Talk:Pseudoephedrine

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.

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In the outdated d/l system (+)-pseudoephedrine is also referred to as l-pseudoephedrine and (−)-pseudoephedrine as d-pseudoephedrine.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

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.

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 PsychonautWiki contributors. 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 ☠.

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

Lethal dosage

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 dopaminergic stimulants, meaning that after the consumption of pseudoephedrine, most other stimulant compounds will have a reduced effect.

Dangerous interactions

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-NBOMe & 25x-NBOH - 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.
• Alcohol - 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.
• DXM - 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.
• MDMA - 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).
• MXE - Some reports suggest combinations with MXE may dangerously increase blood pressure and increase the risk of mania and psychosis.
• Dissociatives - Both classes carry a risk of delusions, mania and psychosis, and these risk may be multiplied when combined.
• Stimulants - Pseudoephedrine may be dangerous to combine with other stimulants like cocaine as they can increase one's heart rate and blood pressure to dangerous levels.
• Tramadol - Tramadol is known to lower the seizure threshold^[1] and combinations with stimulants may further increase this risk.

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 Class B Part II controlled drug in the Misuse of Drugs Act 1975, making it illegal to supply or possess except on prescription.^[9][10]
• Turkey - Medications containing pseudoephedrine are available with prescription only.^[11]
• 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.^[12]
• 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.^[13][14]

• Responsible use
• Stimulant
• Methamphetamine
• Methcathinone

• Pseudoephedrine (Wikipedia)
• Pseudoephedrine (Erowid Vault)
• Pseudoephedrine (DrugBank)