Advil Cold and Sinus

Brand Name:Contact Cold 12 Hour Relief Non-Drowsy, Eltor 120, Sudafed Decongestant 12 Hour, Robitussin (combined with Dextromethorphan (DM)), Sudafed Decongestant, Nasal Decongestant, Allegra-D (combined with Fexofenadine), Benadryl Total, Tylenol Sinus, Sinutab(combined with Chlorpheniramine), Reactine Allergy and Sinus (combined with Cetirizine), Liberator (combined with Loratadine/Desloratadine) , Trinalin (combined with Azatadine)

Prescription needed: Yes, In Some Cases

What is this drug used for?

Pseudoephedrine is a common nasal and sinus decongestant that is found in many over-the-counter and prescription allergy and cold and flu remedies. It also helps reduce the congestion associated with middle ear infections.

Is there any reason not to take this drug?

You should not take this drug if you have a known allergy to pseudoephedrine.

If you ever experienced a feeling of anxiety, nervousness, tremors, sensation of “racing heart” to certain medications (e.g. salbutamol, amphetamines, ephedrine, epinephrine, isoproterenol, norepinephrine, phenylephrine, phenylpropanolamine, or terbutaline) you may be sensitive to the side effects of pseudoephedrine.

Always disclose your full medical history with the medical team that is taking care of you, in order for them to provide you with the safest and most effective care.

Tell your doctor if you have or have ever had:

  • diabetes
  • glaucoma
  • heart, prostate or thyroid problems
  • high blood pressure
  • urinary retention

What about possible side effects?

The most common side effects are:

  • nervousness
  • restlessness
  • trouble sleeping

Other less common side effects include:

  • difficult or painful urination
  • dizziness or lightheadedness
  • headache
  • increased sweating
  • nausea
  • pale skin
  • rapid or pounding heartbeat
  • trembling
  • vomiting
  • weakness
  • drowsiness

These side effects are usually related to dose, the use of other medications and other factors (e.g. older age, other medical conditions). As well, some of these side effects may go away with time. Talk to your doctor or pharmacist about whether you have any risk factors that may make you more sensitive to these side effects. Contact your doctor if these symptoms continue or become worse.If you experience any of these rare side effects (usually associated with high doses of pseudoephedrine), stop taking pseudoephedrine and call your doctor:

  • hallucinations
  • irregular or slow heartbeat
  • seizures
  • trouble breathing

If you experience any of the following symptoms, you may be allergic to pseudoephedrine – stop taking right away and seek emergency medical attention:

  • swelling of the face, throat or tongue
  • an itchy skin reaction combined with redness and hives
  • any skin reaction involving a large area of the body
  • severe dizziness or fainting
  • shortness of breath, difficulty breathing or wheezing
  • sensation of choking

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as these are the most common interactions and he/she may need to make changes or monitor you more closely:

  • drugs that control your blood pressure or control heart rate (e.g. atenolol, acebutolol, bisoprolol, water pills, ramipril, amlodipine, nifedipine, verapamil, diltiazem, doxazosin, valsartan, irbesartan, cilazapril, benazapril, methyldopa, reserpine, among others) – pseudoephedrine has been shown to raise blood pressure and increase heart rate - may interfere with your heart medication and ability to lower blood pressure or regulate your heart rate
  • Other cough and cold or allergy drugs, prescription and non-prescription – these other products may contain pseudoephedrine as well, resulting in a double dose – check labels and ask your pharmacist
  • Thioridazine, chlorpromazine – rare risk of causing heart problems
  • Sleep medications (e.g. zopiclone, lorazepam, trazodone, temazepam, nitrazepam, oxazepam) – taking pseudoephedrine at the same time may decrease how well these drugs help you get to sleep
  • Cocaine—May raise the risk of heart problems and other side effects
  • salbutamol, amphetamines, ephedrine, epinephrine, norepinephrine, phenylephrine, phenylpropanolamine, terbutaline, theophylline, caffeine – these drugs may increase the risk of side effects from pseudoephedrine
  • herbs including ephedra, ma huang, yohimbe – may increase risks of side effects from pseudoephedrine
  • Monoamine oxidase inhibitors (MAOIs) e.g. phenelzine (brand name Nardil), tranylcypromine (brand name Parnate), moclobemide (brand name Manerix, generics available) isocarboxazid (available in the U.S.A. under the brand name Marplan) – do not take pseudoephedrine while taking an MAOI or until 14 days after stopping an MAOI – risk of serious side effects, including a sharp rise blood pressure.

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

Special Instructions:

Pseudoephedrine should not be taken for longer than 7 days unless recommended by your doctor.

If your symptoms include a fever, you may have a more serious infection – see your doctor.

Long acting formulations (e.g. Entex LA, Eltor 120) should be swallowed as a whole tablet, not crushed or chewed.

Pseudoephedrine may increase blood pressure and race the heart, risks of these side effects increase if you are taking interacting drugs or if you already have a heart condition. Be aware of the Warning Signs of a heart attack or stroke.

Children: Not recommended for those under the age of 2 – for these younger children, consider instead using saline drops to soften dry nasal secretions, a cool-mist humidifier only using water, or a suction bulb to remove nasal secretions (available at your pharmacy)For older children, a lower dose is necessary.

Seniors: May be more sensitive to side effects. Higher risks because elderly are more likely to have heart problems, diabetes or taking other drugs. If used, lower doses may be necessary. For first time use, try a formulation that is NOT long acting to assess tolerability, otherwise side effects may be prolonged.

Pregnancy: Safety not established. Talk to your doctor.

Women who are nursing: This drug passes into breast milk in small amounts and may decrease milk production. While generally considered safe for breastfeeding, consider other options. Talk to your doctor.

People who drive or operate machinery: Should not do so until they know how this drug affects them personally. Pseudoephedrine may cause dizziness, drowsiness, trembling, or nervousness

Alcohol: If you drink, always drink in moderation.

Overdose: A large overdose of this medicine could cause serious side effects, including hallucinations, seizures or loss of consciousness. If you experience any unusual reactions or if you seriously exceed the recommended dosage, call your doctor or 911.

Stopping the drug: Can be safely stopped when no longer required.

If you miss a dose: Take it as soon as you remember, skip the next scheduled dose then continue taking as prescribed/directed. Never take a double dose.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom) and light; always out of reach of children.

Dietary precautions: None unless recommended by your doctor.