Side Effects of Sudafed (pseudoephedrine)

Sudafed (pseudoephedrine) is a decongestant used to reduce nasal congestion caused by allergies or the common cold. Sudafed causes blood vessels in the nasal passages to shrink (vasoconstrict).

Vasoconstriction reduces nasal congestion by preventing fluid from draining from blood vessels into nasal passages. Sudafed also directly stimulates beta-adrenergic receptors and causes relaxation of bronchioles, as well as increased heart rate and contractility. Sudafed is available over-the-counter (OTC) and as a generic. 

Common side effects of Sudafed include

• tremor,
• restlessness,
• insomnia,
• nausea,
• vomiting, and
• nervousness.

Serious side effects of Sudafed include

• high blood pressure (hypertension),
• heart attack,
• abnormal heartbeats, and
• ischemic colitis.

Drug interactions of Sudafed include monoamine oxidase inhibitors (MAOIs) because such combinations may cause an acute hypertensive episode.

Use of Sudafed by pregnant women has not been adequately evaluated. Sudafed is secreted in breast milk. However, it is considered safe to use while breastfeeding.

Common side effects of pseudoephedrine include:

• Tremor
• Restlessness
• Insomnia
• Nausea
• Vomiting
• Nervousness
• Possible serious side effects of pseudoephedrine include:
• High blood pressure
• Heart attack
• Abnormal heartbeats
• Ischemic colitis

Pseudoephedrine should not be used by people with severe hypertension or coronary artery disease.

It should be used with caution in people with

• mild to moderate hypertension,
• cardiac disease,
• hyperthyroidism,
• hyperglycemia,
• benign prostatic hyperplasia,
• diabetes mellitus,
• kidney problems,
• seizure disorder, and
• glaucoma.

Common side effects of Sudafed include

• nervousness,
• restlessness or excitability (especially in children),
• dizziness,
• headache,
• fear,
• anxiety,
• loss of appetite,
• sleep problems (insomnia),
• skin rash,
• itching,
• tremors,
• hallucinations,
• convulsions (seizures),
• nausea,
• vomiting, and
• flushing (warmth, tingling, or redness under your skin).

Sudafed drug interactions include

• monoamine oxidase inhibitors or MAOIs (for example, isocarboxazid [Marplan]),
• serotonin and norepinephrine reuptake inhibitors (for example, venlafaxine [Effexor]),
• bronchodilators (for example, albuterol [Proventil]),
• blood pressure medications (such as beta blockers [Atenolol]) and
• calcium channel blockers [for example, verapamil]).