Because they contain pseudoephedrine, vasoconstrictor drugs can cause heart attacks and strokes.
Present in several medications, particularly to relieve cold symptoms, pseudoephedrine is not without risks. So much so that in October 2023, theANSM has It is not recommended to use cold medications containing it. “Of the heart attack of the myocardium and stroke can occur after medication use vasoconstrictors (pseudoephedrine) intended to relieve cold symptoms. The risk is very low but these events can occur whatever the dose and duration of treatment” explained the medicines agency.
Definition: what is pseudoephedrine?
Pseudoephedrine is a vasoconstrictor, that is to say a substance reducing the diameter of blood vessels employed for unblock the nose. It can be administered orally and always associated with paracetamol or ibuprofen to relieve symptoms such as headache and fever. Its use is exclusively reserved for adults and children over 15 years old.
In which medications?
In combination with paracetamol or ibuprofen, pseudoephedrine is present in the following medications:
- Active cold®
- Actifed cold day and night®
- Dolirhume®
- Dolirhumepro Paracetamol Pseudoephedrine and Doxylamine®
- Humex Cold®
- Nurofen Cold®
- Rhinadvil Cold Ibuprofen/ Pseudoephedrine®
- Rhinadvilcaps Cold Ibuprofen/ Pseudoephedrine®
What are the effects of pseudoephedrine?
Pseudoephedrine induces a narrowing of blood vessels to curb mucus production at the level of the nasal mucosa. This allows to relieve the feeling of stuffy nose in the context of a cold or flu. This molecule is therefore qualified as both vasoconstrictor and decongestant.
Is it available without a prescription?
All medications containing pseudoephedrine are available in pharmacy without prescription. Please note that if prescribed by a doctor, they are not subject to‘no refund by Health Insurance.
What is the maximum dose?
According to commercial specialties, pseudoephedrine is dosed at 30 mg or 60 mg per tablet can be administered at a rate ofone to two per dose. Knowing that these tablets should not be taken more than 3 times a day, the maximum daily dose of pseudoephedrine is set at 180 mg. The maximum duration of treatment is 4 to 5 days. If symptoms do not improve, a medical consultation is necessary.
What are the dangers of pseudoephedrine?
The most common side effects observed with pseudoephedrine are:
- a dry mouth,
- nausea,
- dizziness,
- nervousness,
- a commotion
- insomnia
- of the headache,
- hallucinations,
- a drowsiness
- seizures are possible.
Of the rashes, itching, allergies or even exceptionally anaphylactic shock were also listed. This molecule can cause inflammation of the colon by reduction in blood supply, narrow-angle glaucoma and optic nerve damage.
Pseudoephedrine-based medications also cause cardiovascular adverse effects such as high blood pressure, heart palpitations. Other rare, but much more severe, manifestations may occur: myocardial infarction, transient ischemic attack (transient obstruction of a blood vessel by a clot) or even a hemorrhagic stroke leading to necrosis of the affected area. These phenomena have mainly been reported in cases of overdose. In order to limit the occurrence of adverse effects, the medication must be started at the minimum effective dose and for the shortest possible period. Moreover, vigilance is required in certain athletes since pseudoephedrine is on the list of substances banned in competition.
What are the contraindications of pseudoephedrine?
Pseudoephedrine has many contraindications:
- allergy to one of the components of the medicine
- risk of urinary retention
- risk of glaucoma closed angle
- severe coronary insufficiency
- high blood pressure severe or unbalanced
- history of seizures
- history of stroke or presence of risk factors that could be responsible for a stroke
- child under 15 years old
- feeding with milk
In addition, pseudoephedrine is formally contraindicated in association with certain medications, like other vasoconstrictors (oral and nasal), midodrine (Gutron®), methyphenidate (Ritaline®), iproniazid (Marsilid®). It is recommended to communicate your medical history and current treatments to your doctor or pharmacist before taking pseudoephedrine. Pseudoephedrine-based medications are not contraindicated during pregnancy but very strongly not recommended.