Pseudoephedrine vs. Phenylephrine

Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

It can be hard to choose the right medication when you are sick. In this lesson, we will compare two commonly used medications - pseudoephedrine and phenylephrine.

Cold and Flu Season

You recognize that time of year, typically starting in fall and going through the winter season. During this time, cold and flu viruses are rampant. Viruses are not treated with antibiotics, so you need a way to manage the symptoms as best you can until your body fights off the virus.

Let's look at Melissa and Chase. Melissa suddenly became struck with a virus. She felt a little achy and within a few hours she had a severe headache, stuffy nose, and low-grade fever. Chase has been fighting a cold for over a week. He is feeling better overall, but he still has a stuffy nose and congestion. So, Melissa and Chase talk with their local pharmacist to see what they could take to help with their symptoms.

How Can I Relieve Nasal Congestion?

The pharmacist discusses two medications that are used to treat nasal congestion. Pseudoephedrine and phenylephrine are both over-the-counter medications effective for treating nasal congestion.

If you've ever visited the cold and flu aisle in your pharmacy, you know there is an overabundance of products. It's important to look at the ingredients of what you choose since many combination products include the same ingredients. While a particular ingredient may work well, more is not better and you want to avoid consuming too much of a particular medication.

Pseudoephedrine is found in Sudafed products, Theraflu, and Tylenol Cold combinations, as well as many others. Phenylephrine is found in Sudafed products as well. Although both are used for nasal congestion, you should only use one. They both work by constricting the blood vessels in the nasal passages. When these blood vessels are dilated, it results in a stuffy nose.

So, how will Melissa and Chase determine which product is best for them?

Comparing Pseudoephedrine and Phenylephrine

We already mentioned that both of these medications are available at your local drug or grocery store and are effective for relieving nasal congestion. They are both available in generic form and come in tablets for oral use. The tablets can be used for up to seven days in a row. So how do they differ?

Phenylephrine is available in a nasal spray that can be used for up to three days in a row. It has fewer side effects compared to pseudoephedrine and it doesn't have a potential for being misused.

Pseudoephedrine is an ingredient used in making illegal methamphetamine. Therefore, even though it does not require a prescription, you will have to present identification to the pharmacist in order to purchase it. It does not come in a nasal spray but it does come in extended-release tablets as well (extended-release tablets allow you to take it less often). Pseudoephedrine does have more side effects that can increase your blood pressure and heart rate.

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