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Pseudoephedrine is a sympathomimetic drug of the phenethylamine and amphetamine chemical classes. It may be used as a nasal/sinus decongestant, as a stimulant, or as a wakefulness-promoting agent in higher doses.

Pseudoephedrine is closely related in structure to methamphetamine, although its CNS actions are much less potent and also longer-lasting than those of the amphetamines. Its peripheral stimulant actions are similar to but less powerful than those of epinephrine (adrenaline), a hormone produced in the body by the adrenal glands.

History and culture

Pseudoephedrine naturally occurs in the plant Ephedra, which contains both Talk:Ephedrine and Pseudoephedrine. Pseudoephedrine is used over-the-counter as a nasal decongestant, which is usually combined with other medications such as NSAID's, acetaminophen, dextromethorphan, guaifenesin and various antihistamines. Pseudoephedrine is used as a precursor to methamphetamine, and is commonly referred to as "pseudo". Because of this, pseudoephedrine is heavily regulated in most parts of the world, either being stored behind the counter, available only by prescription, or banned entirely.

There have been reports of off-label uses of pseudoephedrine for its stimulant properties. Long-distance truck drivers and athletes, for example, have reportedly used pseudoephedrine as a stimulant to increase their state of alertness/awareness.

Chemistry

Pseudoephedrine is a substituted amphetamine and a structural methamphetamine analogue. Pseudoephedrine is a diastereomer of ephedrine and is readily reduced into methamphetamine or oxidized into methcathinone.

The dextrorotary (+)- or d- enantiomer is (1S,2S)-pseudoephedrine, whereas the levorotating (−)- or l- form is (1R,2R)-pseudoephedrine.

In the outdated d/l system (+)-pseudoephedrine is also referred to as l-pseudoephedrine and (−)-pseudoephedrine as d-pseudoephedrine.

Often the d/l system (with small caps) and the d/l system (with lower-case) are confused. The result is that the dextrorotary d-pseudoephedrine is wrongly named d-pseudoephedrine and the levorotary l-ephedrine (the diastereomer) wrongly l-ephedrine.

The IUPAC names of the two enantiomers are (1S,2S)- respectively (1R,2R)-2-methylamino-1-phenylpropan-1-ol. Synonyms for both are psi-ephedrine and threo-ephedrine.

Pseudoephedrine is the International Nonproprietary Name of the (+)-form, when used as pharmaceutical substance.

Pharmacology

Pseudoephedrine is a sympathomimetic amine with a mixed mechanism of action, both direct and indirect. It indirectly stimulates alpha-adrenergic receptors, prompting the release of endogenous norepinephrine from the granularity of neurons. It also directly stimulates beta-adrenergic receptors. It increases catecholamine activity at alpha, beta-1, and beta-2 adrenergic receptors.

It is very similar to ephedrine but notably weaker, and it has a lower ability to cause tachycardia and increase systolic blood pressure. Its central effect is weaker than that of amphetamine, while its peripheral effect is similar to that of epinephrine (adrenaline).

Subjective effects

Effect::Stimulation - Pseudoephedrine is reported to be mildly stimulating in moderate to high doses. This stimulation is reported to be weaker than other stimulants like amphetamine and methylphenidate, but stronger than caffeine or nicotine.
Effect::Bronchodilation
Effect::Appetite suppression
Effect::Stamina enhancement
Effect::Physical euphoria - Pseudoephedrine is capable of producing mild physical euphoria. This effect is reported to be slightly stronger than caffeine in non-tolerant users, but significantly weaker than other stimulants such as amphetamine.
Effect::Nausea - At high doses pseudoephedrine is reported to cause nausea.
Effect::Dry mouth
Vasoconstriction - This effect is pronounced with pseudoephedrine, and its primary therapeutic use is constricting inflamed blood vessels in the nasal passages.

Pseudoephedrine is commonly described as having a stimulating headspace. The cognitive effects of pseudoephedrine are usually somewhat weak, except at strong and heavy doses. It should also be noted that anxiety and negative adrenaline-related effects increase proportional to dose.

Effect::Cognitive euphoria - Pseudoephedrine is reported to produce mild cognitive euphoria stronger than that of caffeine but significantly weaker than other stimulants such as amphetamine.
Effect::Anxiety
Effect::Focus enhancement
Effect::Memory enhancement
Effect::Thought acceleration
Effect::Increased music appreciation
Effect::Ego inflation

The effects which occur during the offset of a stimulant experience generally feel negative and uncomfortable in comparison to the effects which occurred during its peak. This is often referred to as a "comedown" and occurs because of neurotransmitter depletion. Its effects commonly include:

Effect::Anxiety
Effect::Appetite suppression
Effect::Cognitive fatigue
Effect::Depression
Effect::Irritability
Effect::Motivation suppression
Effect::Thought deceleration
Effect::Wakefulness - The insomnia following a repeated series of pseudoephedrine doses can last for longer than a day in some users.

Experience reports

There are currently no anecdotal reports which describe the effects of this compound within our experience index. Additional experience reports can be found here:

Erowid Experience Vaults: Pseudoephedrine

Toxicity and harm potential

It is strongly recommended that one use harm reduction practices when using this substance.

Lethal dosage

The oral median lethal dose of pseudoephedrine hydrochloride in rats was 1674 mg/kg.

Tolerance and addiction potential

As with other stimulants, the chronic use of pseudoephedrine can be considered moderately addictive and is capable of causing psychological dependence among certain users.

Tolerance to the effects of pseudoephedrine are quickly built after repeated and frequent usage. Pseudoephedrine presents cross-tolerance with other dopaminergic stimulants, meaning that after the consumption of pseudoephedrine, most other stimulant compounds will have a reduced effect.

Dangerous interactions

Legal status

Australia - Pseudoephedrine is federally regulated as a schedule 3 (Pharmacist Only) medication.
Mexico - Pseudoephedrine was made illicit due to the popularity of use as a precursor in the synthesis of methamphetamine.
Canada - Products whose only active ingredient is pseudoephedrine must be kept behind the pharmacy counter. Products containing pseudoephedrine along with other active ingredients may be displayed on store shelves but may be sold only in a pharmacy when a pharmacist is present. Products containing both pseudoephedrine and caffeine are banned.
Colombia - The Colombian government prohibited the trade of pseudoephedrine in 2010.
Japan - Medications that contain more than 10% pseudoephedrine are prohibited under the Stimulants Control Law in Japan.
Netherlands - Pseudoephedrine was withdrawn from sale in 1989 due to concerns about adverse cardiac side effects.
New Zealand - Pseudoephedrine is currently classified as a Class B Part II controlled drug in the Misuse of Drugs Act 1975, making it illegal to supply or possess except on prescription.
Turkey - Medications containing pseudoephedrine are available with prescription only.
United Kingdom - Pseudoephedrine is available over the counter under the supervision of a qualified pharmacist, or on prescription. In 2007, the MHRA reacted to concerns over diversion of ephedrine and pseudoephedrine for the illicit manufacture of methamphetamine by introducing voluntary restrictions limiting over the counter sales to one box containing no more than 720 mg of pseudoephedrine in total per transaction.
United States - Pseudophedrine is federally regulated due to its use in the illicit production of methamphetamine. Most states require pseudoephedrine to be sold "behind the counter" and limit the number of units that can be sold. The states of Oregon and Mississippi previously required a prescription for the purchase of products containing pseudoephedrine, but as of January 1, 2022, these restrictions have been repealed.

External links

References

Discussion