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{{SummarySheet}}
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{{SubstanceBox/Pseudoephedrine}}
{{SubstanceBox/Pseudoephedrine}}
'''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''' (also known as '''pseudo''') 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-acting 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.
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]], a [[hormone]] produced in the body by the adrenal glands.
==History and culture==
==History and culture==
{{historyStub}}
{{historyStub}}
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, or completely banned.
Pseudoephedrine naturally occurs in the plant Ephedra, which contains both [[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 both [[methamphetamine]] and [[methcathinone]].{{citation needed}} 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.{{citation needed}}
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 and awareness.
==Chemistry==
==Chemistry==
{{chemistry}}
{{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]].
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 (1''S'',2''S'')-pseudoephedrine, whereas the levorotating (−)- or l- form is (1''R'',2''R'')-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 (1''S'',2''S'')- respectively (1''R'',2''R'')-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==
==Pharmacology==
{{pharmacology}}
{{pharmacology}}
Pseudoephedrine primary mechanism of action is through increasing catecholamine activity at alpha, beta-1, and beta-2 [[adrenergic]] [[receptor]]s.
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]] [[receptor]]s.
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]].
==Subjective effects==
==Subjective effects==
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|{{effects/physical|
|{{effects/physical|
*'''[[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::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::Sedation]]''' - At high to excessively high doses, pseudoephedrine may cause drowsiness.
*'''[[Effect::Bronchodilation]]'''
*'''[[Effect::Bronchodilation]]'''
*'''[[Effect::Compulsive redosing]]'''
*'''[[Effect::Appetite suppression]]'''
*'''[[Effect::Appetite suppression]]'''
*'''[[Effect::Stamina enhancement]]'''
*'''[[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::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::Nausea]]''' - At high doses pseudoephedrine is reported to cause nausea.
*'''[[Effect::Dry mouth]]'''
*'''[[Effect::Dry mouth]]'''
*'''[[Vasoconstriction]]'''
*'''[[Vasoconstriction]]''' - This effect is pronounced with pseudoephedrine, and its primary therapeutic use is constricting inflamed blood vessels in the nasal passages.
*'''[[Effect::Pupil dilation]]''' - Pupil dilation is normally only experienced at excessively high doses.
}}
}}
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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.
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]]''' - Pseduoephedrine is reported to produce mild cognitive euphoria stronger than that of [[caffeine]] but significantly weaker than other stimulants such as [[amphetamine]].
*'''[[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::Anxiety]]'''
*'''[[Effect::Focus enhancement]]'''
*'''[[Effect::Focus enhancement]]'''
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*'''[[Effect::Motivation suppression]]'''
*'''[[Effect::Motivation suppression]]'''
*'''[[Effect::Thought deceleration]]'''
*'''[[Effect::Thought deceleration]]'''
*'''[[Effect::Wakefulness]]''' - The insomnia following a repeated series of pseudoephedrine doses can last for longer than a day in some users.
*'''[[Effect::Wakefulness]]''' - The [[insomnia]] following a repeated series of pseudoephedrine doses can last for longer than a day in some users.
It is strongly recommended that one use [[responsible use|harm reduction practices]] when using this substance.
===Lethal dosage===
===Lethal dosage===
The oral median lethal dose of pseudoephedrine hydrochloride in rats was 1674 mg/kg.{{citation needed}}
===Tolerance and addiction potential===
===Tolerance and addiction potential===
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==Legal status==
==Legal status==
{{LegalStub}}
In the early 2000s many countries started putting pseudoephedrine behind the counter, requiring prescriptions or outright banning it, due to its common usage as a precursor in the production of illicit [[methamphetamine]].{{citation needed}}
*'''Australia''' - Pseudoephedrine is federally regulated as a schedule 3 (Pharmacist Only) medication
*'''Australia''' - Pseudoephedrine in amounts in or under 800mg (liquid form) or 720mg, falls under schedule 3 (Pharmacist Only), otherwise under schedule 4 (Prescription only).<ref>https://www.legislation.gov.au/Details/F2023L01294</ref>
*'''Mexico''' - Pseudoephedrine was made illicit due to the popularity of use as a precursor in the synthesis of methamphetamine.
*'''Mexico''' - Pseudoephedrine was made illicit due to the popularity of use as a precursor in the synthesis of methamphetamine.<ref>http://www.eluniversal.com.mx/notas/465055.html</ref>
*'''United states''' - Pseudophedrine is federally regulated due to production of methamphetamine using pseudoephedrine, and legality can vary from state to state.
*'''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.<ref>https://web.archive.org/web/20151025125803/http://pharmacytechniciansletter.therapeuticresearch.com/(S(uvxrnu55cowfcdintotjyq45))/mobile/Newsletter.aspx?nidchk=1&cs=&s=PTL&vo=1&dd=271114&dt=2&vodd=3</ref><ref>https://web.archive.org/web/20160618165544/http://www.familyhealthonline.ca/fho/pharmacycare/PC_OTCdrugs_fhb07.asp</ref>
Products containing both pseudoephedrine and caffeine are banned.{{citation needed}}
*'''Colombia''' - The Colombian government prohibited the trade of pseudoephedrine in 2010.<ref>http://www.eltiempo.com/archivo/documento/CMS-5824648</ref>
*'''Japan''' - Medications that contain more than 10% pseudoephedrine are prohibited under the Stimulants Control Law in Japan.<ref>{{cite web |url=http://www.seattle.us.emb-japan.go.jp/about/import_restrictions.html |title=Customs Information |newspaper=Consulate-General of Japan in Seattle |access-date= 27 August 2015}}</ref>
*'''Netherlands''' - Pseudoephedrine was withdrawn from sale in 1989 due to concerns about adverse cardiac side effects.<ref>https://www.in-pharmatechnologist.com/Article/2007/09/03/Pseudoephedrine-drugs-still-OTC</ref>
*'''New Zealand''' - Pseudoephedrine is currently classified as a Pharmacist Only medication making it available after consultation with a pharmacist<ref>https://www.health.govt.nz/regulation-legislation/medicines-control/controlled-drugs/pseudoephedrine-cold-and-flu-medicines</ref>
*'''Turkey''' - Medications containing pseudoephedrine are available with prescription only.<ref>https://web.archive.org/web/20140311224333/http://www.istanbulsaglik.gov.tr/w/sb/ecz/ykmrecete/belge/normal_recete_verilmesi.pdf</ref>
*'''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.<ref>http://www.mhra.gov.uk/home/idcplg?IdcService=GET_FILE&dDocName=CON014095&RevisionSelectionMethod=LatestReleased</ref>
*'''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.<ref>http://www.wlox.com/Global/story.asp?S=11919990</ref><ref>https://www.nytimes.com/2010/11/16/opinion/16bovett.html</ref>
It may contain incorrect information, particularly with respect to dosage, duration, subjective effects, toxicity and other risks. It may also not meet PW style and grammar standards.
WARNING: Always start with lower doses due to differences between individual body weight, tolerance, metabolism, and personal sensitivity. See responsible use section.
DISCLAIMER: PW's dosage information is gathered from users and resources for educational purposes only. It is not a recommendation and should be verified with other sources for accuracy.
Pseudoephedrine (also known as pseudo) 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, a hormone produced in the body by the adrenal glands.
As a result, it may contain incomplete or wrong information. You can help by expanding it.
Pseudoephedrine naturally occurs in the plant Ephedra, which contains both 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 both methamphetamine and methcathinone.[citation needed] 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.[citation needed]
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 and awareness.
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.
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 adrenergicreceptors.
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.
Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), an open research literature based on anecdotal user reports and the personal analyses of PsychonautWikicontributors. As a result, they should be viewed with a healthy degree of skepticism.
It is also worth noting that these effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects. Likewise, adverse effects become increasingly likely with higher doses and may include addiction, severe injury, or death ☠.
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.
Nausea - At high doses pseudoephedrine is reported to cause nausea.
Vasoconstriction - This effect is pronounced with pseudoephedrine, and its primary therapeutic use is constricting inflamed blood vessels in the nasal passages.
Pupil dilation - Pupil dilation is normally only experienced at excessively high doses.
Cognitive effects
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.
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:
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:
The oral median lethal dose of pseudoephedrine hydrochloride in rats was 1674 mg/kg.[citation needed]
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 dopaminergicstimulants, meaning that after the consumption of pseudoephedrine, most other stimulant compounds will have a reduced effect.
Warning:Many psychoactive substances that are reasonably safe to use on their own can suddenly become dangerous and even life-threatening when combined with certain other substances. The following list provides some known dangerous interactions (although it is not guaranteed to include all of them).
Always conduct independent research (e.g. Google, DuckDuckGo, PubMed) to ensure that a combination of two or more substances is safe to consume. Some of the listed interactions have been sourced from TripSit.
]] & ]] - 25x compounds are highly stimulating and physically straining. Combinations with Pseudoephedrine should be strictly avoided due to the risk of excessive stimulation and heart strain. This can result in increased blood pressure, vasoconstriction, panic attacks, thought loops, seizures, and heart failure in extreme cases.
]] - Combining alcohol with stimulants can be dangerous due to the risk of accidental over-intoxication. Stimulants mask alcohol's depressant effects, which is what most people use to assess their degree of intoxication. Once the stimulant wears off, the depressant effects will be left unopposed, which can result in blackouts and severe respiratory depression. If mixing, the user should strictly limit themselves to only drinking a certain amount of alcohol per hour.
]] - Combinations with DXM should be avoided due to its inhibiting effects on serotonin and norepinephrine reuptake. There is an increased risk of panic attacks and hypertensive crisis, or serotonin syndrome with serotonin releasers (MDMA, methylone, mephedrone, etc.). Monitor blood pressure carefully and avoid strenuous physical activity.
]] - Any neurotoxic effects of MDMA are likely to be increased when other stimulants are present. There is also a risk of excessive blood pressure and heart strain (cardiotoxicity).
]] - Some reports suggest combinations with MXE may dangerously increase blood pressure and increase the risk of mania and psychosis.
]] - Both classes carry a risk of delusions, mania and psychosis, and these risk may be multiplied when combined.
]] - Tramadol is known to lower the seizure threshold[1] and combinations with stimulants may further increase this risk.
Legal status
In the early 2000s many countries started putting pseudoephedrine behind the counter, requiring prescriptions or outright banning it, due to its common usage as a precursor in the production of illicit methamphetamine.[citation needed]
Australia - Pseudoephedrine in amounts in or under 800mg (liquid form) or 720mg, falls under schedule 3 (Pharmacist Only), otherwise under schedule 4 (Prescription only).[2]
Mexico - Pseudoephedrine was made illicit due to the popularity of use as a precursor in the synthesis of methamphetamine.[3]
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.[4][5]
Products containing both pseudoephedrine and caffeine are banned.[citation needed]
Colombia - The Colombian government prohibited the trade of pseudoephedrine in 2010.[6]
Japan - Medications that contain more than 10% pseudoephedrine are prohibited under the Stimulants Control Law in Japan.[7]
Netherlands - Pseudoephedrine was withdrawn from sale in 1989 due to concerns about adverse cardiac side effects.[8]
New Zealand - Pseudoephedrine is currently classified as a Pharmacist Only medication making it available after consultation with a pharmacist[9]
Turkey - Medications containing pseudoephedrine are available with prescription only.[10]
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.[11]
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.[12][13]
↑Talaie, H.; Panahandeh, R.; Fayaznouri, M. R.; Asadi, Z.; Abdollahi, M. (2009). "Dose-independent occurrence of seizure with tramadol". Journal of Medical Toxicology. 5 (2): 63–67. doi:10.1007/BF03161089. eISSN1937-6995. ISSN1556-9039. OCLC163567183.
