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What Is the Difference between Phenylephrine and Pseudoephedrine?

Phenylephrine and pseudoephedrine are decongestants available over-the-counter for allergy and cold treatments.
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  • Written By: Christian Petersen
  • Edited By: Susan Barwick
  • Last Modified Date: 08 November 2014
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Phenylephrine and pseudoephedrine are both decongestants and can both be found in many over-the-counter formulations marketed as treatments for cold and allergy symptoms. They are significantly different, however, in many respects. Pseudoephedrine is derived from a naturally occurring substance, ephedra, which is found in many plant species. It is also a stimulant of the amphetamine class. Phenylephrine is a synthetic chemical used to increase blood pressure and as a detumescent.

On a molecular level, these decongestants differ significantly. Pseudoephedrine has a chemical formula of C10H15NO, while phenylephrine has a chemical formula of C9H13NO2. Unlike pseudoephedrine, phenylephrine is quickly metabolized by a common gastrointestinal enzyme. This means that the bioavailability, or the amount of a substance taken into the body that is actually absorbed and has an effect, is only 38% for phenylephrine, compared to 100% for pseudoephedrine.

Phenylephrine and pseudoephedrine, while both used as nasal decongestants, are in different chemical classes. As an amphetamine, pseudoephedrine is a stimulant that acts to release adrenaline and is easily converted to methamphetamine, a potentially dangerous stimulant that is often used illicitly. Phenylephrine does not have this effect and cannot be used to manufacture methamphetamine. It is often used as an alternative decongestant for this reason. It does boost blood pressure, however, but without the stimulant effects of the other drug.

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The drugs are also used differently. Pseudoephedrine, in addition to its use as a nasal and sinus decongestant, may also be used for reducing congestion of the eustachian tubes and for helping to suppress coughs. It is also used as a stimulant and as an ingredient in many weight-loss pills.

In addition to acting as a nasal decongestant, phenylephrine can be used to boost blood pressure without increasing heart rate. This gives it an advantage in this respect as pseudoephedrine will increase heart rate, sometimes dramatically. Phenylephrine is also sometimes used to dilate pupils, which makes it useful for some types of eye examinations. It is sometimes used to treat priapism as well.

These drugs also have different side effects. Phenylephrine has fewer possible side effects and is much less likely to cause hypertension, anxiety, sleeplessness, or heart palpitations. Pseudoephedrine is not recommended for people with several health conditions including diabetes, certain types of glaucoma, heart conditions, and pregnancy. Its possible use in manufacture of methamphetamine has also resulted in its sale and use being regulated by law in many countries. It is also listed as a banned substance by many sports organizations.

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Magpie52
Post 3

I am glad that pseudoephedrine is available over the counter in Canada, because phenylephrine is useless for controlling nasal rhinitis. This is not merely anecdotal. Two studies published in 2009 were unable to distinguish between the effects of phenylephrine or a placebo, whereas the effects of pseudoephedrine were significant.

EdRick
Post 2

@Kat919 - I actually got tricked by that! I bought a medicine that I had bought before and it didn't work as well for me because they had changed out the decongestant. Now I know to go the counter.

But apparently phenylephrine vs pseudophedrine is a personal choice. My sister really likes the new formulations because pseudophedrine makes her feel kind of wired, while the phenylephrine does not.

Kat919
Post 1

For consumers, the most important difference may be where you buy them! By law in the US, all medicines containing pseudophedrine are kept behind the pharmacy counter (meaning you can only get it when the pharmacy part of the store is open) and there may be certain other hoops to jump through; I think you have to show ID, sign your name, etc. It does not, however, require a prescription; the idea is just to make it harder to get so as to, in theory, keep people from using it to make meth. Probably it actually inconveniences regular people more!

Phenylephrine had largely disappeared from over-the-counter medicines until the new law. Now it is often found in combination medicines especially so that they can be sold on the store shelves.

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