineffective replacement for pseudoephedrine? | journal = J Allergy Clin Immunol | volume = 118 | issue = 1 | pages = 279–280 | date = July 2006 | pmid = 16815167 | doi = 10.1016/j.jaci.2006.03.002 | url = }}</ref> In 2022, the combination with ] and ] was the 265th most commonly prescribed medication in the United States, with more than 1{{nbsp}}million prescriptions.<ref name="Top 300 of 2022">{{cite web | title=The Top 300 of 2022 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=30 August 2024 | archive-date=30 August 2024 | archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live }}</ref><ref name="Top 300 of 2022" /><ref>{{cite web | title = Brompheniramine; Dextromethorphan; Pseudoephedrine Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/BrompheniramineDextromethorphanPseudoephedrine | access-date = 30 August 2024 }}</ref> In 2022, the combination with ] was the 289th most commonly prescribed medication in the United States, with more than 500,000 prescriptions.<ref name="Top 300 of 2022" /><ref>{{cite web | title = Loratadine; Pseudoephedrine Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/LoratadinePseudoephedrine | access-date = 30 August 2024 }}</ref>
			{{TOC limit|3}}
			==Medical uses==
			===Nasal congestion===
			{{More citations needed section|date=December 2011}}
			Pseudoephedrine is a ] and is well-known for shrinking swollen nasal mucous membranes, so it is often used as a ]. It reduces tissue ], ], and ] commonly associated with ] or ]. Other beneficial effects may include increasing the drainage of ] secretions, and opening of obstructed ]s. The same ] action can also result in ], which is a noted side effect of pseudoephedrine.
			Pseudoephedrine can be used either as oral or as ]. Due to its ] qualities, however, the oral preparation is more likely to cause adverse effects, including ].<ref>{{cite web|url=https://www.auanet.org/education/urinary-incontinence.cfm|title=American Urological Association – Medical Student Curriculum – Urinary Incontinence|publisher=American Urological Association|access-date=12 August 2015|archive-date=9 July 2015|archive-url=https://web.archive.org/web/20150709153620/http://www.auanet.org/education/urinary-incontinence.cfm|url-status=dead}}</ref><ref>{{cite web |url=http://www.turkishjournalpediatrics.org/?fullTextId=481&lang=eng |title=Acute urinary retention due to pseudoephedrine hydrochloride in a 3-year-old child |publisher=The Turkish Journal of Pediatrics |access-date=12 August 2015 |archive-date=14 August 2016 |archive-url=https://web.archive.org/web/20160814231751/http://www.turkishjournalpediatrics.org/?fullTextId=481&lang=eng |url-status=live }}</ref> According to one study, pseudoephedrine may show effectiveness as an ] drug (suppression of ]).<ref>{{cite journal | vauthors = Minamizawa K, Goto H, Ohi Y, Shimada Y, Terasawa K, Haji A | title = Effect of d-pseudoephedrine on cough reflex and its mode of action in guinea pigs | journal = Journal of Pharmacological Sciences | volume = 102 | issue = 1 | pages = 136–142 | date = September 2006 | pmid = 16974066 | doi = 10.1254/jphs.FP0060526 | doi-access = free | title-link = doi }}</ref>
			Pseudoephedrine is ] for the treatment of nasal congestion, sinus congestion, and Eustachian tube congestion.<ref name="Bicopoulos">{{cite book | veditors = Bicopoulos D | title = AusDI: Drug information for the healthcare professional | edition = 2nd | location = Castle Hill | publisher = Pharmaceutical Care Information Services | date = 2002 }}</ref> Pseudoephedrine is also indicated for ] and as an adjunct to other agents in the optimum treatment of ], ], ], ], and ].<ref name="Bicopoulos" />
			===Other uses===
			]s and other ] agents are known to have ]s and are used in the treatment of ] and ].<ref name="SakaiChikahisaNishino2010">{{cite journal | vauthors =Sakai N, Chikahisa S, Nishino S | title=Stimulants in Excessive Daytime Sleepiness | journal=Sleep Medicine Clinics | volume=5 | issue=4 | date=2010 | doi=10.1016/j.jsmc.2010.08.009 | pages=591–607}}</ref><ref name="TakenoshitaNishino2020">{{cite journal | vauthors = Takenoshita S, Nishino S | title = Pharmacologic Management of Excessive Daytime Sleepiness | journal = Sleep Med Clin | volume = 15 | issue = 2 | pages = 177–194 | date = June 2020 | pmid = 32386693 | doi = 10.1016/j.jsmc.2020.02.006 | url = }}</ref><ref name="BoutrelKoob2004">{{cite journal | vauthors = Boutrel B, Koob GF | title = What keeps us awake: the neuropharmacology of stimulants and wakefulness-promoting medications | journal = Sleep | volume = 27 | issue = 6 | pages = 1181–1194 | date = September 2004 | pmid = 15532213 | doi = 10.1093/sleep/27.6.1181 | url = }}</ref> Pseudoephedrine at therapeutic doses does not appear to improve or worsen daytime ], daytime ], or ] in people with ].<ref name="GłowackaWiela-Hojeńska2021" /><ref name="SherkatSardanaSafaee2011">{{cite journal | vauthors = Sherkat AA, Sardana N, Safaee S, Lehman EB, Craig TJ | title = The role of pseudoephedrine on daytime somnolence in patients suffering from perennial allergic rhinitis (PAR) | journal = Ann Allergy Asthma Immunol | volume = 106 | issue = 2 | pages = 97–102 | date = February 2011 | pmid = 21277510 | doi = 10.1016/j.anai.2010.11.013 | url = }}</ref> Likewise, ] was not lower in children with the ] treated with pseudoephedrine for nasal congestion.<ref name="GelotteAlbrechtHynson2019">{{cite journal | vauthors = Gelotte CK, Albrecht HH, Hynson J, Gallagher V | title = A Multicenter, Randomized, Placebo-Controlled Study of Pseudoephedrine for the Temporary Relief of Nasal Congestion in Children With the Common Cold | journal = J Clin Pharmacol | volume = 59 | issue = 12 | pages = 1573–1583 | date = December 2019 | pmid = 31274197 | pmc = 6851811 | doi = 10.1002/jcph.1472 | url = }}</ref> In any case, ] is a known ] of pseudoephedrine, although the incidence is low.<ref name="TavernerLatte2007" /> In addition, doses of pseudoephedrine above the normal therapeutic range have been reported to produce ] effects including insomnia and fatigue resistance.<ref name="SchifanoChiappiniMiuli2021" />
			There has been interest in pseudoephedrine as an ] for the treatment of ].<ref name="MunafòFraraPerico2021">{{cite journal | vauthors = Munafò A, Frara S, Perico N, Di Mauro R, Cortinovis M, Burgaletto C, Cantarella G, Remuzzi G, Giustina A, Bernardini R | title = In search of an ideal drug for safer treatment of obesity: The false promise of pseudoephedrine | journal = Rev Endocr Metab Disord | volume = 22 | issue = 4 | pages = 1013–1025 | date = December 2021 | pmid = 33945051 | pmc = 8724077 | doi = 10.1007/s11154-021-09658-w | url = }}</ref> However, due to lack of clinical data and potential cardiovascular side effects, this use is not recommended.<ref name="MunafòFraraPerico2021" /> Only a single ]-] study of pseudoephedrine for ] exists (120{{nbsp}}mg/day ] for 12{{nbsp}}weeks) and found no significant difference in weight lost compared to placebo (-4.6{{nbsp}}kg vs. -4.5{{nbsp}}kg).<ref name="MunafòFraraPerico2021" /><ref name="GreenwayHerberRaum1999">{{cite journal | vauthors = Greenway F, Herber D, Raum W, Herber D, Morales S | title = Double-blind, randomized, placebo-controlled clinical trials with non-prescription medications for the treatment of obesity | journal = Obes Res | volume = 7 | issue = 4 | pages = 370–378 | date = July 1999 | pmid = 10440593 | doi = 10.1002/j.1550-8528.1999.tb00420.x | url = }}</ref> This was in contrast to ], which has been found to be more effective at promoting weight loss compared to placebo and has been more widely studied and used in the treatment of obesity.<ref name="CoulterRebelloGreenway2018">{{cite journal | vauthors = Coulter AA, Rebello CJ, Greenway FL | title = Centrally Acting Agents for Obesity: Past, Present, and Future | journal = Drugs | volume = 78 | issue = 11 | pages = 1113–1132 | date = July 2018 | pmid = 30014268 | pmc = 6095132 | doi = 10.1007/s40265-018-0946-y | url = }}</ref><ref name="Ioannides-DemosProiettoMcNeil2005">{{cite journal | vauthors = Ioannides-Demos LL, Proietto J, McNeil JJ | title = Pharmacotherapy for obesity | journal = Drugs | volume = 65 | issue = 10 | pages = 1391–418 | date = 2005 | pmid = 15977970 | doi = 10.2165/00003495-200565100-00006 | url = }}</ref><ref name="GreenwayHerberRaum1999" />
			Pseudoephedrine has been used limitedly in the treatment of ] including ]<ref name="FreemanKaufmann2007">{{cite journal | vauthors = Freeman R, Kaufmann H | title=Disorders of Orthostatic Tolerance—Orthostatic Hypotension, Postural Tachycardia Syndrome, and Syncope | journal=Continuum: Lifelong Learning in Neurology | volume=13 | date=2007 | issn=1080-2371 | doi=10.1212/01.CON.0000299966.05395.6c | pages=50–88}}</ref> and ] (POTS).<ref name="Fedorowski2019">{{cite journal | vauthors = Fedorowski A | title = Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management | journal = J Intern Med | volume = 285 | issue = 4 | pages = 352–366 | date = April 2019 | pmid = 30372565 | doi = 10.1111/joim.12852 | url = }}</ref><ref name="FedorowskiMelander2013">{{cite journal | vauthors = Fedorowski A, Melander O | title = Syndromes of orthostatic intolerance: a hidden danger | journal = J Intern Med | volume = 273 | issue = 4 | pages = 322–335 | date = April 2013 | pmid = 23216860 | doi = 10.1111/joim.12021 | url = }}</ref><ref name="AbedBallWang2012">{{cite journal | vauthors = Abed H, Ball PA, Wang LX | title = Diagnosis and management of postural orthostatic tachycardia syndrome: A brief review | journal = J Geriatr Cardiol | volume = 9 | issue = 1 | pages = 61–67 | date = March 2012 | pmid = 22783324 | pmc = 3390096 | doi = 10.3724/SP.J.1263.2012.00061 | url = }}</ref> However, its effectiveness in the treatment of POTS is controversial.<ref name="Fedorowski2019" /><ref name="FedorowskiMelander2013" /> Pseudoephedrine has also been used limitedly in the treatment of refractory ] in ]s.<ref name="VanBerkelFuller2015">{{cite journal | vauthors = Van Berkel MA, Fuller LA, Alexandrov AW, Jones GM | title = Methylene blue, midodrine, and pseudoephedrine: a review of alternative agents for refractory hypotension in the intensive care unit | journal = Crit Care Nurs Q | volume = 38 | issue = 4 | pages = 345–358 | date = 2015 | pmid = 26335214 | doi = 10.1097/CNQ.0000000000000086 | url = }}</ref> However, data on this use are limited to ]s and ].<ref name="VanBerkelFuller2015" />
			Pseudoephedrine is also used as a first-line prophylactic for recurrent ].<ref name="MuneerMinhasArya2008">{{cite journal | vauthors = Muneer A, Minhas S, Arya M, Ralph DJ | title = Stuttering priapism--a review of the therapeutic options | journal = Int J Clin Pract | volume = 62 | issue = 8 | pages = 1265–1270 | date = August 2008 | pmid = 18479367 | doi = 10.1111/j.1742-1241.2008.01780.x | url = | doi-access = free }}</ref> ] is largely a ] response, so the sympathetic action of pseudoephedrine may serve to relieve this condition. Data for this use are however ] and effectiveness has been described as variable.<ref name="MuneerMinhasArya2008" />
			Treatment of ] is an ] for pseudoephedrine and related medications.<ref>{{cite journal |url=https://www.aafp.org/pubs/afp/issues/2005/0115/p315.html |title=Selecting Medications for the Treatment of Urinary Incontinence – January 15, 2005 – American Family Physician |journal=American Family Physician |volume=71 |issue=2 |pages=315–322 |access-date=6 May 2012 |date=15 January 2005 |vauthors=Weiss BD |archive-date=7 July 2022 |archive-url=https://web.archive.org/web/20220707101320/https://www.aafp.org/pubs/afp/issues/2005/0115/p315.html |url-status=live }}</ref><ref>{{cite journal | vauthors = Culligan PJ, Heit M | title = Urinary incontinence in women: evaluation and management | journal = American Family Physician | volume = 62 | issue = 11 | pages = 2433–44, 2447, 2452 | date = December 2000 | pmid = 11130230 | url = https://www.aafp.org/pubs/afp/issues/2019/0915/p339.html | access-date = 7 September 2023 | archive-date = 7 September 2023 | archive-url = https://web.archive.org/web/20230907050537/https://www.aafp.org/pubs/afp/issues/2019/0915/p339.html | url-status = live }}</ref>
			===Available forms===
			{{See also|Azatadine/pseudoephedrine|Carbinoxamine/pseudoephedrine|Cetirizine/pseudoephedrine|Dexbrompheniramine/pseudoephedrine|Fexofenadine/pseudoephedrine|Pseudoephedrine/loratadine|Naproxen/pseudoephedrine}}
			Pseudoephedrine is available by itself ] in the form of 30 and 60{{nbsp}}mg ] and 120 and 240{{nbsp}}mg ] ] ]s in the ].<ref name="Drugs@FDA">{{cite web | title=Drugs@FDA: FDA-Approved Drugs | publisher = Food and Drug Administration | website=accessdata.fda.gov | url=https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm | access-date=14 July 2024}}</ref><ref name="KiziorHodgson2014">{{cite book | vauthors = Kizior R, Hodgson BB | title=Saunders Nursing Drug Handbook 2015 - E-Book: Saunders Nursing Drug Handbook 2015 - E-Book | publisher=Elsevier Health Sciences | year=2014 | isbn=978-0-323-28018-1 | url=https://books.google.com/books?id=qVRTBAAAQBAJ&pg=PA1016 | access-date=14 July 2024 | page=1016}}</ref><ref name="Braun2012">{{cite book | vauthors = Braun DD | title=Over the Counter Pharmaceutical Formulations | publisher=Elsevier Science | year=2012 | isbn=978-0-8155-1849-5 | url=https://books.google.com/books?id=gLjegID0K7wC&pg=PA181 | access-date=26 July 2024 | page=181}}</ref><ref name="Berry2001">{{cite book | vauthors = Berry TM | title=Nursing Nonprescription Drug Handbook | publisher=Springhouse | series=Nursing Drug Handbook Series | year=2001 | isbn=978-1-58255-101-2 | url=https://books.google.com/books?id=LVN0sLrHB8kC&pg=PA114 | access-date=14 July 2024 | page=114}}</ref>
			Pseudoephedrine is also available over-the-counter and ] ] with numerous other drugs, including ]s (], ], ], ], ], ], ], ], ], ], ], ]), ]s (], ], ], ], ]), ]s (]), and ]s (]).<ref name="Drugs@FDA" /><ref name="KiziorHodgson2014" />
			Pseudoephedrine has been used in the form of the ] and ] ]s and in a polistirex form.<ref name="Drugs@FDA" /> The drug has been used in more than 135 over-the-counter and prescription formulations.<ref name="SalernoJackson2005" /> Many prescription formulations containing pseudoephedrine have been discontinued over time.<ref name="Drugs@FDA" />
			==Contraindications==
			Pseudoephedrine is ] in patients with ], ], severe or uncontrolled ], severe ], ], ], ], or by ] women.<ref name="Rossi" /> The safety and effectiveness of nasal decongestant use in children is unclear.<ref name=Deckx2016>{{cite journal | vauthors = Deckx L, De Sutter AI, Guo L, Mir NA, van Driel ML | title = Nasal decongestants in monotherapy for the common cold | journal = The Cochrane Database of Systematic Reviews | volume = 2016 | issue = 10 | pages = CD009612 | date = October 2016 | pmid = 27748955 | pmc = 6461189 | doi = 10.1002/14651858.CD009612.pub2 }}</ref>
			==Side effects==
			Common side effects with pseudoephedrine therapy may include ] (CNS) ], ], ], ], ], and ].<ref name="MunafòFraraPerico2021" /><ref name="VanBerkelFuller2015" /><ref name="HughesEmpeyLand1983" /> Infrequent side effects include ] or ]s.<ref name="MunafòFraraPerico2021" /> Rarely, pseudoephedrine therapy may be associated with ] (dilated pupils), ]s, ]s, ], ]s, and ]; as well as severe ]s known as recurrent pseudo-scarlatina, ], and non-pigmenting ].<ref name="MunafòFraraPerico2021" /><ref>{{cite journal | vauthors = Vidal C, Prieto A, Pérez-Carral C, Armisén M | title = Nonpigmenting fixed drug eruption due to pseudoephedrine | journal = Annals of Allergy, Asthma & Immunology | volume = 80 | issue = 4 | pages = 309–310 | date = April 1998 | pmid = 9564979 | doi = 10.1016/S1081-1206(10)62974-2 }}</ref><ref name="Rossi">{{cite book | veditors = Rossi S | title = ] | date = 2006 | location = Adelaide | publisher = Australian Medicines Handbook | isbn = 0-9757919-2-3 }}</ref> Pseudoephedrine, particularly when combined with other drugs including ]s, may also play a role in the precipitation of episodes of ].<ref name="MunafòFraraPerico2021" /><ref>{{cite web |url=http://home.intekom.com/pharm/adcock/a-tussnd.html |title=Adco-Tussend |publisher=Home.intekom.com |date=15 March 1993 |access-date=6 May 2012 |archive-date=30 April 2012 |archive-url=https://web.archive.org/web/20120430182731/http://home.intekom.com/pharm/adcock/a-tussnd.html |url-status=dead }}</ref> It has also been reported that pseudoephedrine, among other ] agents, may be associated with the occurrence of ] and other ]s.<ref name="MunafòFraraPerico2021" /><ref name="CantuArauzMurillo-Bonilla2003">{{cite journal | vauthors = Cantu C, Arauz A, Murillo-Bonilla LM, López M, Barinagarrementeria F | title = Stroke associated with sympathomimetics contained in over-the-counter cough and cold drugs | journal = Stroke | volume = 34 | issue = 7 | pages = 1667–1672 | date = July 2003 | pmid = 12791938 | doi = 10.1161/01.STR.0000075293.45936.FA | doi-access = free | title-link = doi }}</ref><ref name="VanBerkelFuller2015" />
			Due to its sympathomimetic effects, pseudoephedrine is a ] and ] (increases ]), a ] (increases ]), and a ] (increases ]s).<ref name="MunafòFraraPerico2021" /><ref name="GłowackaWiela-Hojeńska2021" /><ref name="SalernoJackson2005" /><ref name="TrinhKimRitsma2015" /><ref name="GheorghievHosseiniMoran2018" /> The influence of pseudoephedrine on blood pressure at clinical doses is controversial.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="SalernoJackson2005" /> A closely related sympathomimetic and decongestant, ], was ] due to associations with markedly increased blood pressure and incidence of hemorrhagic stroke.<ref name="SalernoJackson2005" /> There has been concern that pseudoephedrine may likewise dangerously increase blood pressure and thereby increase the risk of stroke, whereas others have contended that the risks are exaggerated.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="SalernoJackson2005" /> Besides hemorrhagic stroke, ], ], and ] have also rarely been reported with sympathomimetic ] compounds like pseudoephedrine and ].<ref name="MunafòFraraPerico2021" /><ref name="VanBerkelFuller2015" />
			A 2005 ] found that pseudoephedrine at recommended doses had no meaningful effect on ] or ] in healthy individuals or people with controlled ].<ref name="GłowackaWiela-Hojeńska2021" /><ref name="SalernoJackson2005">{{cite journal | vauthors = Salerno SM, Jackson JL, Berbano EP | title = Effect of oral pseudoephedrine on blood pressure and heart rate: a meta-analysis | journal = Arch Intern Med | volume = 165 | issue = 15 | pages = 1686–1694 | date = 2005 | pmid = 16087815 | doi = 10.1001/archinte.165.15.1686 | url = }}</ref> Systolic blood pressure was found to slightly increase by 0.99{{nbsp}}mm{{nbsp}}Hg on average and heart rate was found to slightly increase by 2.83{{nbsp}}bpm on average.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="SalernoJackson2005" /> Conversely, there was no significant influence on diastolic blood pressure, which increased by 0.63{{nbsp}}mg{{nbsp}}Hg.<ref name="SalernoJackson2005" /> In people with controlled hypertension, systolic hypertension increased by a similar degree of 1.20{{nbsp}}mm{{nbsp}}Hg.<ref name="SalernoJackson2005" /> ] preparations, higher doses, being male, and shorter duration of use were all associated with greater cardiovascular effects.<ref name="SalernoJackson2005" /> A small subset of individuals with ], perhaps in turn resulting in greater adrenergic receptor sensitivity, may be substantially more sensitive to the cardiovascular effects of sympathomimetics.<ref name="SalernoJackson2005" /> Subsequent to the 2005 meta-analysis, a 2015 ] and a 2018 meta-analysis found that pseudoephedrine at high doses (>170{{nbsp}}mg) could increase heart rate and physical performance with larger ]s than lower doses.<ref name="TrinhKimRitsma2015" /><ref name="GheorghievHosseiniMoran2018" />
			A 2007 ] assessed the side effects of short-term use of pseudoephedrine at recommended doses as a nasal decongestant.<ref name="TavernerLatte2007" /> It found that pseudoephedrine had a small risk of ] and this was the only side effect that occurred at rates significantly different from placebo.<ref name="TavernerLatte2007" /> Insomnia occurred at a rate of 5% and had an ] (OR) of 6.18.<ref name="TavernerLatte2007" /> Other side effects, including ] and ], occurred at rates of less than 4% and were not different from placebo.<ref name="TavernerLatte2007" />
			] is known to develop with prolonged use of pseudoephedrine, especially when it is re-administered at short intervals.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="MunafòFraraPerico2021" />
			There is a case report of temporary ] upon ] and ] from pseudoephedrine.<ref name="MunafòFraraPerico2021" /><ref name="WebbDubose2013">{{cite journal | vauthors = Webb J, Dubose J | title = Symptoms of major depression after pseudoephedrine withdrawal: a case report | journal = J Neuropsychiatry Clin Neurosci | volume = 25 | issue = 2 | pages = E54–E55 | date = 2013 | pmid = 23686066 | doi = 10.1176/appi.neuropsych.12060138 | url = }}</ref> The withdrawal symptoms included worsened ] and ], profoundly decreased ], a worsened view of oneself, decreased concentration, ], increased ], and increased need for ].<ref name="MunafòFraraPerico2021" /><ref name="WebbDubose2013" />
			Pseudoephedrine has psychostimulant effects at high doses and is a ] with ]-like effects in animals including rats and monkeys.<ref name="FreemanWangWoolverton2010">{{cite journal | vauthors = Freeman KB, Wang Z, Woolverton WL | title = Self-administration of (+)-methamphetamine and (+)-pseudoephedrine, alone and combined, by rhesus monkeys | journal = Pharmacol Biochem Behav | volume = 95 | issue = 2 | pages = 198–202 | date = April 2010 | pmid = 20100506 | pmc = 2838499 | doi = 10.1016/j.pbb.2010.01.005 | url = }}</ref><ref name="WeeOrdwayWoolverton2004">{{cite journal | vauthors = Wee S, Ordway GA, Woolverton WL | title = Reinforcing effect of pseudoephedrine isomers and the mechanism of action | journal = Eur J Pharmacol | volume = 493 | issue = 1–3 | pages = 117–125 | date = June 2004 | pmid = 15189772 | doi = 10.1016/j.ejphar.2004.04.030 | url = }}</ref><ref name="TongjaroenbuangamMeksuriyenGovitrapong1998">{{cite journal | vauthors = Tongjaroenbuangam W, Meksuriyen D, Govitrapong P, Kotchabhakdi N, Baldwin BA | title = Drug discrimination analysis of pseudoephedrine in rats | journal = Pharmacol Biochem Behav | volume = 59 | issue = 2 | pages = 505–510 | date = February 1998 | pmid = 9477001 | doi = 10.1016/s0091-3057(97)00459-0 | url = }}</ref><ref name="AkibaSatohMastumura1982" /> However, it is substantially less ] than ] or ].<ref name="FreemanWangWoolverton2010" /><ref name="WeeOrdwayWoolverton2004" /><ref name="TongjaroenbuangamMeksuriyenGovitrapong1998" />
			==Overdose==
			The maximum total daily dose of pseudoephedrine is 240{{nbsp}}mg.<ref name="GłowackaWiela-Hojeńska2021" /> Symptoms of ] may include ], ], impaired concentration, ], ], ], ], ]s, ]s, ]s, ], ], ], ], ], ], ], ], ], ]s, ], ], ], ], difficulty with ], ], and ].<ref name="GłowackaWiela-Hojeńska2021" /> In children, symptoms have more often included ], ], ]es, ], and ].<ref name="GłowackaWiela-Hojeńska2021" /> Pseudoephedrine may produce ] effects both with use of supratherapeutic doses but also in people who are more sensitive to the effects of sympathomimetics.<ref name="GłowackaWiela-Hojeńska2021" /> ] of the drug has been reported in one case at massive doses of 3,000 to 4,500{{nbsp}}mg (100–150{{nbsp}}×{{nbsp}}30-mg tablets) per day, with the doses gradually increased over time by this individual.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="DiazWiseSemchyshyn1979" /> No fatalities due to pseudoephedrine misuse have been reported as of 2021.<ref name="SchifanoChiappiniMiuli2021" /> However, death with pseudoephedrine has been reported generally.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="LaccourreyeWernerGiroud2015" /><ref name="MunafòFraraPerico2021" />
			==Interactions==
			Concomitant or recent (previous 14{{nbsp}}days) ] (MAOI) use can lead to ], including ], and should be avoided.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="Rossi" /> Clinical studies have found minimal or no influence of certain MAOIs like the weak non-selective MAOI ] and the potent selective MAO-B inhibitor ] (as a ]) on the ] of pseudoephedrine.<ref name="StalkerJungbluth2003">{{cite journal | vauthors = Stalker DJ, Jungbluth GL | title = Clinical pharmacokinetics of linezolid, a novel oxazolidinone antibacterial | journal = Clin Pharmacokinet | volume = 42 | issue = 13 | pages = 1129–1140 | date = 2003 | pmid = 14531724 | doi = 10.2165/00003088-200342130-00004 | url = }}</ref><ref name="JacobWagnerSage2003">{{cite journal | vauthors = Jacob JE, Wagner ML, Sage JI | title = Safety of selegiline with cold medications | journal = Ann Pharmacother | volume = 37 | issue = 3 | pages = 438–441 | date = March 2003 | pmid = 12639177 | doi = 10.1345/aph.1C175 | url = }}</ref><ref name="HendershotAntalWelshman2001">{{cite journal | vauthors = Hendershot PE, Antal EJ, Welshman IR, Batts DH, Hopkins NK | title = Linezolid: pharmacokinetic and pharmacodynamic evaluation of coadministration with pseudoephedrine HCl, phenylpropanolamine HCl, and dextromethorpan HBr | journal = J Clin Pharmacol | volume = 41 | issue = 5 | pages = 563–572 | date = May 2001 | pmid = 11361053 | doi = 10.1177/00912700122010302 | url = }}</ref><ref name="AzzaroVanDenBergZiemniak2007">{{cite journal | vauthors = Azzaro AJ, VanDenBerg CM, Ziemniak J, Kemper EM, Blob LF, Campbell BJ | title = Evaluation of the potential for pharmacodynamic and pharmacokinetic drug interactions between selegiline transdermal system and two sympathomimetic agents (pseudoephedrine and phenylpropanolamine) in healthy volunteers | journal = J Clin Pharmacol | volume = 47 | issue = 8 | pages = 978–990 | date = August 2007 | pmid = 17554106 | doi = 10.1177/0091270007302950 | url = }}</ref> This is in accordance with the fact that pseudoephedrine is not ] by ] (MAO).<ref name="ODonnell1995" /><ref name="ChuaBenrimojTriggs1989" /><ref name="JohnsonHricik1993" /> However, pseudoephedrine ], which MAOIs inhibit the metabolism of, and as such, MAOIs can still potentiate the effects of pseudoephedrine.<ref name="Broadley2010">{{cite journal | vauthors = Broadley KJ | title = The vascular effects of trace amines and amphetamines | journal = Pharmacol Ther | volume = 125 | issue = 3 | pages = 363–375 | date = March 2010 | pmid = 19948186 | doi = 10.1016/j.pharmthera.2009.11.005 | url = | quote = It is also relevant to other sympathomimetic amines contained in over-the-counter cough and cold remedies as decongestants, such as phenylpropanolamine and pseudoephedrine. Thus, MAO inhibitors potentiate the peripheral effects of indirectly acting sympathomimetic amines. It is not often realized, however, that this potentiation occurs irrespective of whether the amine is a substrate for MAO. An α-methyl group on the side chain, as in amphetamine and ephedrine, renders the amine immune to deamination so that they are not metabolized in the gut. Similarly, β-PEA would not be deaminated in the gut as it is a selective substrate for MAO-B which is not found in the gut. However, MAO inhibition in sympathetic neurones allows the cytoplasmic pool of noradrenaline to increase. It is this pool that is released by indirectly acting sympathomimetic amines and their responses are therefore potentiated irrespective of whether they are deaminated by MAO (Youdim & Finberg, 1991).}}</ref><ref name="GłowackaWiela-Hojeńska2021" /><ref name="JacobWagnerSage2003" /> No significant pharmacodynamic interactions have been found with selegiline,<ref name="JacobWagnerSage2003" /><ref name="AzzaroVanDenBergZiemniak2007" /> but linezolid potentiated ] increases with pseudoephedrine.<ref name="StalkerJungbluth2003" /><ref name="HendershotAntalWelshman2001" /> However, this was deemed to be without clinical significance in the case of linezolid, though it was noted that some individuals may be more sensitive to the ] effects of pseudoephedrine and related agents.<ref name="StalkerJungbluth2003" /><ref name="HendershotAntalWelshman2001" /> Pseudoephedrine is ] with MAOIs like ], ], ], and ] due to the potential for synergistic sympathomimetic effects and hypertensive crisis.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="MunafòFraraPerico2021" /> It is also considered to be contraindicated with linezolid and selegiline as some individuals may react more sensitively to coadministration.<ref name="StalkerJungbluth2003" /><ref name="HendershotAntalWelshman2001" /><ref name="JacobWagnerSage2003" /><ref name="AzzaroVanDenBergZiemniak2007" />
			Concomitant use of pseudoephedrine with other ]s, including ]s like ] and ], ], ], ], ], and ], among others, is not recommended due to the possibility of greater increases in blood pressure and risk of ].<ref name="GłowackaWiela-Hojeńska2021" /> Sympathomimetic effects and cardiovascular risks of pseudoephedrine may also be increased with ]s, ]s, ]s, and ]s.<ref name="GłowackaWiela-Hojeńska2021" /> Likewise, greater sympathomimetic effects of pseudoephedrine may occur when it is combined with other sympathomimetic agents.<ref name="MunafòFraraPerico2021" /> Rare but serious cardiovascular complications have been reported with the combination of pseudoephedrine and ].<ref name="LaccourreyeWernerGiroud2015" /><ref name="Marcucci2015">{{cite book | vauthors = Marcucci C | title=A Case Approach to Perioperative Drug-Drug Interactions | chapter=Too Young to Die | publisher=Springer New York | publication-place=New York, NY | date=2015 | isbn=978-1-4614-7494-4 | doi=10.1007/978-1-4614-7495-1_120 | pages=543–545}}</ref><ref name="PedersonKuntzGarbe2001">{{cite journal | vauthors = Pederson KJ, Kuntz DH, Garbe GJ | title = Acute myocardial ischemia associated with ingestion of bupropion and pseudoephedrine in a 21-year-old man | journal = Can J Cardiol | volume = 17 | issue = 5 | pages = 599–601 | date = May 2001 | pmid = 11381283 | doi = | url = }}</ref> Increase of ] activity can occur when pseudoephedrine is used concomitantly with ].<ref name="GłowackaWiela-Hojeńska2021" /> The ] effects of ], ], ], ], and ] may be reduced by sympathomimetics like pseudoepehdrine.<ref name="GłowackaWiela-Hojeńska2021" /> ]s like ] may reduce the effects of pseudoephedrine.<ref name="Mariani1986">{{cite journal | vauthors = Mariani PJ | title = Pseudoephedrine-induced hypertensive emergency: treatment with labetalol | journal = Am J Emerg Med | volume = 4 | issue = 2 | pages = 141–142 | date = March 1986 | pmid = 3947442 | doi = 10.1016/0735-6757(86)90159-2 | url = }}</ref><ref name="MoresCampiaNavarra1999">{{cite journal | vauthors = Mores N, Campia U, Navarra P, Cardillo C, Preziosi P | title = No cardiovascular effects of single-dose pseudoephedrine in patients with essential hypertension treated with beta-blockers | journal = Eur J Clin Pharmacol | volume = 55 | issue = 4 | pages = 251–254 | date = June 1999 | pmid = 10424315 | doi = 10.1007/s002280050624 | url = }}</ref>
			] like ] and ] can increase the ] of and thereby reduce exposure to ]s including pseudoephedrine, whereas ] including ]s like ] as well as ] can reduce the excretion of these agents and thereby increase exposure to them.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="ChuaBenrimojTriggs1989" /><ref name="PatrickMarkowitz1997">{{cite journal | vauthors=Patrick KS, Markowitz JS | title=Pharmacology of methylphenidate, amphetamine enantiomers and pemoline in attention-deficit hyperactivity disorder | journal=Human Psychopharmacology: Clinical and Experimental | volume=12 | issue=6 | date=1997 | issn=0885-6222 | doi=10.1002/(SICI)1099-1077(199711/12)12:6<527::AID-HUP932>3.0.CO;2-U | pages=527–546}}</ref>
			==Pharmacology==
			===Pharmacodynamics===
			Pseudoephedrine is a ] which acts primarily or exclusively by ].<ref name="Abraham2003">{{cite book | vauthors = Abraham DJ | title=Burger's Medicinal Chemistry and Drug Discovery | publisher=Wiley | date=15 January 2003 | isbn=978-0-471-26694-5 | doi=10.1002/0471266949.bmc093 | page=}}</ref><ref name="ODonnell1995">{{cite journal | vauthors = O'Donnell SR | title = Sympathomimetic vasoconstrictors as nasal decongestants | journal = Med J Aust | volume = 162 | issue = 5 | pages = 264–267 | date = March 1995 | pmid = 7534374 | doi = 10.5694/j.1326-5377.1995.tb139882.x | url = }}</ref><ref name="Eccles2007" /><ref name="RothmanVuPartilla2003" /> Hence, it is an indirectly acting sympathomimetic.<ref name="Abraham2003" /><ref name="ODonnell1995" /><ref name="Eccles2007" /> Some sources state that pseudoephedrine has a mixed ] consisting of both indirect and direct effects by binding to and acting as an ] of ]s.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="VanBerkelFuller2015" /> However, the ] of pseudoephedrine for adrenergic receptors is described as very low or negligible.<ref name="Abraham2003" /> ] suggest that the sympathomimetic effects of pseudoephedrine are exclusively due to norepinephrine release.<ref name="GadAzabKhattab2021">{{cite journal | vauthors = Gad MZ, Azab SS, Khattab AR, Farag MA | title = Over a century since ephedrine discovery: an updated revisit to its pharmacological aspects, functionality and toxicity in comparison to its herbal extracts | journal = Food Funct | volume = 12 | issue = 20 | pages = 9563–9582 | date = October 2021 | pmid = 34533553 | doi = 10.1039/d1fo02093e | url = }}</ref><ref name="KobayashiEndouSakuraya2003">{{cite journal | vauthors = Kobayashi S, Endou M, Sakuraya F, Matsuda N, Zhang XH, Azuma M, Echigo N, Kemmotsu O, Hattori Y, Gando S | title = The sympathomimetic actions of l-ephedrine and d-pseudoephedrine: direct receptor activation or norepinephrine release? | journal = Anesth Analg | volume = 97 | issue = 5 | pages = 1239–1245 | date = November 2003 | pmid = 14570629 | doi = 10.1213/01.ANE.0000092917.96558.3C | url = }}</ref>
			{| class="wikitable sortable floatright" style="font-size:small;"
			|+ Monoamine release by pseudoephedrine and related agents ({{Abbrlink|EC<sub>50</sub>|half maximal effective concentration}}, nM)<ref name="RothmanBaumann2003">{{cite journal | vauthors = Rothman RB, Baumann MH | title = Monoamine transporters and psychostimulant drugs | journal = Eur. J. Pharmacol. | volume = 479 | issue = 1–3 | pages = 23–40 | year = 2003 | pmid = 14612135 | doi = 10.1016/j.ejphar.2003.08.054}}</ref><ref name="RothmanBaumann2006" />
			|-
			! Compound !! data-sort-type="number" | {{abbrlink|NE|Norepinephrine}} !! data-sort-type="number" | {{abbrlink|DA|Dopamine}} !! data-sort-type="number" | {{abbrlink|5-HT|Serotonin}} !! Ref
			|-
			| ] (''S''(+)-amphetamine) || 6.6–7.2 || 5.8–24.8 || 698–1765 || <ref name="RothmanBaumannDersch2001">{{cite journal | vauthors = Rothman RB, Baumann MH, Dersch CM, Romero DV, Rice KC, Carroll FI, Partilla JS | title = Amphetamine-type central nervous system stimulants release norepinephrine more potently than they release dopamine and serotonin | journal = Synapse | volume = 39 | issue = 1 | pages = 32–41 | date = January 2001 | pmid = 11071707 | doi = 10.1002/1098-2396(20010101)39:1<32::AID-SYN5>3.0.CO;2-3 | url = }}</ref><ref name="BaumannPartillaLehner2013">{{cite journal | vauthors = Baumann MH, Partilla JS, Lehner KR, Thorndike EB, Hoffman AF, Holy M, Rothman RB, Goldberg SR, Lupica CR, Sitte HH, Brandt SD, Tella SR, Cozzi NV, Schindler CW | title = Powerful cocaine-like actions of 3,4-methylenedioxypyrovalerone (MDPV), a principal constituent of psychoactive 'bath salts' products | journal = Neuropsychopharmacology | volume = 38 | issue = 4 | pages = 552–562 | year = 2013 | pmid = 23072836 | pmc = 3572453 | doi = 10.1038/npp.2012.204 }}</ref>
			|-
			| ] || 12.4 || 18.5 || 2366 || <ref name="RothmanVuPartilla2003" />
			|-
			| ] ((–)-ephedrine) || 43.1–72.4 || 236–1350 || >10000 || <ref name="RothmanBaumannDersch2001" />
			|-
			| (+)-Ephedrine || 218 || 2104 || >10000 || <ref name="RothmanBaumannDersch2001" /><ref name="RothmanVuPartilla2003" />
			|-
			| ] (''S''(+)-methamphetamine) || 12.3–13.8 || 8.5–24.5 || 736–1291.7 || <ref name="RothmanBaumannDersch2001" /><ref name="BaumannAyestasPartilla2012">{{cite journal | vauthors = Baumann MH, Ayestas MA, Partilla JS, Sink JR, Shulgin AT, Daley PF, Brandt SD, Rothman RB, Ruoho AE, Cozzi NV | title = The designer methcathinone analogs, mephedrone and methylone, are substrates for monoamine transporters in brain tissue | journal = Neuropsychopharmacology | volume = 37 | issue = 5 | pages = 1192–203 | date = April 2012 | pmid = 22169943 | pmc = 3306880 | doi = 10.1038/npp.2011.304 | url = }}</ref>
			|-
			| ] (''R''(–)-methamphetamine) || 28.5 || 416 || 4640 || <ref name="RothmanBaumannDersch2001" />
			|-
			| ] ((+)-norephedrine) || 42.1 || 302 || >10000 || <ref name="RothmanVuPartilla2003" />
			|-
			| ] ((–)-norephedrine) || 137 || 1371 || >10000 || <ref name="RothmanVuPartilla2003" />
			|-
			| ] ((+)-norpseudoephedrine) || 15.0 || 68.3 || >10000 || <ref name="RothmanVuPartilla2003" />
			|-
			| ] || 30.1 || 294 || >10000 || <ref name="RothmanVuPartilla2003" />
			|-
			| (–)-Pseudoephedrine || 4092 || 9125 || >10000 || <ref name="RothmanVuPartilla2003" />
			|-
			| ] ((+)-pseudoephedrine) || 224 || 1988 || >10000 || <ref name="RothmanVuPartilla2003" />
			|-
			| colspan="7" style="width: 1px; background-color:#eaecf0; text-align: center;" | '''Notes:''' The smaller the value, the more strongly the substance releases the neurotransmitter. See also ] for a larger table with more compounds.
			|-
			|}
			Pseudoephedrine ] '']'' with an {{Abbrlink|EC<sub>50</sub>|half maximal effective concentration}} of 224{{nbsp}}nM for ] and 1,988{{nbsp}}nM for ], whereas it is inactive for ].<ref name="RothmanVuPartilla2003">{{cite journal | vauthors = Rothman RB, Vu N, Partilla JS, Roth BL, Hufeisen SJ, Compton-Toth BA, Birkes J, Young R, Glennon RA | title = In vitro characterization of ephedrine-related stereoisomers at biogenic amine transporters and the receptorome reveals selective actions as norepinephrine transporter substrates | journal = J Pharmacol Exp Ther | volume = 307 | issue = 1 | pages = 138–145 | date = October 2003 | pmid = 12954796 | doi = 10.1124/jpet.103.053975 | url = }}</ref><ref name="RothmanBaumann2005">{{cite journal | vauthors = Rothman RB, Baumann MH | title = Targeted screening for biogenic amine transporters: potential applications for natural products | journal = Life Sci | volume = 78 | issue = 5 | pages = 512–518 | date = December 2005 | pmid = 16202429 | doi = 10.1016/j.lfs.2005.09.001 | url = }}</ref><ref name="RothmanBaumann2006">{{cite journal | vauthors = Rothman RB, Baumann MH | title = Therapeutic potential of monoamine transporter substrates | journal = Curr Top Med Chem | volume = 6 | issue = 17 | pages = 1845–1859 | date = 2006 | pmid = 17017961 | doi = 10.2174/156802606778249766 | url = }}</ref> As such, it is about 9-fold ] for induction of norepinephrine release over dopamine release.<ref name="RothmanVuPartilla2003" /><ref name="RothmanBaumann2005" /><ref name="RothmanBaumann2006" /> The drug has negligible agonistic activity at the ] and ]s (K<sub>act</sub> >10,000{{nbsp}}nM).<ref name="RothmanVuPartilla2003" /> At the ] and ]s, it acts as a ] with relatively low ] (β<sub>1</sub> = K<sub>act</sub> = 309{{nbsp}}μM, {{Abbrlink|IA|intrinsic activity}} = 53%; β<sub>2</sub> = 10{{nbsp}}μM; {{Abbr|IA|intrinsic activity}} = 47%).<ref name="VansalFeller1999">{{cite journal | vauthors = Vansal SS, Feller DR | title = Direct effects of ephedrine isomers on human beta-adrenergic receptor subtypes | journal = Biochem Pharmacol | volume = 58 | issue = 5 | pages = 807–810 | date = September 1999 | pmid = 10449190 | doi = 10.1016/s0006-2952(99)00152-5 | url = }}</ref> It was an ] or very weak partial agonist of the ] (K<sub>act</sub> = {{Abbr|ND|not determined (due to low intrinsic activity)}}; {{Abbr|IA|Intrinsic activity}} = 7%).<ref name="VansalFeller1999" /> It is about 30,000 to 40,000{{nbsp}}times less potent as a β-adrenergic receptor agonist than ].<ref name="VansalFeller1999" />
			Pseudoephedrine's principal mechanism of action relies on its action on the adrenergic system.<ref name="American Medical Association, AMA Department of Drugs 1977 627">{{cite book| author = American Medical Association, AMA Department of Drugs|title=AMA Drug Evaluations|date=1977|publisher=PSG Publishing Co., Inc.|page=627}}</ref><ref name="Thomson/Micromedex 2007 2452">{{cite book| publisher = Thomson/Micromedex|title=Drug Information for the Health Care Professional | volume = 1 |date= 2007 |location=Greenwood Village, Colorado.|page=2452}}</ref> The ] that pseudoephedrine produces is believed to be principally an α-adrenergic receptor response.<ref name='drew'>{{cite journal | vauthors = Drew CD, Knight GT, Hughes DT, Bush M | title = Comparison of the effects of D-(-)-ephedrine and L-(+)-pseudoephedrine on the cardiovascular and respiratory systems in man | journal = British Journal of Clinical Pharmacology | volume = 6 | issue = 3 | pages = 221–225 | date = September 1978 | pmid = 687500 | pmc = 1429447 | doi = 10.1111/j.1365-2125.1978.tb04588.x }}</ref> Pseudoephedrine acts on α- and β<sub>2</sub>-adrenergic receptors, to cause vasoconstriction and relaxation of smooth muscle in the bronchi, respectively.<ref name="American Medical Association, AMA Department of Drugs 1977 627"/><ref name="Thomson/Micromedex 2007 2452"/> α-Adrenergic receptors are located on the muscles lining the walls of blood vessels. When these receptors are activated, the muscles contract, causing the blood vessels to constrict (vasoconstriction). The constricted blood vessels now allow less fluid to leave the blood vessels and enter the nose, throat, and sinus linings, which results in decreased inflammation of nasal membranes, as well as decreased mucus production. Thus, by constriction of blood vessels, mainly those located in the nasal passages, pseudoephedrine causes a decrease in the symptoms of nasal congestion.<ref name="Eccles2007" /> Activation of β<sub>2</sub>-adrenergic receptors produces relaxation of the smooth muscle of the bronchi,<ref name="American Medical Association, AMA Department of Drugs 1977 627"/> causing bronchial dilation and in turn decreasing congestion (although not fluid) and difficulty breathing.
			Pseudoephedrine is less ] as a sympathomimetic and ] than ].<ref name="GłowackaWiela-Hojeńska2021" /><ref name="HughesEmpeyLand1983">{{cite journal | vauthors = Hughes DT, Empey DW, Land M | title = Effects of pseudoephedrine in man | journal = J Clin Hosp Pharm | volume = 8 | issue = 4 | pages = 315–321 | date = December 1983 | pmid = 6198336 | doi = 10.1111/j.1365-2710.1983.tb01053.x | url = | doi-access = free }}</ref> Clinical studies have found that pseudoephedrine is about 3.5- to 4-fold less potent than ephedrine as a sympathomimetic agent in terms of ] increases and 3.5- to 7.2-fold or more less potent as a ].<ref name="HughesEmpeyLand1983" /> Pseudoephedrine is also said to have much less central effect than ephedrine and to be only a weak psychostimulant.<ref name="ODonnell1995" /><ref name="HughesEmpeyLand1983" /><ref name="Eccles2007" /><ref name="Abraham2003" /><ref name="AkibaSatohMastumura1982">{{cite journal | vauthors = Akiba K, Satoh S, Matsumura H, Suzuki T, Kohno H, Tadano T, Kisara K | title = | language = Japanese | journal = Nihon Yakurigaku Zasshi | volume = 79 | issue = 5 | pages = 401–408 | date = May 1982 | pmid = 6813205 | doi = 10.1254/fpj.79.401| url = }}</ref> ]s in the nose are around five times more sensitive than the ] to the actions of circulating ] (adrenaline), which may help to explain how pseudoephedrine at the low doses used in over-the-counter products can produce nasal decongestion with minimal effects on the heart.<ref name="Eccles2007" /> Compared to ], pseudoephedrine is about 30 to 35{{nbsp}}times less potent as a norepinephrine releasing agent and 80 to 350{{nbsp}}times less potent as a ] '']''.<ref name="RothmanVuPartilla2003" /><ref name="RothmanBaumannDersch2001" /><ref name="BaumannPartillaLehner2013" />
			Pseudoephedrine is a very weak ] of ] (MAO) ''in vitro'', including both ] and ] (K<sub>i</sub> = 1,000–5,800{{nbsp}}μM).<ref name="UlusMaherWurtman2000">{{cite journal | vauthors = Ulus IH, Maher TJ, Wurtman RJ | title = Characterization of phentermine and related compounds as monoamine oxidase (MAO) inhibitors | journal = Biochem Pharmacol | volume = 59 | issue = 12 | pages = 1611–1621 | date = June 2000 | pmid = 10799660 | doi = 10.1016/s0006-2952(00)00306-3 | url = }}</ref> It is far less potent in this action than other agents like dextroamphetamine and ].<ref name="UlusMaherWurtman2000" />
			===Pharmacokinetics===
			====Absorption====
			Pseudoephedrine is ] and is readily ] from the ].<ref name="GłowackaWiela-Hojeńska2021" /><ref name="Eccles2007" /> Its oral ] is approximately 100%.<ref name="BruntonLazoParker2006" /> The drug reaches ] concentrations after 1 to 4{{nbsp}}hours (mean 1.9{{nbsp}}hours) in the case of the ] formulation and after 2 to 6{{nbsp}}hours in the case of the ] formulation.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="Eccles2007" /> The ] of pseudoephedrine is 30{{nbsp}}minutes.<ref name="GłowackaWiela-Hojeńska2021" />
			====Distribution====
			Pseudoephedrine, due to its lack of ] ] ]s, is relatively ].<ref name="ChuaBenrimojTriggs1989" /> This is a property it shares with related sympathomimetic and decongestant agents like ] and ].<ref name="ChuaBenrimojTriggs1989" /> These agents are widely ] throughout the body and cross the ].<ref name="ChuaBenrimojTriggs1989" /> However, it is said that pseudoephedrine and phenylpropanolamine cross the blood-brain barrier only to some extent and that pseudoephedrine has limited ] activity, suggesting that it is partially ].<ref name="ODonnell1995" /><ref name="BouchardWeberGeiger2002" /> The blood-brain barrier permeability of pseudoephedrine, ephedrine, and phenylpropanolamine is reduced compared to other ] due to the presence of a ] at the β carbon which decreases their ].<ref name="BouchardWeberGeiger2002">{{cite journal | vauthors = Bouchard R, Weber AR, Geiger JD | title = Informed decision-making on sympathomimetic use in sport and health | journal = Clin J Sport Med | volume = 12 | issue = 4 | pages = 209–224 | date = July 2002 | pmid = 12131054 | doi = 10.1097/00042752-200207000-00003 | url = }}</ref> As such, they have a greater ratio of peripheral cardiovascular to central psychostimulant effect.<ref name="BouchardWeberGeiger2002" /> Besides entering the brain, these substances also cross the ] and enter ].<ref name="ChuaBenrimojTriggs1989" />
			The ] of pseudoephedrine has been reported to be approximately 21 to 29%.<ref name="VolppHolzgrabe2019" /><ref name="Schmidt2023" /> It is bound to ] (AGP) and ] (HSA).<ref name="VolppHolzgrabe2019" /><ref name="Schmidt2023" />
			====Metabolism====
			Pseudoephedrine is not extensively ] and is subjected to minimal ] with oral administration.<ref name="ChuaBenrimojTriggs1989" /><ref name="GłowackaWiela-Hojeńska2021" /><ref name="Eccles2007" /> Due to its ] at the α ] (i.e., it is an ]), pseudoephedrine is not a ] for ] (MAO) and is not metabolized by this ].<ref name="ODonnell1995" /><ref name="ChuaBenrimojTriggs1989" /><ref name="JohnsonHricik1993">{{cite journal | vauthors = Johnson DA, Hricik JG | title = The pharmacology of alpha-adrenergic decongestants | journal = Pharmacotherapy | volume = 13 | issue = 6 Pt 2 | pages = 110S–115S; discussion 143S–146S | date = 1993 | pmid = 7507588 | doi = 10.1002/j.1875-9114.1993.tb02779.x| url = }}</ref><ref name="Broadley2010" /> It is also not metabolized by ] (COMT).<ref name="ODonnell1995" /> Pseudoephedrine is ] into the ] ] to a small extent.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="ChuaBenrimojTriggs1989" /> Similarly to pseudoephedrine, this metabolite is ] and shows ]-like effects.<ref name="ChuaBenrimojTriggs1989" /> Approximately 1 to 6% of pseudoephedrine is metabolized in the ] via ''N''-demethylation to form norpseudoephedrine.<ref name="GłowackaWiela-Hojeńska2021" />
			====Elimination====
			Pseudoephedrine is ] primarily via the ]s in ].<ref name="GłowackaWiela-Hojeńska2021" /><ref name="ChuaBenrimojTriggs1989" /> Its urinary excretion is highly influenced by urinary ] and is decreased when the urine is ] and is increased when it is ].<ref name="GłowackaWiela-Hojeńska2021" /><ref name="ChuaBenrimojTriggs1989" /><ref name="HughesEmpeyLand1983" />
			The ] of pseudoephedrine on average is 5.4{{nbsp}}hours<ref name="Eccles2007" /> and ranges from 3 to 16{{nbsp}}hours depending on urinary pH.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="ChuaBenrimojTriggs1989" /> At a pH of 5.6 to 6.0, the ] of pseudoephedrine was 5.2 to 8.0{{nbsp}}hours.<ref name="ChuaBenrimojTriggs1989" /> In one study, a more acidic pH of 5.0 resulted in a half-life of 3.0 to 6.4{{nbsp}}hours, whereas a more alkaline pH of 8.0 resulted in a half-life of 9.2 to 16.0{{nbsp}}hours.<ref name="ChuaBenrimojTriggs1989" /> Substances that influence urinary acidity and are known to affect the excretion of amphetamine derivatives include ] like ] and ] as well as ] like ].<ref name="PatrickMarkowitz1997">{{cite journal | vauthors=Patrick KS, Markowitz JS | title=Pharmacology of methylphenidate, amphetamine enantiomers and pemoline in attention-deficit hyperactivity disorder | journal=Human Psychopharmacology: Clinical and Experimental | volume=12 | issue=6 | date=1997 | issn=0885-6222 | doi=10.1002/(SICI)1099-1077(199711/12)12:6<527::AID-HUP932>3.0.CO;2-U | pages=527–546}}</ref>
			A majority of an ] dose of pseudoephedrine is excreted unchanged in urine within 24{{nbsp}}hours of administration.<ref name="ChuaBenrimojTriggs1989" /> This has been found to range from 43 to 96%.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="ChuaBenrimojTriggs1989" /><ref name="Eccles2007" /> The amount excreted unchanged is dependent on urinary pH similarly to the drug's half-life, as a longer half-life and duration in the body allows more time for the drug to be metabolized.<ref name="ChuaBenrimojTriggs1989" />
			The ] of pseudoephedrine, which is dependent on its ], is 4 to 12{{nbsp}}hours.<ref name="GłowackaWiela-Hojeńska2021" /><ref name="Aaron1990" />
			Pseudoephedrine has been reported to accumulate in people with ].<ref name="Sequeira1998">{{cite book | vauthors = Sequeira RP N| title=Side Effects of Drugs Annual | chapter=Central nervous system stimulants and drugs that suppress appetite | publisher=Elsevier | volume=21 | date=1998 | isbn=978-0-444-82818-7 | doi=10.1016/s0378-6080(98)80005-6 | page=1–8}}</ref><ref name="SicaComstock1989">{{cite journal | vauthors = Sica DA, Comstock TJ | title = Pseudoephedrine accumulation in renal failure | journal = Am J Med Sci | volume = 298 | issue = 4 | pages = 261–263 | date = October 1989 | pmid = 2801760 | doi = 10.1097/00000441-198910000-00010 | url = }}</ref><ref name="LyonTurney1996">{{cite journal | vauthors = Lyon CC, Turney JH | title = Pseudoephedrine toxicity in renal failure | journal = Br J Clin Pract | volume = 50 | issue = 7 | pages = 396–397 | date = 1996 | pmid = 9015914 | doi = 10.1111/j.1742-1241.1996.tb09584.x| url = }}</ref>
			==Chemistry==
			Pseudoephedrine, also known structurally as (1''S'',2''S'')-α,''N''-dimethyl-β-hydroxyphenethylamine or as (1''S'',2''S'')-''N''-methyl-β-hydroxyamphetamine, is a ], ], and ] ].<ref name="GłowackaWiela-Hojeńska2021" /><ref name="LaccourreyeWernerGiroud2015" /><ref name="Eccles2007" /> It is a ] of ].<ref name="AbourashedEl-AlfyKhan2003" />
			Pseudoephedrine is a ] ] with the ] C<sub>10</sub>H<sub>15</sub>NO and a ] of 165.23{{nbsp}}g/mol.<ref name="PubChem">{{cite web | title=Pseudoephedrine | website=PubChem | url=https://pubchem.ncbi.nlm.nih.gov/compound/7028 | access-date=25 July 2024}}</ref><ref name="DrugBank">{{cite web | title=Pseudoephedrine: Uses, Interactions, Mechanism of Action | website=DrugBank Online | date=1 October 1994 | url=https://go.drugbank.com/drugs/DB00852 | access-date=25 July 2024}}</ref> It has an experimental ] of 0.89, while its predicted log P values range from 0.9 to 1.32.<ref name="PubChem" /><ref name="DrugBank" /><ref name="KrilFung1990">{{cite journal | vauthors = Kril MB, Fung HL | title = Influence of hydrophobicity on the ion exchange selectivity coefficients for aromatic amines | journal = J Pharm Sci | volume = 79 | issue = 5 | pages = 440–443 | date = May 1990 | pmid = 2352166 | doi = 10.1002/jps.2600790517 | url = }}</ref> The compound is relatively ],<ref name="ChuaBenrimojTriggs1989">{{cite journal | vauthors = Chua SS, Benrimoj SI, Triggs EJ | title = Pharmacokinetics of non-prescription sympathomimetic agents | journal = Biopharm Drug Dispos | volume = 10 | issue = 1 | pages = 1–14 | date = 1989 | pmid = 2647163 | doi = 10.1002/bdd.2510100102 | url = }}</ref> but is also more ] than other amphetamines.<ref name="BouchardWeberGeiger2002" /> The lipophilicity of amphetamines is closely related to their brain permeability.<ref name="BharateMignaniWishwakarma2018">{{cite journal | vauthors = Bharate SS, Mignani S, Vishwakarma RA | title = Why Are the Majority of Active Compounds in the CNS Domain Natural Products? A Critical Analysis | journal = J Med Chem | volume = 61 | issue = 23 | pages = 10345–10374 | date = December 2018 | pmid = 29989814 | doi = 10.1021/acs.jmedchem.7b01922 | url = }}</ref> For comparison to pseudoephedrine, the experimental log P of ] is 2.1,<ref name="SchepSlaughterBeasley2010">{{cite journal | vauthors = Schep LJ, Slaughter RJ, Beasley DM | title = The clinical toxicology of metamfetamine | journal = Clin Toxicol (Phila) | volume = 48 | issue = 7 | pages = 675–694 | date = August 2010 | pmid = 20849327 | doi = 10.3109/15563650.2010.516752 | url = | quote = Metamfetamine acts in a manner similar to amfetamine, but with the addition of the methyl group to the chemical structure. It is more lipophilic (Log p value 2.07, compared with 1.76 for amfetamine),<sup>4</sup> thereby enabling rapid and extensive transport across the blood–brain barrier.<sup>19</sup>}}</ref> of ] is 1.8,<ref name="PubChem-Amphetamine">{{cite web | title=Amphetamine | website=PubChem | url=https://pubchem.ncbi.nlm.nih.gov/compound/3007 | access-date=26 July 2024}}</ref><ref name="SchepSlaughterBeasley2010" /> of ] is 1.1,<ref name="PubChem-Ephedrine">{{cite web | title=Ephedrine | website=PubChem | url=https://pubchem.ncbi.nlm.nih.gov/compound/9294 | access-date=26 July 2024}}</ref> of ] is 0.7,<ref name="PubChem-Phenylpropanolamine">{{cite web | title=Norephedrine | website=PubChem | url=https://pubchem.ncbi.nlm.nih.gov/compound/26934 | access-date=26 July 2024}}</ref> of ] is -0.3,<ref name="PubChem-Phenylephrine">{{cite web | title=Phenylephrine | website=PubChem | url=https://pubchem.ncbi.nlm.nih.gov/compound/6041 | access-date=21 July 2024}}</ref> and of ] is -1.2.<ref name="PubChem-Norepinephrine">{{cite web | title=Norepinephrine | website=PubChem | url=https://pubchem.ncbi.nlm.nih.gov/compound/439260 | access-date=26 July 2024}}</ref> Methamphetamine has high brain permeability,<ref name="SchepSlaughterBeasley2010" /> whereas phenylephrine and norepinephrine are ]s.<ref name="Eccles2007" /><ref name="FroeseDianGomez2020">{{cite journal | vauthors = Froese L, Dian J, Gomez A, Unger B, Zeiler FA | title = The cerebrovascular response to norepinephrine: A scoping systematic review of the animal and human literature | journal = Pharmacol Res Perspect | volume = 8 | issue = 5 | pages = e00655 | date = October 2020 | pmid = 32965778 | doi = 10.1002/prp2.655 | pmc = 7510331 | url = }}</ref> The optimal log P for brain permeation and central activity is about 2.1 (range 1.5–2.7).<ref name="PajouheshLenz2005">{{cite journal | vauthors = Pajouhesh H, Lenz GR | title = Medicinal chemical properties of successful central nervous system drugs | journal = NeuroRx | volume = 2 | issue = 4 | pages = 541–553 | date = October 2005 | pmid = 16489364 | pmc = 1201314 | doi = 10.1602/neurorx.2.4.541 | url = | quote = Lipophilicity was the first of the descriptors to be identified as important for CNS penetration. Hansch and Leo54 reasoned that highly lipophilic molecules will partitioned into the lipid interior of membranes and will be retained there. However, ClogP correlates nicely with LogBBB with increasing lipophilicity increasing brain penetration. For several classes of CNS active substances, Hansch and Leo54 found that blood-brain barrier penetration is optimal when the LogP values are in the range of 1.5-2.7, with the mean value of 2.1. An analysis of small drug-like molecules suggested that for better brain permeation46 and for good intestinal permeability55 the LogD values need to be greater than 0 and less than 3. In comparison, the mean value for ClogP for the marketed CNS drugs is 2.5, which is in good agreement with the range found by Hansch et al.22}}</ref>
			Pseudoephedrine is readily ] into ] or ] into ].<ref name="GłowackaWiela-Hojeńska2021" />
			]: ] (top) and pseudoephedrine (bottom).]]
			===Nomenclatures===
			The ] (+)- or d- ] is (1''S'',2''S'')-pseudoephedrine, whereas the levorotating (−)- or l- form is (1''R'',2''R'')-pseudoephedrine.
			In the outdated ] (+)-pseudoephedrine is also referred to as {{sc|l-}}pseudoephedrine and (−)-pseudoephedrine as {{sc|d-}}pseudoephedrine (in the ] then the phenyl ring is drawn at bottom).<ref>{{cite journal | vauthors = Patil PN, Tye A, Lapidus JB | title = A Pharmacological Study of the Ephedrine Isomers | journal = The Journal of Pharmacology and Experimental Therapeutics | volume = 148 | issue = 2 | pages = 158–168 | date = May 1965 | pmid = 14301006 | url = http://jpet.aspetjournals.org/content/148/2/158.abstract | access-date = 24 December 2009 | archive-date = 7 January 2020 | archive-url = https://web.archive.org/web/20200107152211/http://jpet.aspetjournals.org/content/148/2/158.abstract | url-status = live }}</ref><ref>{{cite book| veditors = Reynolds JE | title=Martindale: The complete drug reference | edition=29th | year=1989 | publisher=Pharmaceutical Press | location=London | isbn= 0-85369-210-6 | author= Martindale| title-link=Martindale: The complete drug reference }}</ref>
			Often the {{sc|d/l}} system (with ]) and the ] (with ]) are confused. The result is that the dextrorotary d-pseudoephedrine is wrongly named {{sc|d-}}pseudoephedrine and the levorotary l-ephedrine (the diastereomer) wrongly {{sc|l-}}ephedrine.
			The IUPAC names of the two enantiomers are (1''S'',2''S'')- respectively (1''R'',2''R'')-2-methylamino-1-phenylpropan-1-ol. Synonyms for both are ''psi''-ephedrine and ''threo''-ephedrine.
			Pseudoephedrine is the {{Abbrlink|INN|International Nonproprietary Name}} of the (+)-form, when used as pharmaceutical substance.<ref> WHO Chronicle, Vol. 15, No. 8, August 1961, pp. 314–20</ref>
			===Detection in body fluids===
			Pseudoephedrine may be quantified in blood, plasma, or urine to monitor any possible performance-enhancing use by athletes, confirm a diagnosis of poisoning, or to assist in a medicolegal death investigation. Some commercial ] screening tests directed at the amphetamines cross-react appreciably with pseudoephedrine, but ] techniques can easily distinguish pseudoephedrine from other phenethylamine derivatives. Blood or plasma pseudoephedrine concentrations are typically in the 50 to 300{{nbsp}}μg/L range in persons taking the drug therapeutically, 500 to 3,000{{nbsp}}μg/L in people with substance use disorder involving pseudoephedrine or poisoned patients, and 10 to 70{{nbsp}}mg/L in cases of acute fatal ].<ref name="BolandReinLew2003">{{cite journal | vauthors = Boland DM, Rein J, Lew EO, Hearn WL | title = Fatal cold medication intoxication in an infant | journal = Journal of Analytical Toxicology | volume = 27 | issue = 7 | pages = 523–526 | date = October 2003 | pmid = 14607011 | doi = 10.1093/jat/27.7.523 | doi-access = free | title-link = doi }}</ref><ref name="Baselt2008">{{cite book | vauthors = Baselt R | url = http://www.biomedicalpublications.com/ | title = Disposition of Toxic Drugs and Chemicals in Man | edition = 8th | publisher = Biomedical Publications | location = Foster City, California | year = 2008 | pages = 1344–1346 | access-date = 19 August 2010 | archive-date = 4 December 2020 | archive-url = https://web.archive.org/web/20201204114016/http://www.biomedicalpublications.com/ | url-status = live }}</ref>
			==Manufacturing==
			Although pseudoephedrine occurs naturally as an ] in certain plant species (for example, as a constituent of extracts from the '']'' species, also known as ''ma huang'', in which it occurs together with other isomers of ]), the majority of pseudoephedrine produced for commercial use is derived from ] ] of ] in the presence of ]. In this process, specialized strains of yeast (typically a variety of '']'' or '']'') are added to large vats containing water, dextrose and the enzyme ] (such as found in ]s and other plants). After the yeast has begun fermenting the dextrose, the benzaldehyde is added to the vats, and in this environment, the yeast converts the ingredients to the precursor ] (L-PAC). L-PAC is then chemically converted to pseudoephedrine via ].<ref>{{cite book | vauthors = Oliver AL, Anderson BN, Roddick FA | chapter = Factors affecting the production of L-phenylacetylcarbinol by yeast: a case study | volume = 41 | pages = 1–45 | year = 1999 | pmid = 10500843 | doi = 10.1016/S0065-2911(08)60164-2 | isbn = 978-0-12-027741-4 | title = Advances in Microbial Physiology }}</ref>
			The bulk of pseudoephedrine is produced by commercial ] in India and China, where economic and industrial conditions favor its mass production for export.<ref>{{cite web | title=Clamp down on shipments of raw ingredients, Oregonian, Press, Congressional Caucus to Fight and Control Methamphetamine | website=U.S. House of Representatives | date=31 August 2005 | url=http://www.house.gov/larsen/meth/press_20041006_oregonian_clampdown.shtml | archive-url=https://web.archive.org/web/20060509004513/http://www.house.gov/larsen/meth/press_20041006_oregonian_clampdown.shtml | archive-date=9 May 2006 | url-status=dead | access-date=7 September 2023}}</ref>
			==History==
			Pseudoephedrine, along with ], occurs ] in ].<ref name="LaccourreyeWernerGiroud2015" /><ref name="AbourashedEl-AlfyKhan2003" /><ref name="Kalix1991">{{cite journal | vauthors = Kalix P | title = The pharmacology of psychoactive alkaloids from ephedra and catha | journal = J Ethnopharmacol | volume = 32 | issue = 1–3 | pages = 201–208 | date = April 1991 | pmid = 1881158 | doi = 10.1016/0378-8741(91)90119-x | url = }}</ref> This herb has been used for thousands of years in ].<ref name="LaccourreyeWernerGiroud2015" /><ref name="AbourashedEl-AlfyKhan2003" /><ref name="Kalix1991" /> Pseudoephedrine was first ] and characterized in 1889 by the German chemists ] and Oelschlägel, who used a sample that had been isolated from '']'' by the ] of ], Germany.<ref name="AbourashedEl-AlfyKhan2003" /><ref name="ChenKao1926" /><ref name="LadenburgOelschlägel1889">{{cite journal |vauthors=Ladenburg A, Oelschlägel C |title=Ueber das "Pseudo-Ephedrin" |journal=Berichte der Deutschen Chemischen Gesellschaft |date=1889 |volume=22 |issue=2 |pages=1823–1827 |url=https://babel.hathitrust.org/cgi/pt?id=osu.32435060218039;view=1up;seq=115 |trans-title=On pseudo-ephedrine |language=de |doi=10.1002/cber.18890220225 |access-date=19 May 2019 |archive-date=8 March 2021 |archive-url=https://web.archive.org/web/20210308053907/https://babel.hathitrust.org/cgi/pt?id=osu.32435060218039;view=1up;seq=115 |url-status=live }}</ref> It was first ] in the 1920s in ].<ref name="LaccourreyeWernerGiroud2015" /> Subsequently, pseudoephedrine was introduced for medical use as a decongestant.<ref name="LaccourreyeWernerGiroud2015" />
			==Society and culture==
			===Generic names===
			''Pseudoephedrine'' is the ] of the drug and its {{Abbrlink|INN|International Nonproprietary Name}} and {{Abbrlink|BAN|British Approved Name}}, while ''pseudoéphédrine'' is its {{Abbrlink|DCF|Dénomination Commune Française}} and ''pseudoefedrina'' is its {{Abbrlink|DCIT|Denominazione Comune Italiana}}.<ref name="Elks2014">{{cite book | vauthors = Elks J | title=The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies | publisher=Springer US | year=2014 | isbn=978-1-4757-2085-3 | url=https://books.google.com/books?id=0vXTBwAAQBAJ&pg=PA793 | access-date=25 July 2024 | page=793}}</ref><ref name="IndexNominum2000">{{cite book | author=Schweizerischer Apotheker-Verein | title=Index Nominum 2000: International Drug Directory | publisher=Medpharm Scientific Publishers | year=2000 | isbn=978-3-88763-075-1 | url=https://books.google.com/books?id=5GpcTQD_L2oC&pg=PA896 | access-date=25 July 2024 | page=896}}</ref><ref name="MortonHall2012">{{cite book | vauthors = Morton IK, Hall JM | title=Concise Dictionary of Pharmacological Agents: Properties and Synonyms | publisher=Springer | location = Netherlands | year=2012 | isbn=978-94-011-4439-1 | url=https://books.google.com/books?id=tsjrCAAAQBAJ&pg=PA239 | access-date=25 July 2024 | page=239}}</ref><ref name="Drugs.com">{{cite web | title=Pseudoephedrine | date=26 April 2016 | url=http://www.drugs.com/international/pseudoephedrine.html | archive-url=https://web.archive.org/web/20160529144104/http://www.drugs.com/international/pseudoephedrine.html | archive-date=29 May 2016 | url-status=unfit | access-date=25 July 2024}}</ref> ''Pseudoephedrine hydrochloride'' is its {{Abbrlink|USAN|United States Adopted Name}} and {{Abbrlink|BANM|British Approved Name}} in the case of the ] ]; ''pseudoephedrine sulfate'' is its {{Abbr|USAN|United States Adopted Name}} in the case of the ] salt; ''pseudoephedrine polistirex'' its {{Abbr|USAN|United States Adopted Name}} in the case of the polistirex form; and ''d-isoephedrine sulfate'' is its {{Abbrlink|JAN|Japanese Accepted Name}} in the case of the sulfate salt.<ref name="Elks2014" /><ref name="IndexNominum2000" /><ref name="MortonHall2012" /><ref name="Drugs.com" /> Pseudoephedrine is also known as ''Ψ-ephedrine'' and ''isoephedrine''.<ref name="Elks2014" /><ref name="MortonHall2012" />
			===Brand names===
			{{List dispute}}
			The following is a list of consumer medicines that either contain pseudoephedrine or have switched to a less-regulated alternative such as ].
			* ] (made by ]) — contains 60&nbsp;mg pseudoephedrine and 2.5&nbsp;mg ] in certain countries.
			* Advil Cold & Sinus (made by Pfizer Canada Inc.) — contains 30&nbsp;mg pseudoephedrine hydrochloride (also 200&nbsp;mg ]).
			* ] (made by ]) — contains 120&nbsp;mg pseudoephedrine hydrochloride (also 220&nbsp;mg ]).
			* ] (made by ]) — contains 120&nbsp;mg of pseudoephedrine hydrochloride (also 60&nbsp;mg of ]).
			* ] (made by ]) — contains 240&nbsp;mg of pseudoephedrine sulfate (also 10&nbsp;mg of ]).
			* ] (made by ], a ] company) — contains 60&nbsp;mg pseudoephedrine hydrochloride (also 8&nbsp;mg ])<ref>{{cite web |title=Benadryl Allergy Relief Plus Decongestant Capsules - Summary of Product Characteristics (SmPC) - (emc) |url=https://www.medicines.org.uk/emc/product/1916/smpc |website=www.medicines.org.uk |publisher=Datapharm |access-date=22 November 2023 |archive-date=22 November 2023 |archive-url=https://web.archive.org/web/20231122134405/https://www.medicines.org.uk/emc/product/1916/smpc |url-status=live }}</ref>
			* ] (made by ]) — contains 120&nbsp;mg pseudoephedrine hydrochloride (also 5&nbsp;mg ]).
			* ] (made by Bayer Healthcare) — contains 120&nbsp;mg of pseudoephedrine sulfate (also 5&nbsp;mg of loratadine).
			* ] (made by Bayer Healthcare) — contains 240&nbsp;mg of pseudoephedrine sulfate (also 10&nbsp;mg of loratadine).
			* Codral (made by ] subsidiary of Johnson & Johnson) — Codral Original contains pseudoephedrine, Codral New Formula substitutes phenylephrine for pseudoephedrine.
			* Congestal (made by ]) — contains 60&nbsp;mg pseudoephedrine hydrochloride (also 650&nbsp;mg ] and 4&nbsp;mg ]).<ref>{{cite web |url=http://drugpamphlet.blogspot.com/2017/02/blog-post_15.html |title=Drug Pamphlet: Congestal |access-date=13 December 2018 |archive-url=https://web.archive.org/web/20181213172031/http://drugpamphlet.blogspot.com/2017/02/blog-post_15.html |archive-date=13 December 2018 |url-status=dead |date=12 February 2017 }}</ref><ref>{{cite web|url=https://1.bp.blogspot.com/-_CsicYHAo2k/WKB-sxodKBI/AAAAAAAAA_w/_RoHeo0BAps_x_7yxX_lPJm7OHZFrEVUgCLcB/s1600/congestal.jpg|format=JPG|title=Photographic image of Congestal tablets information sheet|website=1.bp.blogspot.com|access-date=28 February 2022|archive-date=13 December 2018|archive-url=https://web.archive.org/web/20181213172103/https://1.bp.blogspot.com/-_CsicYHAo2k/WKB-sxodKBI/AAAAAAAAA_w/_RoHeo0BAps_x_7yxX_lPJm7OHZFrEVUgCLcB/s1600/congestal.jpg|url-status=live}}</ref>
			* Contac (made by GlaxoSmithKline) — previously contained pseudoephedrine, now contains phenylephrine. As at Nov 2014 UK version still contains 30&nbsp;mg pseudoephedrine hydrochloride per tablet.
			* Demazin (made by Bayer Healthcare) — contains pseudoephedrine sulfate and ] maleate
			* Eltor (made by Sanofi Aventis) — contains pseudoephedrine hydrochloride.
			* ] (made by ]) — contains 60&nbsp;mg pseudoephedrine hydrochloride (also 1200&nbsp;mg ]).
			* ] (made by ]) — contains 30&nbsp;mg pseudoephedrine per tablet, formulated with Impede Meth-Deterrent technology.
			* ] Cold & Flu (made by Reckitt Benckiser) — contains 30&nbsp;mg pseudoephedrine hydrochloride (also 200&nbsp;mg ibuprofen).
			* Respidina – contains 120&nbsp;mg of pseudoephedrine in the form of extended release tablets.
			* Rhinex Flash (made by ], Cambodia) — contains pseudoephedrine combined with paracetamol and triprolidine.
			* Rhinos SR (made by ]) — contains 120&nbsp;mg of pseudoephedrine hydrochloride
			* ] (made by McNeil Consumer Healthcare, a Kenvue Company) — contains 500&nbsp;mg paracetamol and 30&nbsp;mg pseudoephedrine hydrochloride.
			* '''Sudafed''' Decongestant (made by McNeil Consumer Healthcare, a Kenvue company) — contains 60&nbsp;mg of pseudoephedrine hydrochloride. Not to be confused with Sudafed PE, which contains phenylephrine.
			* '''Theraflu''' (made by ]) — previously contained pseudoephedrine, now contains phenylephrine
			* Trima — contains 60&nbsp;mg pseudoephedrine hydrochloride
			* Tylol Hot (made by NOBEL İLAÇ SANAYİİ VE TİCARET A.Ş., Turkey) — a packet of 20&nbsp;g contains 60&nbsp;mg pseudoephedrine hydrochloride, 500&nbsp;mg paracetamol and 4&nbsp;mg ]
			* Unifed (made by ], Jordan) — contains pseudoephedrine hydrochloride (also triprolidine and ]).
			* ] 12 Hour (made by McNeil Consumer Healthcare, a Kenvue company) — contains 120&nbsp;mg pseudoephedrine hydrochloride (also 5&nbsp;mg of cetirizine).
			* Zephrex-D (made by ]) – a special meth-resistant form of pseudoephedrine that becomes gooey when heated.
			===Recreational use===
			] pseudoephedrine has been ]d as a ].<ref name="SchifanoChiappiniMiuli2021">{{cite journal | vauthors = Schifano F, Chiappini S, Miuli A, Mosca A, Santovito MC, Corkery JM, Guirguis A, Pettorruso M, Di Giannantonio M, Martinotti G | title = Focus on Over-the-Counter Drugs' Misuse: A Systematic Review on Antihistamines, Cough Medicines, and Decongestants | journal = Front Psychiatry | volume = 12 | issue = | pages = 657397 | date = 2021 | pmid = 34025478 | pmc = 8138162 | doi = 10.3389/fpsyt.2021.657397 | doi-access = free | url = }}</ref> Six ]s and one ] of pseudoephedrine misuse have been published as of 2021.<ref name="SchifanoChiappiniMiuli2021" /> There is a case report of ] with pseudoephedrine in massive doses for treatment of ].<ref name="SchifanoChiappiniMiuli2021" /><ref name="DiazWiseSemchyshyn1979">{{cite journal | vauthors = Diaz MA, Wise TN, Semchyshyn GO | title = Self-medication with pseudoephedrine in a chronically depressed patient | journal = Am J Psychiatry | volume = 136 | issue = 9 | pages = 1217–1218 | date = September 1979 | pmid = 474820 | doi = 10.1176/ajp.136.9.1217 | url = }}</ref>
			===Use in exercise and sports===
			Pseudoephedrine has been used as a ] in ] and ] due to its sympathomimetic and stimulant effects.<ref name="TrinhKimRitsma2015">{{cite journal | vauthors = Trinh KV, Kim J, Ritsma A | title = Effect of pseudoephedrine in sport: a systematic review | journal = BMJ Open Sport Exerc Med | volume = 1 | issue = 1 | pages = e000066 | date = 2015 | pmid = 27900142 | pmc = 5117033 | doi = 10.1136/bmjsem-2015-000066 | url = }}</ref><ref name="GheorghievHosseiniMoran2018">{{cite journal | vauthors = Gheorghiev MD, Hosseini F, Moran J, Cooper CE | title = Effects of pseudoephedrine on parameters affecting exercise performance: a meta-analysis | journal = Sports Med Open | volume = 4 | issue = 1 | pages = 44 | date = October 2018 | pmid = 30291523 | pmc = 6173670 | doi = 10.1186/s40798-018-0159-7 | doi-access = free | url = }}</ref> Because of these effects, pseudoephedrine can increase ], elevate ], improve ], and reduce ], among other performance-enhancing effects.<ref name="TrinhKimRitsma2015" /><ref name="GheorghievHosseiniMoran2018" /><ref name="SalernoJackson2005" />
			A 2015 ] found that pseudoephedrine lacked performance-enhancing effects at therapeutic doses (60–120{{nbsp}}mg) but significantly enhanced athletic performance at supratherapeutic doses (≥180{{nbsp}}mg).<ref name="TrinhKimRitsma2015" /> A subsequent 2018 ], which included seven additional studies, found that pseudoephedrine had a small positive effect on heart rate ({{Abbrlink|SMD|standardized mean difference}} = 0.43) but insignificant effects on time trials, perceived exertion ratings, blood ] levels, and blood ] levels.<ref name="GheorghievHosseiniMoran2018" /> However, subgroup analyses revealed that ]s were larger for heart rate increases and quicker time trials in well-trained athletes and younger participants, for shorter exercise sessions with pseudoephedrine administered within 90{{nbsp}}minutes beforehand, and with higher doses of pseudoephedrine.<ref name="GheorghievHosseiniMoran2018" /> A ] was established, with larger doses (>170{{nbsp}}mg) showing greater increases in heart rate and faster time trials than with smaller doses (≤170{{nbsp}}mg) ({{Abbr|SMD|standardized mean difference}} = 0.85 for heart rate and {{Abbr|SMD|standardized mean difference}} = -0.24 for time trials, respectively).<ref name="GheorghievHosseiniMoran2018" /> In any case, the meta-analysis concluded that the performance-enhancing effects of pseudoephedrine were marginal to small and likely to be lower in magnitude than with ].<ref name="GheorghievHosseiniMoran2018" /> It is relevant in this regard that caffeine is a permitted stimulant in competitive sports.<ref name="GheorghievHosseiniMoran2018" />
			Pseudoephedrine was on the ]'s (IOC) banned substances list until 2004 when the ] (WADA) list replaced the IOC list. Although WADA initially only ''monitored'' pseudoephedrine, it went back onto the "banned" list on 1 January 2010.<ref>{{cite web |url=http://www.wada-ama.org/en/News-Center/Articles/WADA-2010-Prohibited-List-Now-Published/ |title=WADA 2010 Prohibited List Now Published – World Anti-Doping Agency |publisher=Wada-ama.org |access-date=6 May 2012 |url-status=dead |archive-url=https://web.archive.org/web/20120220000116/http://www.wada-ama.org/en/News-Center/Articles/WADA-2010-Prohibited-List-Now-Published/ |archive-date=20 February 2012 }}</ref>
			Pseudoephedrine is excreted through urine, and the concentration in urine of this drug shows a large inter-individual spread; that is, the same dose can give a vast difference in urine concentration for different individuals.<ref>{{cite web|url=https://www.researchgate.net/publication/8957642|access-date=24 February 2014|title=Elimination of ephedrines in urine following multiple dosing the consequences for athletes in relation to doping control|archive-date=29 August 2021|archive-url=https://web.archive.org/web/20210829014432/https://www.researchgate.net/publication/8957642_Elimination_of_ephedrines_in_urine_following_multiple_dosing_The_consequences_for_athletes_in_relation_to_doping_control|url-status=live}}</ref> Pseudoephedrine is approved to be taken up to 240&nbsp;mg per day. In seven healthy male subjects, this dose yielded a urine concentration range of 62.8 to 294.4 microgram per milliliter (μg/mL) with mean ± standard deviation 149 ± 72&nbsp;μg/mL.<ref>{{cite journal | vauthors = Strano-Rossi S, Leone D, de la Torre X, Botrè F | title = The relevance of the urinary concentration of ephedrines in anti-doping analysis: determination of pseudoephedrine, cathine, and ephedrine after administration of over-the-counter medicaments | journal = Therapeutic Drug Monitoring | volume = 31 | issue = 4 | pages = 520–526 | date = August 2009 | pmid = 19571776 | doi = 10.1097/FTD.0b013e3181ac6006 | s2cid = 21333203 }}</ref> Thus, normal dosage of 240&nbsp;mg pseudoephedrine per day can result in urine concentration levels exceeding the limit of 150&nbsp;μg/mL set by WADA for about half of all users.<ref>{{cite web|url=http://www.wada-ama.org/Documents/World_Anti-Doping_Program/WADP-Prohibited-list/WADA_Additional_Info_Pseudoephedrine_2010_EN.pdf|title=Ressources|access-date=18 August 2016|archive-url=https://web.archive.org/web/20140529020420/http://www.wada-ama.org/Documents/World_Anti-Doping_Program/WADP-Prohibited-list/WADA_Additional_Info_Pseudoephedrine_2010_EN.pdf|archive-date=29 May 2014|url-status=dead}}</ref> Furthermore, hydration status does not affect the urinary concentration of pseudoephedrine.<ref>{{cite journal | vauthors = Jolley D, Dawson B, Maloney SK, White J, Goodman C, Peeling P | title = Hydration and urinary pseudoephedrine levels after a simulated team game | journal = International Journal of Sport Nutrition and Exercise Metabolism | volume = 24 | issue = 3 | pages = 325–332 | date = June 2014 | pmid = 24458099 | doi = 10.1123/ijsnem.2013-0076 | url = http://research-repository.uwa.edu.au/en/publications/hydration-and-urinary-pseudoephedrine-levels-after-a-simulated-team-game(f5215f21-7653-4fd6-85f6-61c790e0eba6).html }}</ref>
			====List of doping cases====
			* Canadian rower ] was stripped of her ] team gold medal after testing positive for pseudoephedrine.<ref>{{cite news|url=http://www.cbc.ca/archives/categories/sports/drugs-in-sports/going-for-dope-canada-and-drugs-in-sport/squeaky-clean-silken-tests-positive.html|title=Silken tests positive|access-date=24 February 2014|archive-date=4 March 2014|archive-url=https://web.archive.org/web/20140304160658/http://www.cbc.ca/archives/categories/sports/drugs-in-sports/going-for-dope-canada-and-drugs-in-sport/squeaky-clean-silken-tests-positive.html|url-status=live}}</ref>
			* In February 2000, ] and ] won gold at the ] but were stripped of their medals after Berezhnaya tested positive. This resulted in a three-month disqualification from the date of the test, and the medal being stripped.<ref name=wallech>{{cite book | url = https://books.google.com/books?id=6EThoEOnGuUC&pg=PA86 | title = Complete Book of the Winter Olympics | vauthors = Wallechinsky D | author-link = David Wallechinsky | year = 2009 | publisher = Greystone Books | access-date =9 July 2010 | isbn = 978-1-55365-502-2 }}</ref> She stated that she had taken cold medication approved by a doctor but had failed to inform the ISU as required.<ref name=disq>{{cite web | url = http://www.iceskatingintnl.com/archive/results_worlds/world00p.htm | title = 2000 World Championships – Pairs | publisher = Ice Skating International | access-date = 6 June 2010 | archive-date = 14 November 2011 | archive-url = https://web.archive.org/web/20111114140356/http://www.iceskatingintnl.com/archive/results_worlds/world00p.htm | url-status = dead }}</ref> The pair missed the World Championships that year as a result of the disqualification.
			* Romanian gymnast ] was stripped of her gold medal at the ] after testing positive. She took two pills given to her by the team coach for a cold. Although she was stripped of the overall gold medal, she kept her other medals, and, unlike in most other doping cases, was not banned from competing again; only the team doctor was banned for a number of years. ], the president of the Romanian Olympic Committee, resigned over the scandal.<ref>{{cite web |url=https://assets.espn.go.com/oly/summer00/news/2000/0925/776388.html |title=Summer Olympics 2000 Raducan tests positive for stimulant |publisher=] |date=26 September 2000 |access-date=6 May 2012 |archive-date=2 October 2011 |archive-url=https://web.archive.org/web/20111002111033/http://assets.espn.go.com/oly/summer00/news/2000/0925/776388.html |url-status=live }}</ref><ref>{{cite web|url=http://www.intlgymnast.com/news2000/oct3.html |archive-url=https://web.archive.org/web/20010715112418/http://www.intlgymnast.com/news2000/oct3.html |archive-date=15 July 2001 |title=Amanar Tops Romanian Money List |publisher=International Gymnast Magazine Online |date=15 October 2000 |access-date=6 May 2012}}</ref>
			* In the ], the IOC issued a reprimand against the Slovak ] player ] for usage of pseudoephedrine.<ref>{{cite web |url=http://www.olympic.org/news/ioc-issues-a-reprimand-against-slovakian-ice-hockey-player-lubomir-visnovsky/77600 |title=IOC issues a reprimand against Slovakian ice hockey player |access-date=24 February 2014 |archive-date=8 March 2014 |archive-url=https://web.archive.org/web/20140308181150/http://www.olympic.org/news/ioc-issues-a-reprimand-against-slovakian-ice-hockey-player-lubomir-visnovsky/77600 |url-status=live }}</ref>
			* In the ] ] and ] ice hockey player ] was prevented from playing in the final for usage of pseudoephedrine. Bäckström claimed he was using it as allergy medication.<ref>{{cite web |url=https://www.tsn.ca/nhl/story/?id=444510 |title=Sweden's Bäckström tests positive for banned substance |access-date=24 February 2014 |archive-url=https://web.archive.org/web/20140227072846/http://www.tsn.ca/nhl/story/?id=444510 |archive-date=27 February 2014 |url-status=dead }}</ref> In March 2014, the IOC Disciplinary Commission decided that Bäckström would be awarded the silver medal.<ref name="IOC">{{cite web | url=http://www.olympic.org/news/ioc-decision-swedish-ice-hockey-player-nicklas-backstrom-to-receive-sochi-silver-medal/227378 | title=IOC Decision – Swedish ice hockey player Nicklas Backstrom to receive Sochi silver medal. | work=IOC | date=14 March 2014 | access-date=14 March 2014 | archive-date=15 March 2014 | archive-url=https://web.archive.org/web/20140315224712/http://www.olympic.org/news/ioc-decision-swedish-ice-hockey-player-nicklas-backstrom-to-receive-sochi-silver-medal/227378 | url-status=live }}</ref> In January 2015 Bäckström, the IOC, WADA and the ] agreed to a settlement in which he accepted a reprimand but was cleared of attempting to enhance his performance.<ref name="Washington Post">{{cite news | url=https://www.washingtonpost.com/blogs/capitals-insider/wp/2015/01/15/nicklas-backstroms-olympic-doping-appeal-resolved-with-reprimand/ | title=Nicklas Backstrom's Olympic doping appeal resolved with reprimand | newspaper=The Washington Post | date=15 January 2015 | access-date=18 January 2015 | vauthors=Prewitt A | archive-date=17 January 2015 | archive-url=https://web.archive.org/web/20150117170505/http://www.washingtonpost.com/blogs/capitals-insider/wp/2015/01/15/nicklas-backstroms-olympic-doping-appeal-resolved-with-reprimand/ | url-status=live }}</ref>
			===Manufacture of amphetamines===
			Its membership in the ] class has made pseudoephedrine a sought-after ] in the ] of ] and ].<ref name="GłowackaWiela-Hojeńska2021" /> As a result of the increasing regulatory restrictions on the sale and distribution of pseudoephedrine, pharmaceutical firms have reformulated medications to use alternative compounds, particularly ], even though its efficacy as an oral decongestant has been demonstrated to be indistinguishable from placebo.<ref name="pmid17264159">{{cite journal | vauthors = Hatton RC, Winterstein AG, McKelvey RP, Shuster J, Hendeles L | title = Efficacy and safety of oral phenylephrine: systematic review and meta-analysis | journal = The Annals of Pharmacotherapy | volume = 41 | issue = 3 | pages = 381–390 | date = March 2007 | pmid = 17264159 | doi = 10.1345/aph.1H679 | s2cid = 25627664 }}</ref>
			In the United States, federal laws control the sale of pseudoephedrine-containing products.<ref name="FDA legal">{{cite web | title=Legal Requirements for the Sale and Purchase of Drug Products Containing Pseudoephedrine, Ephedrine, and Phenylpropanolamine | website=U.S. Food and Drug Administration | date=9 March 2006 | url=https://www.fda.gov/drugs/information-drug-class/legal-requirements-sale-and-purchase-drug-products-containing-pseudoephedrine-ephedrine-and | access-date=7 September 2023 | archive-date=25 December 2023 | archive-url=https://web.archive.org/web/20231225071516/https://www.fda.gov/drugs/information-drug-class/legal-requirements-sale-and-purchase-drug-products-containing-pseudoephedrine-ephedrine-and | url-status=live }} {{PD-notice}}</ref><ref name="CMEA" /><ref name="MPPA" /> Retailers in the US have created corporate policies restricting the sale of pseudoephedrine-containing products.<ref>{{cite web|title=Pseudoephedrine Compliance|url=https://www.walgreens.com/topic/faq/questionandanswer.jsp?questionTierId=900002&faqId=1300052|website=Walgreens|access-date=24 January 2016|archive-url=https://web.archive.org/web/20160130161224/http://www.walgreens.com/topic/faq/questionandanswer.jsp?questionTierId=900002&faqId=1300052|archive-date=30 January 2016|url-status=dead}}</ref><ref>{{cite web|title=Target Announces That All Products Containing Pseudoephedrine Will Be Placed Behind Pharmacy Counter|url=http://www.prnewswire.com/news-releases/target-announces-that-all-products-containing-pseudoephedrine-will-be-placed-behind-pharmacy-counter-54327552.html|website=PRNewswire|access-date=24 January 2016|archive-url=https://web.archive.org/web/20160131060830/http://www.prnewswire.com/news-releases/target-announces-that-all-products-containing-pseudoephedrine-will-be-placed-behind-pharmacy-counter-54327552.html|archive-date=31 January 2016|url-status=dead}}</ref> Their policies restrict sales by limiting purchase quantities and requiring a minimum age and government issued photographic identification.<ref name="CMEA" /><ref name="MPPA" /> These requirements are similar to and sometimes more stringent than existing law. Internationally, pseudoephedrine is listed as a ] under the ].<ref name="autogenerated1">{{cite web |url=http://www.incb.org/pdf/e/list/red.pdf |title=Microsoft Word - RedListE2007.doc |access-date=6 May 2012 |url-status=dead |archive-url=https://web.archive.org/web/20080227224025/http://www.incb.org/pdf/e/list/red.pdf |archive-date=27 February 2008 }}</ref>
			===Legal status===
			====Australia====
			]
			Illicit diversion of pseudoephedrine in Australia has caused significant changes to the way the products are regulated. {{As of|2006}}, all products containing pseudoephedrine have been rescheduled as either "Pharmacist Only Medicines" (Schedule 3) or "Prescription Only Medicines" (Schedule 4), depending on the amount of pseudoephedrine in the product. A Pharmacist Only Medicine may only be sold to the public if a pharmacist is directly involved in the transaction. These medicines must be kept behind the counter, away from public access.
			Pharmacists are also encouraged (and in some states required) to log purchases with the online database Project STOP.<ref>{{cite web |url=http://www.innovationrx.com.au/OurProducts/ProjectSTOP.aspx |title=Project STOP video – Online Advertising |publisher=Innovationrx.com.au |access-date=6 May 2012 |archive-url=https://web.archive.org/web/20120426041458/http://www.innovationrx.com.au/OurProducts/ProjectSTOP.aspx |archive-date=26 April 2012 |url-status=dead }}</ref>
			As a result, some pharmacies no longer stock Sudafed, the common brand of pseudoephedrine cold/sinus tablets, opting instead to sell Sudafed PE, a ] product that has not been proven effective in clinical trials.<ref name="pmid17264159"/><ref>{{cite journal | vauthors = Horak F, Zieglmayer P, Zieglmayer R, Lemell P, Yao R, Staudinger H, Danzig M | title = A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber | journal = Annals of Allergy, Asthma & Immunology | volume = 102 | issue = 2 | pages = 116–120 | date = February 2009 | pmid = 19230461 | doi = 10.1016/S1081-1206(10)60240-2 }}</ref><ref name="Eccles2007" />
			====Belgium====
			Until 2024, several formulations of pseudoephedrine were available over-the-counter in Belgium.<ref>{{cite web |title=PRAC February 2023 – Start of a safety review of pseudoephedrine-containing medicines {{!}} FAMHP |url=https://www.famhp.be/en/news/prac_february_2023_start_of_a_safety_review_of_pseudoephedrine_containing_medicines |access-date=15 August 2023 |website=www.famhp.be |archive-date=15 August 2023 |archive-url=https://web.archive.org/web/20230815141124/https://www.famhp.be/en/news/prac_february_2023_start_of_a_safety_review_of_pseudoephedrine_containing_medicines |url-status=live }}</ref> However, new legislation came into effect in November 2024, banning the over-the-counter sale of all medicines containing pseudoephedrine.<ref>{{Cite web |url=https://www.fagg-afmps.be/nl/news/geneesmiddelen_met_de_werkzame_bestanddelen_pseudo_efedrine_en_fusidinezuur_zijn_in_belgie |title=Geneesmiddelen met de werkzame bestanddelen (pseudo-)efedrine en fusidinezuur zijn in België vanaf 1 november 2024 voorschriftplichtig |author=<!--Not stated--> |date=30 September 2024 |website=Federaal Agentschap voor Geneesmiddelen en Gezondheidsproducten |access-date=2 December 2024}}</ref><ref>{{Cite web |url=https://www.bcfi.be/nl/pseudo-efedrine-en-fusidinezuur-vanaf-1-november-enkel-nog-op-voorschrift |title=(Pseudo-)efedrine en fusidinezuur vanaf 1 november enkel nog op voorschrift! |author=<!--Not stated--> |date=24 October 2024 |website=Belgisch centrum voor farmacotherapeutische informatie |access-date=2 December 2024}}</ref>
			====Canada====
			] has investigated the risks and benefits of pseudoephedrine and ]/]. Near the end of the study, Health Canada issued a warning on their website stating that those who are under the age of 12, or who have heart disease and may have strokes, should avoid taking pseudoephedrine and ephedrine. Also, they warned that everyone should avoid taking ephedrine or pseudoephedrine with other stimulants like ]. They also banned all products that contain both ephedrine (or pseudoephedrine) and caffeine.<ref>{{cite web|url=http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2008/13279a-eng.php|title=Archived – Health Canada Reminds Canadians not to use Ephedra/Ephedrine Products|website=healthycanadians.gc.ca|date=20 August 2021|access-date=1 July 2015|archive-date=27 April 2014|archive-url=https://web.archive.org/web/20140427035929/http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2008/13279a-eng.php|url-status=live}}</ref>
			Products whose only medicinal ingredient is pseudoephedrine must be kept behind the pharmacy counter. Products containing pseudoephedrine along with other medicinal ingredients may be displayed on store shelves but may be sold only in a pharmacy when a pharmacist is present.<ref>{{cite web |url=http://pharmacytechniciansletter.therapeuticresearch.com/mobile/Newsletter.aspx?nidchk=1&cs=&s=PTL&vo=1&dd=271114&dt=2&vodd=3 |title=What ingredients are commonly found in OTC cough and cold products? What do they do? | work = Pharmacy Technician's Letter |access-date=25 August 2015 |archive-url=https://web.archive.org/web/20151025125803/http://pharmacytechniciansletter.therapeuticresearch.com/(S(uvxrnu55cowfcdintotjyq45))/mobile/Newsletter.aspx?nidchk=1&cs=&s=PTL&vo=1&dd=271114&dt=2&vodd=3 |archive-date=25 October 2015 |url-status=dead }}</ref><ref>{{cite web|url=http://www.familyhealthonline.ca/fho/pharmacycare/PC_OTCdrugs_fhb07.asp|title=Family Health Online – Family Health Magazine -PHARMACY CARE – Over-the-Counter Medication – Why must I ask for that?|access-date=18 August 2016|archive-url=https://web.archive.org/web/20160618165544/http://www.familyhealthonline.ca/fho/pharmacycare/PC_OTCdrugs_fhb07.asp|archive-date=18 June 2016|url-status=dead}}</ref>
			====Colombia====
			The Colombian government prohibited the trade of pseudoephedrine in 2010.<ref>{{cite web |url=http://www.eltiempo.com/archivo/documento/CMS-5824648 |title=Gobierno prohĂbe antigripales con pseudoefedrina a partir de finales de 2010 – Archivo – Archivo Digital de Noticias de Colombia y el Mundo desde 1.990 |trans-title=Government Prohibits Flu Pseudoephedrine in Late 2010 – Archive – News Archive Digital Colombia and the World since 1990 |language=es |publisher=Eltiempo.com |date=8 July 2009 |orig-year=Published 11 August 2009 |access-date=6 May 2012 |archive-date=21 May 2011 |archive-url=https://web.archive.org/web/20110521191538/http://www.eltiempo.com/archivo/documento/CMS-5824648 |url-status=live }}</ref>
			====Estonia====
			Pseudoephedrine is an over-the-counter drug in Estonia.<ref>{{cite web |date=28 October 2016 |title=Keskmise eestlase kodust leiab portsu dopingut |url=https://sakala.postimees.ee/3889229/keskmise-eestlase-kodust-leiab-portsu-dopingut |access-date=9 July 2023 |website=Uudised |language=et |archive-date=9 July 2023 |archive-url=https://web.archive.org/web/20230709092834/https://sakala.postimees.ee/3889229/keskmise-eestlase-kodust-leiab-portsu-dopingut |url-status=live }}</ref>
			====Finland====
			Pseudoephedrine medicines can only be obtained with a prescription in Finland.<ref>{{cite web |date=29 January 2018 |title=Kysy Kiminkiseltä: Parasta flunssan hoitoa on lepo ja mummon mustaviinimarjamehu |url=https://www.apu.fi/kysymykset/kysy-kiminkiselta-parasta-flunssan-hoitoa-lepo-ja-mummon-mustaviinimarjamehu |access-date=9 July 2023 |website=www.apu.fi |archive-date=9 July 2023 |archive-url=https://web.archive.org/web/20230709093047/https://www.apu.fi/kysymykset/kysy-kiminkiselta-parasta-flunssan-hoitoa-lepo-ja-mummon-mustaviinimarjamehu |url-status=live }}</ref>{{Failed verification|date=September 2023}}
			====France====
			Pseudoephedrine-containing combination products are available over the counter from pharmacies, most commonly with Paracetamol under the brand name "Dolihrume". Products combining pseudoephedrine and ibuprofen or certain antihistamines are also available. However, products containing pseudoephedrine as a single ingredient are not sold.{{Citation needed|date=December 2024}} In October 2023, the French health department officially warned against the usage of pseudoephedrine for patients with a cold. It also suggested the substance's availability could be restricted in the future, pending its pharmaceutical re-evaluation on ] level.<ref>{{Cite web |url=https://ansm.sante.fr/actualites/en-cas-de-rhume-evitez-les-medicaments-vasoconstricteurs-par-voie-orale |title=En cas de rhume, évitez les médicaments vasoconstricteurs par voie orale ! |author=<!--Not stated--> |date=22 October 2023 |website=Agence nationale de sécurité du médicament et des produits de santé |access-date=2 December 2024}}</ref><ref>{{Cite web |url=https://www.vidal.fr/actualites/30758-pas-de-pseudoephedrine-pour-un-rhume-l-ansm-alerte-a-nouveau-les-professionnels-de-sante.html |title=Pas de pseudoéphédrine pour un rhume : l'ANSM alerte à nouveau les professionnels de santé |last=Paitraud |first=David |date=9 April 2024 |website=VIDAL |access-date=2 December 2024}}</ref>
			In December 2024, the government announced pseudoephedrine medicines would henceforth only be obtainable with a prescription.
			====Germany====
			Various pseudoephedrine-containing products in combination with ibuprofen, ], or antihistamines can be obtained without a prescription upon request at a pharmacy. Common names include Aspirin Complex, Reactine Duo, and RhinoPront. Products containing pseudoephedrine as a single ingredient are not available.{{Citation needed|date=December 2024}}
			====Japan====
			Medications that contain more than 10% pseudoephedrine are prohibited under the Stimulants Control Law in Japan.<ref>{{cite web |url=http://www.seattle.us.emb-japan.go.jp/about/import_restrictions.html |title=Customs Information |newspaper=Consulate-General of Japan in Seattle |access-date=27 August 2015 |archive-date=19 August 2015 |archive-url=https://web.archive.org/web/20150819081843/http://www.seattle.us.emb-japan.go.jp/about/import_restrictions.html |url-status=live }}</ref>
			====Mexico====
			On 23 November 2007, the use and trade of pseudoephedrine in Mexico was made illegal as it was argued that it was extremely popular as a precursor in the synthesis of methamphetamine.<ref>{{cite web |url=http://www.eluniversal.com.mx/notas/465055.html |title=Prohibirán definitivamente uso de pseudoefedrina |trans-title=A Permanent Ban on Pseudoephedrine |language=es |date=23 November 2007 |orig-year=Published 2 December 2007 |access-date=17 December 2013 |archive-date=19 December 2013 |archive-url=https://web.archive.org/web/20131219194924/http://www.eluniversal.com.mx/notas/465055.html |url-status=dead }}</ref>
			====Netherlands====
			Pseudoephedrine was withdrawn from sale in 1989 due to concerns about adverse cardiac side effects.<ref>{{cite web |url=https://www.in-pharmatechnologist.com/Article/2007/09/03/Pseudoephedrine-drugs-still-OTC |title=Pseudoephedrine drugs still OTC |vauthors=Megget K |date=2 September 2007 |access-date=15 October 2018 |archive-date=29 August 2021 |archive-url=https://web.archive.org/web/20210829014405/https://www.outsourcing-pharma.com/Article/2007/09/03/Pseudoephedrine-drugs-still-OTC |url-status=live }}</ref>
			====New Zealand====
			Since April 2024, pseudoephedrine has been classified as a restricted (pharmacist-only) drug in the ] which allows the purchase of medicines containing pseudoephedrine from a pharmacist without a prescription.<ref>{{cite news |title=Bill to make pseudoephedrine-based medicines available over-the-counter passes third reading |url=https://www.rnz.co.nz/news/political/513863/bill-to-make-pseudoephedrine-based-medicines-available-over-the-counter-passes-third-reading |access-date=4 June 2024 |work=] |date=9 April 2024 |language=en-nz}}</ref>
			Pseudoephedrine, ephedrine, and any product containing these substances, e.g. cold and flu medicines, were first classified in October 2004 as Class C Part III (partially exempted) controlled drugs, due to being the principal ingredient in methamphetamine.<ref>{{cite web|url=http://www.medsafe.govt.nz/regulatory/Guideline/ephedrineAndPseudoephedrine.asp |archive-url=https://web.archive.org/web/20070308163452/http://www.medsafe.govt.nz/regulatory/Guideline/ephedrineAndPseudoephedrine.asp |archive-date=8 March 2007 |title=Ephedrine and Pseudoephedrine to Become Controlled Drugs |publisher=Medsafe, New Zealand Medicines and Medical Devices Safety Authority}}</ref> New Zealand Customs and police officers continued to make large interceptions of precursor substances believed to be destined for ] production. On 9 October 2009, Prime Minister ] announced pseudoephedrine-based cold and flu tablets would become prescription-only drugs and reclassified as a class B2 drug.<ref>{{cite web|url=http://www.listener.co.nz/issue/3568/features/11902/chemical_brothers_,2.html;jsessionid=2E67428F477FDC15DA070E729BBBC8FF |archive-url=https://web.archive.org/web/20100523020320/http://www.listener.co.nz/issue/3568/features/11902/chemical_brothers_,2.html |archive-date=23 May 2010 |title=Chemical Brothers |publisher=Listener (New Zealand)}}</ref> The law was amended by The Misuse of Drugs Amendment Bill 2010, which passed in August 2011.<ref>{{cite web|title=Misuse of Drugs Amendment Bill|url=https://www.parliament.nz/en/pb/bills-and-laws/bills-proposed-laws/document/00DBHOH_BILL9857_1/misuse-of-drugs-amendment-bill|website=parliament.nz|access-date=6 July 2017|archive-date=6 July 2017|archive-url=https://web.archive.org/web/20170706154647/https://www.parliament.nz/en/pb/bills-and-laws/bills-proposed-laws/document/00DBHOH_BILL9857_1/misuse-of-drugs-amendment-bill|url-status=live}}</ref>
			On 24 November 2023, the recently-formed ] announced that the sale of cold medication containing pseudoephedrine would be allowed (as part of the coalition agreement between the National and ACT parties).<ref>{{Cite web |title=New govt: Pseudoephedrine to go back on shelves after ban |url=https://www.1news.co.nz/2023/11/24/pseudoephedrine-to-go-back-on-shelves-after-lengthy-ban/ |access-date=2024-02-06 |website=1 News |language=en}}</ref>
			====Switzerland====
			Pseudoephedrine is available without a prescription in combination (with ]) under the brand name "Aspirin Complex". There is also a preparation consisting of a single ingredient 120mg extended-release tablet that can be obtained at pharmacies with a prescription or after consultation with a pharmacist.{{Citation needed|date=December 2024}}
			====Turkey====
			In Turkey, medications containing pseudoephedrine are available by prescription only.<ref>{{cite web |url=http://www.istanbulsaglik.gov.tr/w/sb/ecz/ykmrecete/belge/normal_recete_verilmesi.pdf |title=Kontrole Tabi İlaçlar |date=July 2013 |publisher=Social Security Institution of Republic of Turkey |access-date=11 March 2014 |archive-date=11 March 2014 |archive-url=https://web.archive.org/web/20140311224333/http://www.istanbulsaglik.gov.tr/w/sb/ecz/ykmrecete/belge/normal_recete_verilmesi.pdf |url-status=dead }}</ref>
			====United Kingdom====
			In the UK, pseudoephedrine is available over the counter under the supervision of a qualified pharmacist, or on prescription. In 2007, the ] reacted to concerns over the diversion of ephedrine and pseudoephedrine for the illicit manufacture of methamphetamine by introducing voluntary restrictions limiting over-the-counter sales to one box containing no more than 720&nbsp;mg of pseudoephedrine in total per transaction. These restrictions became law in April 2008.<ref>{{cite web |url=http://www.mhra.gov.uk/home/idcplg?IdcService=GET_FILE&dDocName=CON014095&RevisionSelectionMethod=LatestReleased |title=Drug Safety Update, March 2008 |format=PDF |date=30 June 2008 |publisher=The ] and the ] |url-status=dead |archive-url=https://web.archive.org/web/20110614160936/http://www.mhra.gov.uk/home/idcplg?IdcService=GET_FILE&dDocName=CON014095&RevisionSelectionMethod=LatestReleased |archive-date=14 June 2011 }}</ref> No form of ID is required.
			====United States====
			=====Federal=====
			The ] has recognized that pseudoephedrine is used in the illegal manufacture of methamphetamine. In 2005, the ] heard testimony concerning education programs and state legislation designed to curb this illegal practice.{{fact|date=December 2023}}
			Attempts to control the sale of the drug date back to 1986, when federal officials at the ] (DEA) first drafted legislation, later proposed by Senator ], that would have placed several chemicals used in the manufacture of illicit drugs under the ]. The bill would have required each transaction involving pseudoephedrine to be reported to the government, and federal approval of all imports and exports. Fearing this would limit legitimate use of the drug, lobbyists from over the counter drug manufacturing associations sought to stop this legislation from moving forward and were successful in exempting from the regulations all chemicals that had been turned into a legal final product, such as Sudafed.<ref>{{cite news | url=http://www.oregonlive.com/special/oregonian/meth/stories/index.ssf?/oregonian/meth/1004_lobbyistsandloopholes.html | work=The Oregonian | title=Search OregonLive.com | access-date=13 December 2010 | archive-date=17 August 2016 | archive-url=https://web.archive.org/web/20160817002349/http://www.oregonlive.com/special/oregonian/meth/stories/index.ssf?%2Foregonian%2Fmeth%2F1004_lobbyistsandloopholes.html | url-status=dead }}</ref>
			Before the passage of the ], sales of the drug became increasingly regulated, as DEA regulators and pharmaceutical companies continued to fight for their respective positions. The DEA continued to make greater progress in their attempts to control pseudoephedrine as methamphetamine production skyrocketed, becoming a serious problem in the western United States. When purity dropped, so did the number of people in rehab and people admitted to emergency rooms with methamphetamine in their systems. This reduction in purity was usually short-lived, however, as methamphetamine producers eventually found a way around the new regulations.<ref>{{cite news |title=How Legislation Changed Meth Purity |url=http://www.oregonlive.com/special/oregonian/meth/pdfs/1004meth_purity.pdf |work=The Oregonian |access-date=13 December 2010 |archive-date=15 November 2011 |archive-url=https://web.archive.org/web/20111115100801/http://www.oregonlive.com/special/oregonian/meth/pdfs/1004meth_purity.pdf |url-status=dead }}</ref>
			Congress passed the Combat Methamphetamine Epidemic Act of 2005 (CMEA) as an amendment to the renewal of the ].<ref name="CMEA">{{cite web | title=CMEA (The Combat Methamphetamine Epidemic Act of 2005) | website=DEA Diversion Control Division | date=14 July 2017 | url=https://www.deadiversion.usdoj.gov/meth/ | access-date=17 February 2020 | archive-date=17 February 2020 | archive-url=https://web.archive.org/web/20200217213621/https://www.deadiversion.usdoj.gov/meth/ | url-status=live }} {{PD-notice}}</ref> Signed into law by President ] on 6 March 2006,<ref name="FDA legal" /> the act amended {{United States Code|21|830}}, concerning the sale of pseudoephedrine-containing products. The law mandated two phases, the first needing to be implemented by 8 April 2006, and the second to be completed by 30 September 2006. The first phase dealt primarily with implementing the new buying restrictions based on the amount, while the second phase encompassed the requirements of storage, employee training, and record keeping.<ref name="papharmacists.com">{{cite web|url=http://www.papharmacists.com/APhA%20Summary%20of%20Combat%20Meth%20Interim%20Final%20Rule.pdf |archive-url=https://web.archive.org/web/20061018011450/http://www.papharmacists.com/APhA%20Summary%20of%20Combat%20Meth%20Interim%20Final%20Rule.pdf |archive-date=18 October 2006 |title=DEA Interim Final Regulation: Ephedrine, Pseudoephedrine, and Phenylpropanolamine Requirements}}</ref> Though the law was mainly directed at pseudoephedrine products it also applies to all over-the-counter products containing ephedrine, pseudoephedrine, and phenylpropanolamine, their salts, optical isomers, and salts of optical isomers.<ref name="papharmacists.com"/>
			Pseudoephedrine was defined as a "]" under {{United States Code|21|802}}(45(A)). The act included the following requirements for merchants ("regulated sellers") who sell such products:
			* Required a retrievable record of all purchases, identifying the name and address of each party, to be kept for two years
			* Required verification of proof of identity of all purchasers
			* Required protection and disclosure methods in the collection of personal information
			* Required reports to the ] of any suspicious payments or disappearances of the regulated products
			* Required training of employees with regard to the requirements of the CMEA. Retailers must self-certify as to training and compliance.
			* The non-liquid dose form of regulated products may only be sold in unit dose blister packs
			* Regulated products must be stored behind the counter or in a locked cabinet in such a way as to restrict public access
			* Sales limits (per customer):
			** Daily sales limit—must not exceed 3.6&nbsp;grams of pseudoephedrine base without regard to the number of transactions
			** 30-day (not monthly) sales limit—must not exceed 7.5&nbsp;grams of pseudoephedrine base if sold by mail order or "mobile retail vendor"
			** 30-day purchase limit—must not exceed 9&nbsp;grams of pseudoephedrine base. (A misdemeanor possession offense under {{UnitedStatesCode|21|844a}} for the person who buys it.)
			The requirements were revised in the Methamphetamine Production Prevention Act of 2008 to require that a regulated seller of scheduled listed chemical products may not sell such a product unless the purchaser:<ref name="MPPA">{{cite web | title=2011 – Final Rule: Implementation of the Methamphetamine Production Prevention Act of 2008 | website=DEA Diversion Control Division | date=1 November 2011 | url=https://www.deadiversion.usdoj.gov/fed_regs/rules/2011/fr1201.htm | access-date=17 February 2020 | archive-date=17 February 2020 | archive-url=https://web.archive.org/web/20200217215202/https://www.deadiversion.usdoj.gov/fed_regs/rules/2011/fr1201.htm | url-status=dead }} {{PD-notice}}</ref>
			* Presents a government-issued photographic identification; and
			* Signs the written logbook with their name, address, and time and date of the sale
			=====State=====
			Most states also have laws regulating pseudoephedrine.<ref>{{cite web|url=http://www.namsdl.org/library/80BFE1EC-1C23-D4F9-7483559FA8ED0B56/|title=State Ephedrine and Pseudoephedrine Single Over-The-Counter Transaction Limits|year=2013|website=Namsdl.org|publisher=National Alliance for Model State Drug Laws (NAMSDL)|format=PDF|access-date=3 December 2016|archive-url=https://web.archive.org/web/20160414233801/http://www.namsdl.org/library/80BFE1EC-1C23-D4F9-7483559FA8ED0B56/|archive-date=14 April 2016}}</ref><ref>{{cite web|url=http://www.namsdl.org/library/80BA8CEC-1C23-D4F9-74BBEEA9C03FDF52/|title=State Daily Gram Limits for Over-The-Counter Transactions Involving Ephedrine and Pseudoephedrine|year=2013|website=Namsdl.org|publisher=National Alliance for Model State Drug Laws (NAMSDL)|format=PDF|access-date=3 December 2016|archive-url=https://web.archive.org/web/20160814033811/http://www.namsdl.org/library/80BA8CEC-1C23-D4F9-74BBEEA9C03FDF52/|archive-date=14 August 2016}}</ref><ref>{{cite web|url=http://www.namsdl.org/library/80B951FD-1C23-D4F9-74F6139A01DF427E/|title=State 30 Day Gram Limits for Over-The-Counter Transactions Involving Ephedrine and Pseudoephedrine|year=2013|website=Namsdl.org|publisher=National Alliance for Model State Drug Laws (NAMSDL)|format=PDF|access-date=3 December 2016|archive-url=https://web.archive.org/web/20160815114625/http://www.namsdl.org/library/80B951FD-1C23-D4F9-74F6139A01DF427E/|archive-date=15 August 2016}}</ref>
			The states of Alabama, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Hawaii ({{as of|2009|May|1|df=US|lc=on}}) Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana ({{as of|2009|August|15|df=US|lc=on}}), Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska,<ref>{{cite web |url=http://journalstar.com/news/local/govt-and-politics/article_52688a5f-85f6-5df1-abf5-b3eba060385b.html |title=Nebraskans to sign for Sudafed |publisher=Lincoln Journal-Star |date=13 March 2006 |access-date=20 August 2012 |archive-date=22 June 2018 |archive-url=https://web.archive.org/web/20180622005239/https://journalstar.com/news/local/govt-and-politics/article_52688a5f-85f6-5df1-abf5-b3eba060385b.html |url-status=live }}</ref> Nevada, New Jersey, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia and Wisconsin have laws requiring pharmacies to sell pseudoephedrine "behind the counter". Though the drug can be purchased without a prescription, states can limit the number of units sold and can collect personal information from purchasers.<ref name=NAMSDL>{{cite web|title = The National Alliance for Model State Drug Laws (NAMSDL) – Issues and Events|url = http://www.namsdl.org/issues-and-events.cfm|website = www.namsdl.org|access-date = 24 October 2015|archive-url = https://web.archive.org/web/20151003040953/http://www.namsdl.org/issues-and-events.cfm|archive-date = 3 October 2015|url-status = dead}}</ref>''
			The states of Oregon and Mississippi previously required a prescription for the purchase of products containing pseudoephedrine. However, as of 1 January 2022, these restrictions have been repealed.<ref>{{cite news|url=http://www.wlox.com/Global/story.asp?S=11919990|title=MS Senate passes bill to restrict pseudoephedrine sales|work=]|publisher=]|date=2 February 2010|access-date=8 May 2010|archive-url=https://web.archive.org/web/20110928133011/http://www.wlox.com/Global/story.asp?S=11919990|archive-date=28 September 2011|url-status=dead}}</ref><ref>{{cite news|url=https://www.nytimes.com/2010/11/16/opinion/16bovett.html|title=How to Kill the Meth Monster|work=]|date=15 November 2010|access-date=16 November 2010|vauthors=Bovett R|archive-date=1 May 2011|archive-url=https://web.archive.org/web/20110501000756/http://www.nytimes.com/2010/11/16/opinion/16bovett.html|url-status=live}}</ref> The state of Oregon reduced the number of methamphetamine lab seizures from <!-- 467 --> 448 in 2004 (the final full year before implementation of the prescription only law)<ref name = "OregonDEC">{{cite web | title = Oregon Meth Lab Incident Statistics | publisher = Oregon Alliance for Drug Endangered Children (OregonDEC)| url = http://www.oregondec.org/OregonMethLabStats.pdf | archive-url = https://web.archive.org/web/20120306044846/http://www.oregondec.org/OregonMethLabStats.pdf | archive-date = 6 March 2012 }}</ref> to a new low of <!-- 12 --> 13 in 2009.<ref name="justice.gov">{{cite web |url=https://www.justice.gov/dea/resource-center/meth-lab-maps.shtml |title=DEA, Maps of Methamphetamine Lab Incidents |publisher=Justice.gov |access-date=6 May 2012 |archive-url=https://web.archive.org/web/20120910081047/http://www.justice.gov/dea/resource-center/meth-lab-maps.shtml |archive-date=10 September 2012 |url-status=dead }}</ref> The decrease in ] incidents in Oregon occurred largely before the prescription-only law took effect, according to a NAMSDL report titled ''Pseudoephedrine Prescription Laws in Oregon and Mississippi''.<ref name=NAMSDL/> The report posits that the decline in meth lab incidents in both states may be due to other factors: "Mexican traffickers may have contributed to the decline in meth labs in Mississippi and Oregon (and surrounding states) as they were able to provide ample supply of equal or greater quality meth at competitive prices". Additionally, similar decreases in meth lab incidents were seen in surrounding states, according to the report, and meth-related deaths in Oregon have dramatically risen since 2007. Some municipalities in Missouri have enacted similar ordinances, including ],<ref>{{cite news|url=http://www.emissourian.com/news/washington_news/article_6aec84e6-f67e-5535-a4d9-9d8be4452a22.html|title=Council Passes Law Restricting Pseudoephedrine|publisher=]|date=7 July 2009|access-date=10 December 2010|archive-date=12 March 2012|archive-url=https://web.archive.org/web/20120312044706/http://www.emissourian.com/news/washington_news/article_6aec84e6-f67e-5535-a4d9-9d8be4452a22.html|url-status=live}}</ref> ],<ref>{{cite news|url=http://www.emissourian.com/news/washington_news/article_6aec84e6-f67e-5535-a4d9-9d8be4452a22.html|title=Union Board Approves Pseudoephedrine Ordinance|publisher=]|date=13 October 2009|access-date=10 December 2010|archive-date=12 March 2012|archive-url=https://web.archive.org/web/20120312044706/http://www.emissourian.com/news/washington_news/article_6aec84e6-f67e-5535-a4d9-9d8be4452a22.html|url-status=live}}</ref> ],<ref>{{cite news|url=http://www.emissourian.com/news/top_stories/article_776823c6-ee98-11df-b2bd-001cc4c03286.html|title=New Haven Passes Prescription Law|publisher=]|date=11 November 2010|access-date=10 December 2010|archive-date=12 March 2012|archive-url=https://web.archive.org/web/20120312050316/http://www.emissourian.com/news/top_stories/article_776823c6-ee98-11df-b2bd-001cc4c03286.html|url-status=live}}</ref> ]<ref>{{cite news|url=http://www.semissourian.com/story/1685849.html|title=Cape Girardeau City Council passes prescription requirement for pseudoephedrine|newspaper=]|date=7 December 2010|access-date=10 December 2010|archive-date=28 January 2011|archive-url=https://web.archive.org/web/20110128112206/http://www.semissourian.com/story/1685849.html|url-status=dead}}</ref> and ].<ref>{{cite news |url=http://ccheadliner.com/news/ozark-passes-pseudoephedrine-ban/article_4d163742-d83e-11e2-9158-0019bb2963f4.html |url-access=subscription |newspaper=CCHeadliner.com |title=Ozark passes pseudoephedrine ban: Drug now prescription-only |date=18 June 2013 |access-date=17 December 2013 |archive-date=24 February 2021 |archive-url=https://web.archive.org/web/20210224220706/https://ccheadliner.com/news/ozark-passes-pseudoephedrine-ban/article_4d163742-d83e-11e2-9158-0019bb2963f4.html |url-status=live }}</ref> Certain pharmacies in ] do so as well.<ref>{{cite news |url=http://tribstar.com/news/x1414109043/Four-Valley-pharmacies-to-require-prescriptions-for-certain-products-to-help-fight-meth-problem |title=Four Valley pharmacies to require prescriptions for certain products to help fight meth problem |work=Terre Haute Tribune-Star |vauthors=Trigg L |date=20 May 2010 |access-date=28 May 2010 |archive-date=24 May 2010 |archive-url=https://web.archive.org/web/20100524120248/http://tribstar.com/news/x1414109043/Four-Valley-pharmacies-to-require-prescriptions-for-certain-products-to-help-fight-meth-problem |url-status=live }} {{link note|note=Subscription required, free access for first 30 days}}</ref>
			Another approach to controlling the drug on the state level mandated by some state governments to control the purchases of their citizens is the use of electronic tracking systems, which require the electronic submission of specified purchaser information by all retailers who sell pseudoephedrine. Thirty-two states now require the ] (NPLEx) to be used for every pseudoephedrine and ephedrine OTC purchase, and ten of the eleven largest pharmacy chains in the US voluntarily contribute all of their similar transactions to NPLEx. These states have seen dramatic results in reducing the number of methamphetamine laboratory seizures. Before the implementation of the system in Tennessee in 2005, methamphetamine laboratory seizures totaled 1,497 in 2004 but were reduced to 955 in 2005, and 589 in 2009.<ref name="justice.gov"/> Kentucky's program was implemented statewide in 2008, and since statewide implementation, the number of laboratory seizures has significantly decreased.<ref name="justice.gov"/> Oklahoma initially experienced success with its tracking system after implementation in 2006, as the number of seizures dropped in that year and again in 2007. In 2008, however, seizures began rising again, and have continued to rise in 2009.<ref name="justice.gov"/>
			NPLEx appears to be successful by requiring the real-time submission of transactions, thereby enabling the relevant laws to be enforced at the point of sale. By creating a multi-state database and the ability to compare all transactions quickly, NPLEx enables pharmacies to deny purchases that would be illegal based on gram limits, age, or even to convicted meth offenders in some states. NPLEx also enforces the federal gram limits across state lines, which was impossible with state-operated systems. Access to the records is by law enforcement agencies only, through an online secure portal.<ref>{{cite web|title = NPLEx – National Precursor Log Exchange|url = http://www.nplexservice.com/|website = www.nplexservice.com|access-date = 24 October 2015|archive-date = 12 October 2015|archive-url = https://web.archive.org/web/20151012235950/http://www.nplexservice.com/|url-status = live}}</ref>
			==Research==
			Pseudoephedrine has been studied in the treatment of ].<ref name="AchuthanMedhi2015">{{cite journal | vauthors = Achuthan S, Medhi B | title = A systematic review of the pharmacological approaches against snoring: can we count on the chickens that have hatched? | journal = Sleep Breath | volume = 19 | issue = 3 | pages = 1035–1042 | date = September 2015 | pmid = 25680547 | doi = 10.1007/s11325-015-1123-0 | url = }}</ref> However, data are inadequate to support this use.<ref name="AchuthanMedhi2015" />
			A study has found that pseudoephedrine can reduce ] in ] women.<ref name="TrimeloniSpencer2016">{{cite journal | vauthors = Trimeloni L, Spencer J | title = Diagnosis and Management of Breast Milk Oversupply | journal = J Am Board Fam Med | volume = 29 | issue = 1 | pages = 139–142 | date = 2016 | pmid = 26769886 | doi = 10.3122/jabfm.2016.01.150164 | url = }}</ref><ref name="AljazafHaleIlett2003">{{cite journal | vauthors = Aljazaf K, Hale TW, Ilett KF, Hartmann PE, Mitoulas LR, Kristensen JH, Hackett LP | title = Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk | journal = British Journal of Clinical Pharmacology | volume = 56 | issue = 1 | pages = 18–24 | date = July 2003 | pmid = 12848771 | pmc = 1884328 | doi = 10.1046/j.1365-2125.2003.01822.x }}</ref> This might have been due to suppression of ] ].<ref name="AljazafHaleIlett2003" /> Pseudoephedrine might be useful for ].<ref name="TrimeloniSpencer2016" /><ref name="AljazafHaleIlett2003" />
			==References==
			{{Reflist}}
			{{Nasal preparations}}
			{{Cardiac stimulants excluding cardiac glycosides}}
			{{Stimulants}}
			{{Monoamine releasing agents}}
			{{Phenethylamines}}
			{{Portal bar | Medicine}}
			{{Authority control}}
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