Pseudoephedrine hydrochloride
Pseudoephedrine has been around since the 1920s. Although the drug occurs naturally in certain plants (eg, ma huang), the majority that is produced derives from yeast fermentation of dextrose in the presence of benzaldehyde. Pharmaceutical manufacturers in China and India produce the bulk of commercially available pseudoephedrine.
MECHANISM OF ACTION
Pseudoephedrine is a sympathomimetic drug belonging to the phenethylamine and amphetamine chemical classes. Its principal mechanism of action depends on its effects on the adrenergic receptor system, causing vasoconstriction. Pseudoephedrine hydrochloride and its sulfate salts are found in an abundance of over-the-counter medications, either as a single ingredient or in combination with other ingredients, such as anti- histamines, acetaminophen, guaifenesin, nonsteroidal anti-inflammatory drugs, and dextromethorphan.1
INDICATIONS
The most common indication for pseudoephedrine is as a decongestant, for conditions including nasal congestion, sinus congestion, and eustachian tube congestion, as it shrinks swollen nasal mucous membranes and reduces tissue hyperemia and edema.2 Other uses include vasomotor rhinitis, first-line treatment for priapism, and off-label use for hyperprolactinemia, while veterinarians often use pseudoephedrine off-label to treat incontinence in dogs and cats.2 In conjunction with other medications, pseudoephedrine is often used to treat allergic rhinitis, croup, sinusitis, otitis media, and tracheobronchitis.1