Effect of Oral Pseudoephedrine on Blood Pressure and Heart Rate—a Meta-analysis

Salerno SM, Jackson J, Berbano EP

A recent study published August 22, 2005, in the Archives of Internal Medicine compiled information from a number of previous studies regarding the effects of oral pseudoephedrine on blood pressure and heart rate. Pseudoephedrine is available over the counter for the treatment of rhinitis and rhinorrhea. After evaluating all of the information it was determined that pseudoephedrine caused a small, but significant, increase in systolic blood pressure of 0.99mmHg and an increase in heart rate of 2.83 beats per minute. The study found there to be no significant effect on diastolic blood pressure with an increase of 0.63mmHg. The study was comprised of 1,285 patients who had participated in 24 trials that recorded subjects' vital signs. Total effects on heart rate and blood pressure were lower when more women were included in a study, which makes it appear that women are less susceptible to the cardiovascular effects of taking pseudoephedrine than men. The analysis also found that higher doses (> 60mg), immediate release preparations, and patients with a shorter duration of use were associated with greater blood pressure increases. In regard to episodes of blood pressure > 140/90 mmHg it was not reported whether these episodes were clinically significant, what the baseline blood pressure was, or what their magnitude was in most of the individual patients affected. It was unknown whether many of these patients were taking other medications, such as NSAIDs, that may have affected blood pressure levels. Due to these findings it is still necessary to conduct a risk-benefit assessment to determine if the use of pseudoephedrine is appropriate in each individual patient. For more information: http://archinte.ama-assn.org/cgi/content/abstract/165/15/1686 Return to Top