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Pseudoephedrine (PSE) is a
sympathomimetic Sympathomimetic drugs (also known as adrenergic drugs and adrenergic amines) are stimulant compounds which mimic the effects of endogenous agonists of the sympathetic nervous system. Examples of sympathomimetic effects include increases in hea ...
drug A drug is any chemical substance that causes a change in an organism's physiology or psychology when consumed. Drugs are typically distinguished from food and substances that provide nutritional support. Consumption of drugs can be via insuffla ...
of the
phenethylamine Phenethylamine (PEA) is an organic compound, natural monoamine alkaloid, and trace amine, which acts as a central nervous system stimulant in humans. In the brain, phenethylamine regulates monoamine neurotransmission by binding to trace amin ...
and
amphetamine Amphetamine (contracted from alpha- methylphenethylamine) is a strong central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. It is also commonly used ...
chemical class Chemical classification systems attempt to classify elements or compounds according to certain chemical functional or structural properties. Whereas the structural properties are largely intrinsic, functional properties and the derived classificat ...
es. It may be used as a nasal/sinus decongestant, as a
stimulant Stimulants (also often referred to as psychostimulants or colloquially as uppers) is an overarching term that covers many drugs including those that increase activity of the central nervous system and the body, drugs that are pleasurable and inv ...
, or as a wakefulness-promoting agent in higher doses. It was first characterized in 1889 by the German chemists Ladenburg and Oelschlägel, who used a sample that had been isolated from ''
Ephedra vulgaris ''Ephedra distachya'' is a shrub in the family Ephedraceae that stands about 25 cm to 50 cm high. The shrub grows in many parts of the world, including southern and central Europe and western and central Asia. Its local names include '' ...
'' by the Merck pharmaceutical corporation of Darmstadt, Germany. The salts pseudoephedrine hydrochloride and pseudoephedrine sulfate are found in many over-the-counter
preparations ''Preparations'' is a studio album by Prefuse 73. It was released on Warp Records Warp Records (or simply Warp) is a British independent record label founded in Sheffield in 1989 by record store employees Steve Beckett and Rob Mitchell and r ...
, either as a single ingredient or (more commonly) in a fixed-dose combination with one or more additional active ingredients such as antihistamines,
guaifenesin Guaifenesin, also known as glyceryl guaiacolate, is an expectorant medication that aids in the elimination of sputum from the respiratory tract. Chemically it is an ether of guaiacol and glycerine. It is often used in combination with other me ...
, dextromethorphan,
paracetamol Paracetamol, also known as acetaminophen, is a medication used to treat fever and mild to moderate pain. Common brand names include Tylenol and Panadol. At a standard dose, paracetamol only slightly decreases body temperature; it is inferior ...
(acetaminophen) or an NSAID (such as aspirin or
ibuprofen Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for treating pain, fever, and inflammation. This includes painful menstrual periods, migraines, and rheumatoid arthritis. It may also be used to close a patent ductus arte ...
).


Medical uses

Pseudoephedrine is a
stimulant Stimulants (also often referred to as psychostimulants or colloquially as uppers) is an overarching term that covers many drugs including those that increase activity of the central nervous system and the body, drugs that are pleasurable and inv ...
, but it is well known for shrinking swollen nasal mucous membranes, so it is often used as a decongestant. It reduces tissue hyperemia,
edema Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels t ...
, and nasal congestion commonly associated with colds or allergies. Other beneficial effects may include increasing the drainage of sinus secretions, and opening of obstructed
Eustachian tube In anatomy, the Eustachian tube, also known as the auditory tube or pharyngotympanic tube, is a tube that links the nasopharynx to the middle ear, of which it is also a part. In adult humans, the Eustachian tube is approximately long and in d ...
s. The same vasoconstriction action can also result in
hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
, which is a noted side effect of pseudoephedrine. Pseudoephedrine can be used either as oral or as topical decongestant. Due to its stimulating qualities, however, the oral preparation is more likely to cause adverse effects, including urinary retention. According to one study, pseudoephedrine may show effectiveness as an antitussive drug (suppression of cough). Pseudoephedrine is indicated for the treatment of nasal congestion, sinus congestion and Eustachian tube congestion.Bicopoulos D, editor. AusDI: Drug information for the healthcare professional, 2nd edition. Castle Hill: Pharmaceutical Care Information Services; 2002. Pseudoephedrine is also indicated for vasomotor rhinitis, and as an adjunct to other agents in the optimum treatment of allergic rhinitis,
croup Croup, also known as laryngotracheobronchitis, is a type of respiratory infection that is usually caused by a virus. The infection leads to swelling inside the trachea, which interferes with normal breathing and produces the classic symptoms o ...
, sinusitis,
otitis media Otitis media is a group of inflammatory diseases of the middle ear. One of the two main types is acute otitis media (AOM), an infection of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, ...
, and tracheobronchitis. Pseudoephedrine is also used as a first-line prophylactic for recurrent
priapism Priapism is a condition in which a penis remains erect for hours in the absence of stimulation or after stimulation has ended. There are three types: ischemic (low-flow), nonischemic (high-flow), and recurrent ischemic (intermittent). Most cases ...
.
Erection An erection (clinically: penile erection or penile tumescence) is a physiological phenomenon in which the penis becomes firm, engorged, and enlarged. Penile erection is the result of a complex interaction of psychological, neural, vascular, ...
is largely a
parasympathetic The parasympathetic nervous system (PSNS) is one of the three divisions of the autonomic nervous system, the others being the sympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of t ...
response, so the sympathetic action of pseudoephedrine may serve to relieve this condition. Treatment for urinary incontinence is an off-label use ("unlabeled use") for these medications.


Adverse effects

Common adverse drug reactions (ADRs) associated with pseudoephedrine therapy include central nervous system stimulation, insomnia, nervousness, excitability, dizziness and anxiety. Infrequent ADRs include tachycardia or palpitations. Rarely, pseudoephedrine therapy may be associated with
mydriasis Mydriasis is the dilation of the pupil, usually having a non-physiological cause, or sometimes a physiological pupillary response. Non-physiological causes of mydriasis include disease, trauma, or the use of certain types of drugs. Normally, as ...
(dilated pupils), hallucinations,
arrhythmia Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults ...
s,
hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
, seizures and
ischemic colitis Ischemic colitis (also spelled ischaemic colitis) is a medical condition in which inflammation and injury of the large intestine result from inadequate blood supply. Although uncommon in the general population, ischemic colitis occurs with greater ...
;Rossi S, editor. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006. as well as severe skin reactions known as recurrent pseudo-scarlatina, systemic contact dermatitis, and nonpigmenting fixed drug eruption. Pseudoephedrine, particularly when combined with other drugs including narcotics, may also play a role in the precipitation of episodes of paranoid psychosis. It has also been reported that pseudoephedrine, among other
sympathomimetic Sympathomimetic drugs (also known as adrenergic drugs and adrenergic amines) are stimulant compounds which mimic the effects of endogenous agonists of the sympathetic nervous system. Examples of sympathomimetic effects include increases in hea ...
agents, may be associated with the occurrence of
stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
.


Precautions and contraindications

Pseudoephedrine is contraindicated in patients with diabetes mellitus,
cardiovascular disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, h ...
, severe or uncontrolled
hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
, severe
coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pla ...
,
prostatic hypertrophy Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss o ...
, hyperthyroidism,
closed angle glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye rem ...
, or by pregnant women. The safety and effectiveness of nasal decongestant use in children is unclear.


Interactions

Concomitant or recent (previous fourteen days)
monoamine oxidase inhibitor Monoamine oxidase inhibitors (MAOIs) are a class of drugs that inhibit the activity of one or both monoamine oxidase enzymes: monoamine oxidase A (MAO-A) and monoamine oxidase B (MAO-B). They are best known as effective antidepressants, espe ...
use can lead to hypertensive reactions, including hypertensive crises. The antihypertensive effects of methyldopa, mecamylamine,
reserpine Reserpine is a drug that is used for the treatment of high blood pressure, usually in combination with a thiazide diuretic or vasodilator. Large clinical trials have shown that combined treatment with reserpine plus a thiazide diuretic reduces m ...
and veratrum alkaloids may be reduced by
sympathomimetics Sympathomimetic drugs (also known as adrenergic drugs and adrenergic amines) are stimulant compounds which mimic the effects of endogenous agonists of the sympathetic nervous system. Examples of sympathomimetic effects include increases in heart ...
.
Beta-adrenergic antagonist Beta blockers, also spelled β-blockers, are a class of medications that are predominantly used to manage abnormal heart rhythms, and to protect the heart from a second heart attack after a first heart attack (secondary prevention). They are al ...
s may also interact with sympathomimetics. Increase of ectopic pacemaker activity can occur when pseudoephedrine is used concomitantly with digitalis. Antacids increase the rate of pseudoephedrine absorption, while kaolin decreases it.


Mechanism of action

Pseudoephedrine is a sympathomimetic amine. Its principal mechanism of action relies on its direct action on the
adrenergic receptor The adrenergic receptors or adrenoceptors are a class of G protein-coupled receptors that are targets of many catecholamines like norepinephrine (noradrenaline) and epinephrine (adrenaline) produced by the body, but also many medications like beta ...
system. The vasoconstriction that pseudoephedrine produces is believed to be principally an α-adrenergic receptor response. Pseudoephedrine acts on α- and β2-adrenergic receptors, to cause vasoconstriction and relaxation of smooth muscle in the bronchi, respectively. α-Adrenergic receptors are located on the muscles lining the walls of blood vessels. When these receptors are activated, the muscles contract, causing the blood vessels to constrict (vasoconstriction). The constricted blood vessels now allow less fluid to leave the blood vessels and enter the nose, throat and sinus linings, which results in decreased inflammation of nasal membranes, as well as decreased mucus production. Thus, by constriction of blood vessels, mainly those located in the nasal passages, pseudoephedrine causes a decrease in the symptoms of nasal congestion. Activation of β2-adrenergic receptors produces relaxation of smooth muscle of the bronchi, causing bronchial dilation and in turn decreasing congestion (although not fluid) and difficulty breathing.


Other uses

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. A study has also found that pseudoephedrine can reduce milk production in breastfeeding women.


Manufacture of amphetamines

Its membership in the
amphetamine Amphetamine (contracted from alpha- methylphenethylamine) is a strong central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. It is also commonly used ...
class has made pseudoephedrine a sought-after
chemical precursor In chemistry, a precursor is a compound that participates in a chemical reaction that produces another compound. In biochemistry, the term "precursor" often refers more specifically to a chemical compound preceding another in a metabolic pathway, ...
in the illicit manufacture of
methamphetamine Methamphetamine (contracted from ) is a potent central nervous system (CNS) stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity. Methamph ...
and methcathinone. As a result of the increasing regulatory restrictions on the sale and distribution of pseudoephedrine, many pharmaceutical firms have reformulated, or are in the process of reformulating medications to use alternative, but less effective, decongestants, such as phenylephrine. In the United States, federal laws control the sale of pseudoephedrine-containing products. Many retailers in the US have created corporate policies restricting the sale of pseudoephedrine-containing products. Their policies restrict sales by limiting purchase quantities and requiring a minimum age and government issued photographic identification. These requirements are similar to and sometimes more stringent than existing law. Internationally, pseudoephedrine is listed as a Table I precursor under the
United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances The United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988 is one of three major drug control treaties currently in force. It provides additional legal mechanisms for enforcing the 1961 Single Con ...
.


Sports

Pseudoephedrine was on the International Olympic Committee's (IOC) banned substances list until 2004, when the World Anti-Doping Agency (WADA) list replaced the IOC list. Although WADA initially only ''monitored'' pseudoephedrine, it went back onto the "banned" list on January 1, 2010. Pseudoephedrine is excreted through urine, and concentration in urine of this drug shows a large inter-individual spread; that is, the same dose can give a vast difference in urine concentration for different individuals. Pseudoephedrine is approved to be taken up to 240 mg per day. In seven healthy male subjects this dose yielded a urine concentration range of 62.8 to 294.4 microgram per milliliter (µg/mL) with mean ± standard deviation 149 ± 72 µg/mL. Thus, normal dosage of 240 mg pseudoephedrine per day can result in urine concentration levels exceeding the limit of 150 µg/mL set by WADA for about half of all users. Furthermore, hydration status does not affect urinary concentration of pseudoephedrine. Canadian rower Silken Laumann was stripped of her
1995 Pan American Games File:1995 Events Collage V2.png, From left, clockwise: O.J. Simpson is acquitted of the murders of Nicole Brown Simpson and Ronald Goldman from the year prior in "The Trial of the Century" in the United States; The Great Hanshin earthquake strike ...
team gold medal after testing positive for pseudoephedrine. In February 2000,
Elena Berezhnaya Elena Viktorovna Berezhnaya (russian: Елена Викторовна Бережная, born 11 October 1977) is a Russian former pair skater. With partner Anton Sikharulidze, she is the 1998 and 1999 World champion, 1998 Olympic silver medali ...
and Anton Sikharulidze won gold at the
2000 European Figure Skating Championships The 2000 European Figure Skating Championships was a senior international figure skating competition in the 1999–2000 season. Medals were awarded in the disciplines of men's singles, ladies' singles, pair skating, and ice dancing. The event w ...
but were stripped of their medals after Berezhnaya tested positive. This resulted in a three-month disqualification from the date of the test, and the medal being stripped. She stated that she had taken cold medication approved by a doctor but had failed to inform the ISU as required. The pair missed the World Championships that year as a result of the disqualification. Romanian gymnast
Andreea Răducan Andreea Mădălina Răducan (; born 30 September 1983) is a retired gymnast from Bârlad, Romania. She currently works as a sports announcer and journalist. Răducan began competing in gymnastics at a young age and was training at the Romanian j ...
was stripped of her gold medal at the
2000 Summer Olympic Games The 2000 Summer Olympics, officially the Games of the XXVII Olympiad and also known as Sydney 2000 (Dharug: ''Gadigal 2000''), the Millennium Olympic Games or the Games of the New Millennium, was an international multi-sport event held from 1 ...
after testing positive. She took two pills given to her by the team coach for a cold. Although she was stripped of the overall gold medal, she kept her other medals, and, unlike in most other doping cases, was not banned from competing again; only the team doctor was banned for a number of years.
Ion Ţiriac An ion () is an atom or molecule with a net electrical charge. The charge of an electron is considered to be negative by convention and this charge is equal and opposite to the charge of a proton, which is considered to be positive by conven ...
, the president of the Romanian Olympic Committee, resigned over the scandal. In the
2010 Winter Olympic Games )'' , nations = 82 , athletes = 2,626 , events = 86 in 7 sports (15 disciplines) , opening = February 12, 2010 , closing = February 28, 2010 , opened_by = Governor General Michaëlle Jean , cauldron = Catriona Le May DoanNancy GreeneWayne Gretz ...
, the IOC issued a reprimand against the Slovak ice hockey player
Lubomir Visnovsky Lubomir, Lyubomir, Lyubomyr, Lubomír, Ľubomír, or Ljubomir is a Slavic given name meaning lub (love) and mir (peace, world). Feminine forms are: Lubomira and Ljubica. Nicknames Lubor, Luboš, Luborek, Lubošek, Borek, Lubo, Ľubo, Ljubo, L ...
for usage of pseudoephedrine. In the
2014 Winter Olympic Games , ''Zharkie. Zimnie. Tvoi'') , nations = 88 , events = 98 in 7 sports (15 disciplines) , athletes = 2,873 , opening = 7 February 2014 , closing = 23 February 2014 , opened_by = President Vladimir Putin , cauldron = , stadium = Fisht Olympic ...
Team Sweden Team Sweden represents Sweden in women's international roller derby. The team was first formed to compete at the 2011 Roller Derby World Cup, and finished the tournament in sixth place. Sweden's first bout was on 8 October 2011, against Team Fin ...
and Washington Capitals ice hockey player Nicklas Bäckström was prevented from playing in the final for usage of pseudoephedrine. Bäckström claimed he was using it as allergy medication. In March 2014, the IOC Disciplinary Commission decided that Bäckström would be awarded the silver medal. In January 2015 Bäckström, the IOC, WADA and the IIHF agreed to a settlement in which he accepted a reprimand but was cleared of attempting to enhance his performance.


Detection of use

Pseudoephedrine may be quantified in blood, plasma, or urine to monitor any possible performance-enhancing use by athletes, confirm a diagnosis of poisoning, or to assist in a medicolegal death investigation. Many commercial immunoassay screening tests directed at the amphetamines cross-react appreciably with pseudoephedrine, but
chromatographic In chemical analysis, chromatography is a laboratory technique for the separation of a mixture into its components. The mixture is dissolved in a fluid solvent (gas or liquid) called the ''mobile phase'', which carries it through a system (a ...
techniques can easily distinguish pseudoephedrine from other phenethylamine derivatives. Blood or plasma pseudoephedrine concentrations are typically in the 50–300 µg/L range in persons taking the drug therapeutically, 500–3000 µg/L in people with substance use disorder involving pseudoephedrine, or poisoned patients and 10–70 mg/L in cases of acute fatal overdose.


Chemistry

Pseudoephedrine is a diastereomer of ephedrine and is readily reduced into
methamphetamine Methamphetamine (contracted from ) is a potent central nervous system (CNS) stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity. Methamph ...
or oxidized into methcathinone.


Nomenclatures

The dextrorotary (+)- or d-
enantiomer In chemistry, an enantiomer ( /ɪˈnænti.əmər, ɛ-, -oʊ-/ ''ih-NAN-tee-ə-mər''; from Ancient Greek ἐνάντιος ''(enántios)'' 'opposite', and μέρος ''(méros)'' 'part') – also called optical isomer, antipode, or optical ant ...
is (1''S'',2''S'')-pseudoephedrine, whereas the levorotating (−)- or l- form is (1''R'',2''R'')-pseudoephedrine. In the outdated system (+)-pseudoephedrine is also referred to as pseudoephedrine and (−)-pseudoephedrine as pseudoephedrine (in the Fisher projection then the phenyl ring is drawn at bottom). Often the system (with
small caps In typography, small caps (short for "small capitals") are characters typeset with glyphs that resemble uppercase letters (capitals) but reduced in height and weight close to the surrounding lowercase letters or text figures. This is technicall ...
) and the d/l system (with
lower-case Letter case is the distinction between the letters that are in larger uppercase or capitals (or more formally ''majuscule'') and smaller lowercase (or more formally ''minuscule'') in the written representation of certain languages. The writing ...
) are confused. The result is that the dextrorotary d-pseudoephedrine is wrongly named pseudoephedrine and the levorotary l-ephedrine (the diastereomer) wrongly 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.


Society and culture


Brand names

The following is a list of consumer medicines that either contain pseudoephedrine or have switched to a less-regulated alternative such as phenylephrine. *
Actifed Actifed is a registered trademark for a combination antihistamine and nasal decongestant medication used for cold and allergy symptoms. Actifed was developed in 1958 by Burroughs Wellcome & Company (now part of GlaxoSmithKline), later Haleon. 200 ...
(made by
GlaxoSmithKline GSK plc, formerly GlaxoSmithKline plc, is a British multinational pharmaceutical and biotechnology company with global headquarters in London, England. Established in 2000 by a merger of Glaxo Wellcome and SmithKline Beecham. GSK is the ten ...
) — contains 60 mg pseudoephedrine and 2.5 mg triprolidine in certain countries. *Advil Cold & Sinus (made by Pfizer Canada Inc.) — contains 30 mg pseudoephedrine hydrochloride and 200 mg Ibuprofen. * Aleve-D Sinus & Cold (made by
Bayer Healthcare Bayer AG (, commonly pronounced ; ) is a German multinational pharmaceutical and biotechnology company and one of the largest pharmaceutical companies in the world. Headquartered in Leverkusen, Bayer's areas of business include pharmaceutica ...
) — contains 120 mg pseudoephedrine hydrochloride (also 220 mg naproxen). *
Allegra-D Fexofenadine/pseudoephedrine, sold under the brand name Allegra-D among others, is a fixed-dose combination medication used for the treatment of nasal congestion and other symptoms of allergies and the common cold. It contains fexofenadine, ...
(made by Sanofi Aventis) — contains 120 mg of pseudoephedrine hydrochloride (also 60 mg of fexofenadine). *
Allerclear-D Pseudoephedrine/loratadine (trade names Claritin-D, Clarinase, Clarinase Repetabs, Lorinase, Rhinos SR, Allerclear-D) is an orally administered combination drug used for the treatment of allergic rhinitis and the common cold. This drug can be bo ...
(made by Kirkland Signature) — contains 240 mg of pseudoephedrine sulfate (also 10 mg of loratadine). * Benadryl Plus (made by McNeil Consumer Healthcare, a
Johnson & Johnson Johnson & Johnson (J&J) is an American multinational corporation founded in 1886 that develops medical devices, pharmaceuticals, and consumer packaged goods. Its common stock is a component of the Dow Jones Industrial Average and the company i ...
company) — contains 60 mg pseudoephedrine hydrochloride (also 8 mg acrivastine) * Cirrus (made by UCB) — contains 120 mg pseudoephedrine hydrochloride (also 5 mg cetirizine). *
Claritin-D Pseudoephedrine/loratadine (trade names Claritin-D, Clarinase, Clarinase Repetabs, Lorinase, Rhinos SR, Allerclear-D) is an orally administered combination drug used for the treatment of allergic rhinitis and the common cold. This drug can be bo ...
(made by
Bayer Healthcare Bayer AG (, commonly pronounced ; ) is a German multinational pharmaceutical and biotechnology company and one of the largest pharmaceutical companies in the world. Headquartered in Leverkusen, Bayer's areas of business include pharmaceutica ...
) — contains 120 mg of pseudoephedrine sulfate (also 5 mg of loratadine). * Claritin-D 24 Hour (made by
Bayer Healthcare Bayer AG (, commonly pronounced ; ) is a German multinational pharmaceutical and biotechnology company and one of the largest pharmaceutical companies in the world. Headquartered in Leverkusen, Bayer's areas of business include pharmaceutica ...
) — contains 240 mg of pseudoephedrine sulfate (also 10 mg of loratadine). *
Codral Cold medicines are a group of medications taken individually or in combination as a treatment for the symptoms of the common cold and similar conditions of the upper respiratory tract. The term encompasses a broad array of drugs, including ...
(made by
Asia-Pacific Asia-Pacific (APAC) is the part of the world near the western Pacific Ocean. The Asia-Pacific region varies in area depending on context, but it generally includes East Asia, Russian Far East, South Asia, Southeast Asia, Australia and Pacific Isla ...
subsidiary of
Johnson & Johnson Johnson & Johnson (J&J) is an American multinational corporation founded in 1886 that develops medical devices, pharmaceuticals, and consumer packaged goods. Its common stock is a component of the Dow Jones Industrial Average and the company i ...
) — Codral Original contains pseudoephedrine, Codral New Formula substitutes phenylephrine for pseudoephedrine. * Congestal (made by SIGMA Pharmaceutical Industries) — contains 60 mg pseudoephedrine hydrochloride (also 650 mg
paracetamol Paracetamol, also known as acetaminophen, is a medication used to treat fever and mild to moderate pain. Common brand names include Tylenol and Panadol. At a standard dose, paracetamol only slightly decreases body temperature; it is inferior ...
and 4 mg chlorpheniramine). *
Contac Pseudoephedrine (PSE) 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. It was first chara ...
(made by
GlaxoSmithKline GSK plc, formerly GlaxoSmithKline plc, is a British multinational pharmaceutical and biotechnology company with global headquarters in London, England. Established in 2000 by a merger of Glaxo Wellcome and SmithKline Beecham. GSK is the ten ...
) — previously contained pseudoephedrine, now contains phenylephrine. As at Nov 2014 UK version still contains 30 mg pseudoephedrine hydrochloride per tablet. *
Demazin Chlorphenamine (CP, CPM), also known as chlorpheniramine, is an antihistamine used to treat the symptoms of allergic conditions such as allergic rhinitis (hay fever). It is taken by mouth. The medication takes effect within two hours and lasts ...
(made by
Bayer Healthcare Bayer AG (, commonly pronounced ; ) is a German multinational pharmaceutical and biotechnology company and one of the largest pharmaceutical companies in the world. Headquartered in Leverkusen, Bayer's areas of business include pharmaceutica ...
) — contains pseudoephedrine sulfate and chlorpheniramine maleate * Eltor (made by Sanofi Aventis) — contains pseudoephedrine hydrochloride. * Mucinex D (made by Reckitt Benckiser) — contains 60 mg pseudoephedrine hydrochloride (also 1200 mg
guaifenesin Guaifenesin, also known as glyceryl guaiacolate, is an expectorant medication that aids in the elimination of sputum from the respiratory tract. Chemically it is an ether of guaiacol and glycerine. It is often used in combination with other me ...
). *
Nexafed Nexafed is a formulation of pseudoephedrine developed by Acura Pharmaceuticals used to deter the use of the pseudoephedrine contained in the product for illicit methamphetamine synthesis. Nexafed uses a polymer matrix that forms a thick gel when ...
(made by
Acura Pharmaceuticals Acura Pharmaceuticals Inc. is a pharmaceutical company focused on the development and commercialization of deterrents to medication abuse and misuse. , the company had several opioid products under development, which would use "Aversion Technolo ...
) — contains 30 mg pseudoephedrine per tablet, formulated with Impede Meth-Deterrent technology. * Nurofen Cold & Flu (made by Reckitt Benckiser) — contains 30 mg pseudoephedrine hydrochloride (also 200 mg
ibuprofen Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for treating pain, fever, and inflammation. This includes painful menstrual periods, migraines, and rheumatoid arthritis. It may also be used to close a patent ductus arte ...
). *Respidina – contains 120 mg of pseudoephedrine in the form of extended release tablets. * Rhinex Flash (made by Pharma Product Manufacturing, Cambodia) — contains pseudoephedrine combined with
paracetamol Paracetamol, also known as acetaminophen, is a medication used to treat fever and mild to moderate pain. Common brand names include Tylenol and Panadol. At a standard dose, paracetamol only slightly decreases body temperature; it is inferior ...
and triprolidine. *
Rhinos SR A rhinoceros (; ; ), commonly abbreviated to rhino, is a member of any of the five extant species (or numerous extinct species) of odd-toed ungulates in the family Rhinocerotidae. (It can also refer to a member of any of the extinct species ...
(made by
Dexa Medica Dual-energy X-ray absorptiometry (DXA, or DEXA) is a means of measuring bone mineral density (BMD) using spectral imaging. Two X-ray beams, with different energy levels, are aimed at the patient's bones. When soft tissue absorption is subtra ...
) — contains 120 mg of pseudoephedrine hydrochloride (also 5 mg loratadine). *Rino-Ebastel (made by Almirall) – contains 120 mg of pseudoephedrine hydrochloride (also 10 mg ebastine). * Sinufed (made by Trima) — contains 60 mg pseudoephedrine hydrochloride. *
Sinutab Sinutab is a sinus, allergy and pain relief medication originally marketed by Warner–Lambert. It is manufactured and distributed by Johnson & Johnson after its acquisition of Pfizer's consumer healthcare division in late December 2006. It is pack ...
(made by McNeil Consumer Healthcare, a
Johnson & Johnson Johnson & Johnson (J&J) is an American multinational corporation founded in 1886 that develops medical devices, pharmaceuticals, and consumer packaged goods. Its common stock is a component of the Dow Jones Industrial Average and the company i ...
company) — contains 500 mg paracetamol and 30 mg pseudoephedrine hydrochloride. *
Sudafed Pseudoephedrine (PSE) is a sympathomimetic drug of the substituted phenethylamine, phenethylamine and substituted amphetamine, amphetamine chemical classes. It may be used as a decongestant, nasal/sinus decongestant, as a stimulant, or as a wake ...
Decongestant (made by McNeil Consumer Healthcare, a
Johnson & Johnson Johnson & Johnson (J&J) is an American multinational corporation founded in 1886 that develops medical devices, pharmaceuticals, and consumer packaged goods. Its common stock is a component of the Dow Jones Industrial Average and the company i ...
company) — contains 60 mg of pseudoephedrine hydrochloride. *
Theraflu Cold medicines are a group of medications taken individually or in combination as a treatment for the symptoms of the common cold and similar conditions of the upper respiratory tract. The term encompasses a broad array of drugs, including a ...
(made by Novartis) — previously contained pseudoephedrine, now contains phenylephrine. * Unifed (made by
United Pharmaceutical Manufacturer United may refer to: Places * United, Pennsylvania, an unincorporated community * United, West Virginia, an unincorporated community Arts and entertainment Films * ''United'' (2003 film), a Norwegian film * ''United'' (2011 film), a BBC Two fi ...
, Jordan) — contains pseudoephedrine hydrochloride (also triprolidine and
guaifenesin Guaifenesin, also known as glyceryl guaiacolate, is an expectorant medication that aids in the elimination of sputum from the respiratory tract. Chemically it is an ether of guaiacol and glycerine. It is often used in combination with other me ...
). *
Zyrtec-D Cetirizine/pseudoephedrine (''Zyrtec-D'') is an antihistamine and decongestant formulation. It is a fixed-dose combination drug containing 5 mg cetirizine hydrochloride and 120 mg pseudoephedrine hydrochloride for symptoms related to seasonal al ...
12 Hour (made by McNeil Consumer Healthcare, a
Johnson & Johnson Johnson & Johnson (J&J) is an American multinational corporation founded in 1886 that develops medical devices, pharmaceuticals, and consumer packaged goods. Its common stock is a component of the Dow Jones Industrial Average and the company i ...
company) — contains 120 mg pseudoephedrine hydrochloride (also 5 mg of cetirizine). *Zephrex-D (made by Westport Pharmaceuticals) – a special meth-resistant form of pseudoephedrine that becomes gooey when heated


Legal status


Australia

Illicit diversion of pseudoephedrine in Australia has caused significant changes to the way the products are regulated. , all products containing pseudoephedrine have been rescheduled as either "Pharmacist Only Medicines" (Schedule 3) or "Prescription Only Medicines" (Schedule 4), depending on the amount of pseudoephedrine in the product. A Pharmacist Only Medicine may only be sold to the public if a pharmacist is directly involved in the transaction. These medicines must be kept behind the counter, away from public access. Pharmacists are also encouraged (and in some states required) to log purchases with the online database Project STOP. This system aims to prevent individuals from purchasing small quantities of pseudoephedrine from many different pharmacies. As a result, many pharmacies no longer stock Sudafed, the common brand of pseudoephedrine cold/sinus tablets, opting instead to sell Sudafed PE, a phenylephrine product that has not been proven effective in clinical trials.


Canada

Health Canada Health Canada (HC; french: Santé Canada, SC)Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the Structure of the Canadian federal government#Departments, with subsidiary unit ...
has investigated the risks and benefits of pseudoephedrine and ephedrine/ Ephedra. Near the end of the study, Health Canada issued a warning on their website stating that those who are under the age of 12, or who have heart disease and may have strokes, should avoid taking pseudoephedrine and ephedrine. Also, they warned that everyone should avoid taking ephedrine or pseudoephrine with other stimulants like caffeine. They also banned all products that contain both ephedrine (or pseudoephedrine) and caffeine. Products whose only medicinal ingredient is pseudoephedrine must be kept behind the pharmacy counter. Products containing pseudoephedrine along with other medicinal ingredients may be displayed on store shelves but may be sold only in a pharmacy when a pharmacist is present.


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.


Mexico

On 23 November 2007, the use and trade of pseudoephedrine in Mexico was made illegal as it was argued that it was extremely popular as a precursor in the synthesis of methamphetamine.


Netherlands

Pseudoephedrine was withdrawn from sale in 1989 due to concerns about adverse cardiac side effects.


New Zealand

In 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. Pseudoephedrine, ephedrine, and any product containing these substances, e.g. cold and flu medicines, were first classified in October 2004 as Class C Part III (partially exempted) controlled drugs, due to being the principal ingredient in methamphetamine. New Zealand Customs and police officers continued to make large interceptions of precursor substances believed to be destined for
methamphetamine Methamphetamine (contracted from ) is a potent central nervous system (CNS) stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity. Methamph ...
production. On 9 October 2009, Prime Minister John Key announced pseudoephedrine-based cold and flu tablets would become prescription-only drugs and reclassified as a class B2 drug. The law was amended by The Misuse of Drugs Amendment Bill 2010, which passed in August 2011.


Turkey

In Turkey, medications containing pseudoephedrine are available with prescription only.


United Kingdom

In the UK, pseudoephedrine is available over the counter under the supervision of a qualified pharmacist, or on prescription. In 2007, the
MHRA MHRA may refer to: Organisations * Medicines and Healthcare products Regulatory Agency, UK * Michigan Hot Rod Association, US * Modern Humanities Research Association, UK ** ''MHRA Style Guide'', an academic style guide Other uses * Men's human r ...
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. These restrictions became law in April 2008. No form of ID is required.


United States


=Federal

= The United States Congress has recognized that pseudoephedrine is used in the illegal manufacture of methamphetamine. In 2005, the Committee on Education and the Workforce heard testimony concerning education programs and state legislation designed to curb this illegal practice. Attempts to control the sale of the drug date back to 1986, when federal officials at the Drug Enforcement Administration (DEA) first drafted legislation, later proposed by Senator
Bob Dole Robert Joseph Dole (July 22, 1923 – December 5, 2021) was an American politician and attorney who represented Kansas in the United States Senate from 1969 to 1996. He was the Republican Leader of the Senate during the final 11 years of his te ...
, that would have placed a number of chemicals used in the manufacture of illicit drugs under the
Controlled Substances Act The Controlled Substances Act (CSA) is the statute establishing federal government of the United States, federal drug policy of the United States, U.S. drug policy under which the manufacture, importation, possession, use, and distribution of ...
. The bill would have required each transaction involving pseudoephedrine to be reported to the government, and federal approval of all imports and exports. Fearing this would limit legitimate use of the drug, lobbyists from over the counter drug manufacturing associations sought to stop this legislation from moving forward, and were successful in exempting from the regulations all chemicals that had been turned into a legal final product, such as Sudafed. Prior to the passage of the Combat Methamphetamine Epidemic Act of 2005, sales of the drug became increasingly regulated, as DEA regulators and pharmaceutical companies continued to fight for their respective positions. The DEA continued to make greater progress in their attempts to control pseudoephedrine as methamphetamine production skyrocketed, becoming a serious problem in the western United States. When purity dropped, so did the number of people in rehab and people admitted to emergency rooms with methamphetamine in their systems. This reduction in purity was usually short lived, however, as methamphetamine producers eventually found a way around the new regulations. Congress passed the '' Combat Methamphetamine Epidemic Act of 2005'' ("CMEA") as an amendment to the renewal of the USA Patriot Act. Signed into law by president
George W. Bush George Walker Bush (born July 6, 1946) is an American politician who served as the 43rd president of the United States from 2001 to 2009. A member of the Republican Party, Bush family, and son of the 41st president George H. W. Bush, he ...
on March 6, 2006, the act amended , concerning the sale of pseudoephedrine-containing products. The law mandated two phases, the first needing to be implemented by April 8, 2006, and the second to be completed by September 30, 2006. The first phase dealt primarily with implementing the new buying restrictions based on amount, while the second phase encompassed the requirements of storage, employee training, and record keeping. Though the law was mainly directed at pseudoephedrine products it also applies to all over-the-counter products containing ephedrine, pseudoephedrine, and phenylpropanolamine, their salts, optical isomers, and salts of optical isomers. Pseudoephedrine was defined as a " scheduled listed chemical product" under (45(A)). The act included the following requirements for merchants ("regulated sellers") who sell such products: * Required a retrievable record of all purchases, identifying the name and address of each party, to be kept for two years * Required verification of proof of identity of all purchasers * Required protection and disclosure methods in the collection of personal information * Required reports to the
Attorney General In most common law jurisdictions, the attorney general or attorney-general (sometimes abbreviated AG or Atty.-Gen) is the main legal advisor to the government. The plural is attorneys general. In some jurisdictions, attorneys general also have exec ...
of any suspicious payments or disappearances of the regulated products * Required training of employees with regard to the requirements of the CMEA. Retailers must self-certify as to training and compliance. * The non-liquid dose form of regulated products may only be sold in unit dose blister packs * Regulated products must be stored behind the counter or in a locked cabinet in such a way as to restrict public access * Sales limits (per customer): ** Daily sales limit—must not exceed 3.6 grams of pseudoephedrine base without regard to the number of transactions ** 30-day (not monthly) sales limit—must not exceed 7.5 grams of pseudoephedrine base if sold by mail order or "mobile retail vendor" ** 30-day purchase limit—must not exceed 9 grams of pseudoephedrine base. (A misdemeanor possession offense under for the person who buys it.) In regards to the identification that may be used by an individual buying pseudoephedrine products the following constitute acceptable forms of identification: * US passport * Alien registration or permanent resident card * Unexpired foreign passport with temporary I-551 stamp * Unexpired Employment Authorization Document * Driver's License or Government issued identification card (including Canadian driver's license) * School ID with picture * Voter's Registration card * US Military Card * Native American tribal documents The requirements were revised in the Methamphetamine Production Prevention Act of 2008 to require that a regulated seller of scheduled listed chemical products may not sell such a product unless the purchaser: * Presents a government issued photographic identification; and * Signs the written logbook with their name, address, and time and date of the sale


=State

= Most states also have laws regulating pseudoephedrine. The states of Alabama, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Hawaii () Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana (), Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia and Wisconsin have laws requiring pharmacies to sell pseudoephedrine "behind the counter". Though the drug can be purchased without a prescription, states can limit the number of units sold and can collect personal information from purchasers.'' The states of Oregon and Mississippi previously required a prescription for the purchase of products containing pseudoephedrine. However as of January 1, 2022 these restrictions have been repealed The state of Oregon reduced the number of methamphetamine lab seizures from 467 in 2004 (the final full year before implementation of the prescription only law) to a new low of 12 in 2009. The decrease in meth lab incidents in Oregon occurred largely before the prescription-only law took effect, according to a NAMSDL report titled ''Pseudoephedrine Prescription Laws in Oregon and Mississippi''. The report posits that the decline in meth lab incidents in both states may be due to other factors: "Mexican traffickers may have contributed to the decline in meth labs in Mississippi and Oregon (and surrounding states) as they were able to provide ample supply of equal or greater quality meth at competitive prices". Additionally, similar decreases in meth lab incidents were seen in surrounding states, according to the report, and meth-related deaths in Oregon have dramatically risen since 2007. Some municipalities in Missouri have enacted similar ordinances, including Washington, Union, New Haven, Cape Girardeau and Ozark. Certain pharmacies in
Terre Haute, Indiana Terre Haute ( ) is a city in and the county seat of Vigo County, Indiana, United States, about 5 miles east of the state's western border with Illinois. As of the 2010 census, the city had a population of 60,785 and its metropolitan area had a ...
do so as well. Another approach to controlling the drug on the state level mandated by some state governments to control the purchases of their citizens is the use of electronic tracking systems, which require the electronic submission of specified purchaser information by all retailers who sell pseudoephedrine. Thirty-two states now require the National Precursor Log Exchange (NPLEx) to be used for every pseudoephedrine and ephedrine OTC purchase, and ten of the eleven largest pharmacy chains in the US voluntarily contribute all of their similar transactions to NPLEx. These states have seen dramatic results in reducing the number of methamphetamine laboratory seizures. Prior to implementation of the system in Tennessee in 2005, methamphetamine laboratory seizures totaled 1,497 in 2004, but were reduced to 955 in 2005, and 589 in 2009. Kentucky's program was implemented statewide in 2008, and since statewide implementation, the number of laboratory seizures has significantly decreased. Oklahoma initially experienced success with their tracking system after implementation in 2006, as the number of seizures dropped in that year and again in 2007. In 2008, however, seizures began rising again, and have continued to rise in 2009. Nonetheless, when Oklahoma adopted NPLEx, their lab seizures also dropped significantly. NPLEx appears to be successful by requiring the real-time submission of transactions, thereby enabling the relevant laws to be enforced at the point of sale. By creating a multi-state database and the ability to compare all transactions quickly, NPLEx enables pharmacies to deny purchases that would be illegal based on gram limits, age, or even to convicted meth offenders in some states. NPLEx also enforces the federal gram limits across state lines, which was impossible with state-operated systems. Access to the records is by law enforcement agencies only, through an online secure portal.


In popular culture

In the pilot episode of ''Breaking Bad'', Walter White first synthesizes methamphetamine through the Nagai route, using
red phosphorus Elemental phosphorus can exist in several allotropes, the most common of which are white and red solids. Solid violet and black allotropes are also known. Gaseous phosphorus exists as diphosphorus and atomic phosphorus. White phosphorus White ...
and
iodine Iodine is a chemical element with the symbol I and atomic number 53. The heaviest of the stable halogens, it exists as a semi-lustrous, non-metallic solid at standard conditions that melts to form a deep violet liquid at , and boils to a vi ...
to reduce pseudoephedrine. In the episode " Vitamin D" of ''
Glee Glee means delight, a form of happiness. Glee may also refer to: * Glee (music), a type of English choral music * ''Glee'' (TV series), an American musical comedy-drama TV series, and related media created by Ryan Murphy * ''Glee'' (Bran Van 30 ...
'',
Terri Terri is an alternative spelling of Terry. It is a common feminine given name and is also a diminutive for Teresa. Notable people with the name include: *Terri Allard (born 1962), American country/folk singer/songwriter *Terri S. Armstrong, Amer ...
takes a job as the school nurse to stop her husband, Will Schuester, from becoming closer to guidance counsellor Emma Pillsbury ( Jayma Mays), but is fired after giving the students performance-enhancing pseudoephedrine tablets. In her 2013 single "
Avant Gardener ''The Double EP: A Sea of Split Peas'' is an EP by Australian rock musician Courtney Barnett which compiles two of her previous EPs: ''I've Got a Friend Called Emily Ferris'' (tracks 7-12) and ''How to Carve a Carrot into a Rose'' (tracks 1-6.) It ...
", Australian rock musician Courtney Barnett refers to the effects of pseudoephedrine: "Reminds me of the time / When I was really sick and I / Had too much pseudoephedrine and I / Couldn't sleep at night". In her 2017 album ''
Melodrama A modern melodrama is a dramatic work in which the plot, typically sensationalized and for a strong emotional appeal, takes precedence over detailed characterization. Melodramas typically concentrate on dialogue that is often bombastic or exces ...
'', pop artist
Lorde Ella Marija Lani Yelich-O'Connor (born 7 November 1996), known professionally as Lorde ( ), is a New Zealand singer-songwriter. Taking inspiration from aristocracy for her stage name, she is known for her unconventional musical styles and i ...
references pseudoephedrine on the song "
Writer in the Dark "Writer in the Dark" is a song recorded by New Zealand singer-songwriter Lorde for her second album '' Melodrama'' (2017). She co-wrote and co-produced the track with Jack Antonoff. It is a piano ballad with sparse production and an outro. It ...
". The lyric reads: "I still feel you, now and then / Slow like pseudoephedrine / When you see me, will you say I've changed?"


Synthesis

Although pseudoephedrine occurs naturally as an alkaloid in certain plant species (for example, as a constituent of extracts from the '' Ephedra'' species, also known as ''ma huang'', in which it occurs together with other isomers of ephedrine), the majority of pseudoephedrine produced for commercial use is derived from yeast
fermentation Fermentation is a metabolic process that produces chemical changes in organic substrates through the action of enzymes. In biochemistry, it is narrowly defined as the extraction of energy from carbohydrates in the absence of oxygen. In food ...
of
dextrose Glucose is a simple sugar with the molecular formula . Glucose is overall the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using ...
in the presence of
benzaldehyde Benzaldehyde (C6H5CHO) is an organic compound consisting of a benzene ring with a formyl substituent. It is the simplest aromatic aldehyde and one of the most industrially useful. It is a colorless liquid with a characteristic almond-like odor. ...
. In this process, specialized strains of yeast (typically a variety of '' Candida utilis'' or '' Saccharomyces cerevisiae'') are added to large vats containing water, dextrose and the enzyme
pyruvate decarboxylase Pyruvate decarboxylase is an enzyme () that catalyses the decarboxylation of pyruvic acid to acetaldehyde. It is also called 2-oxo-acid carboxylase, alpha-ketoacid carboxylase, and pyruvic decarboxylase. In anaerobic conditions, this enzyme is ...
(such as found in beets and other plants). After the yeast has begun fermenting the dextrose, the benzaldehyde is added to the vats, and in this environment the yeast converts the ingredients to the precursor l-phenylacetylcarbinol (L-PAC). L-PAC is then chemically converted to pseudoephedrine via reductive amination. The bulk of pseudoephedrine is produced by commercial pharmaceutical manufacturers in India and
China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's most populous country, with a population exceeding 1.4 billion, slightly ahead of India. China spans the equivalent of five time zones and ...
, where economic and industrial conditions favor its mass production for export.Suo, Steve. Clamp down on shipments of raw ingredients. The Oregonian; 6 October 2004. From a version reprinted on a U.S
congressional caucus
website.


See also

*
Amphetamine Amphetamine (contracted from alpha- methylphenethylamine) is a strong central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. It is also commonly used ...
* Carbinoxamine/pseudoephedrine * Ephedrine *
Methamphetamine Methamphetamine (contracted from ) is a potent central nervous system (CNS) stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity. Methamph ...
* ''N''-Methylpseudoephedrine * Phenylephrine *
Phenylpropanolamine Phenylpropanolamine (PPA) is a sympathomimetic agent which is used as a decongestant and appetite suppressant. It was commonly used in prescription and over-the-counter cough and cold preparations. In veterinary medicine, it is used to contro ...
* Thomas Latham, sponsor of the "Angie Fatino Save the Children from Meth Act"


References


External links

* {{Portal bar , Medicine Amphetamine alkaloids Decongestants Methamphetamine Norepinephrine releasing agents Phenylethanolamines