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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Pseudoephedrine - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf</title>
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<meta name="citation_inbook_title" content="Drugs and Lactation Database (LactMed®) [Internet]">
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<meta name="citation_title" content="Pseudoephedrine">
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<meta name="citation_publisher" content="National Institute of Child Health and Human Development">
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<meta name="citation_date" content="2020/04/20">
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<meta name="citation_keywords" content="PSEUDOEPHEDRINE">
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<meta name="citation_keywords" content="Isoephedrine">
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<meta name="citation_keywords" content="Sudafed">
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<meta name="citation_keywords" content="trans-Ephedrine">
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<meta name="citation_keywords" content="(+)-Pseudoephedrine">
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<meta name="citation_keywords" content="d-Pseudoephedrine">
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<meta name="citation_keywords" content="Pseudoephedrinum">
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<meta name="citation_keywords" content="L(+)-psi-Ephedrine">
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<meta name="citation_keywords" content="(+)-threo-Ephedrine">
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<meta name="citation_keywords" content="(+)-psi-Ephedrine">
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<meta name="citation_keywords" content="L-(+)-Pseudoephedrine">
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<meta name="citation_keywords" content="(1S,2S)-Pseudoephedrine">
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<meta name="citation_keywords" content="(1S,2S)-(+)-Pseudoephedrine">
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<meta name="citation_keywords" content="psi-Ephedrine, (+)-">
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<meta name="citation_keywords" content="(+)-(1S,2S)-Pseudoephedrine">
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<meta name="citation_keywords" content="Pseudoefedrina [INN-Spanish]">
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<meta name="citation_keywords" content="Pseudoephedrine [INN:BAN]">
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<meta name="citation_keywords" content="Pseudoephedrinum [INN-Latin]">
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<meta name="citation_keywords" content="Pseudoephedrine, L-(+)-">
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<meta name="citation_keywords" content="d-psi-2-Methylamino-1-phenyl-1-propanol">
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<meta name="citation_keywords" content="HSDB 3177">
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<meta name="citation_keywords" content="EINECS 202-018-6">
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<meta name="citation_keywords" content="90-82-4">
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<meta name="citation_keywords" content="alpha-(1-(Methylamino)ethyl)benzyl alcohol">
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<meta name="citation_keywords" content="EC 202-018-6">
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<meta name="citation_keywords" content="Benzenemethanol, alpha-(1-(methylamino)ethyl)-, (S-(R*,R*))-">
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<meta name="citation_keywords" content="Benzenemethanol, alpha-((1S)-1-(methylamino)ethyl)-, (alphaS)-">
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<meta name="DC.Title" content="Pseudoephedrine">
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<meta name="description" content="Although the small amounts of pseudoephedrine in breastmilk are unlikely to harm the nursing infant, it may cause irritability occasionally. A single dose of pseudoephedrine decreases milk production acutely and repeated use seems to interfere with lactation. Mothers with newborns whose lactation is not yet well established or in mothers who are having difficulties producing sufficient milk should not receive pseudoephedrine. A treatment scheme has been reported for mothers with hypergalactia that uses pseudoephedrine to decrease milk supply.[1]">
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<meta name="og:description" content="Although the small amounts of pseudoephedrine in breastmilk are unlikely to harm the nursing infant, it may cause irritability occasionally. A single dose of pseudoephedrine decreases milk production acutely and repeated use seems to interfere with lactation. Mothers with newborns whose lactation is not yet well established or in mothers who are having difficulties producing sufficient milk should not receive pseudoephedrine. A treatment scheme has been reported for mothers with hypergalactia that uses pseudoephedrine to decrease milk supply.[1]">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501085_"><span class="title" itemprop="name">Pseudoephedrine</span></h1><p class="fm-aai"><a href="#_NBK501085_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 2 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 90-82-4</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/134971121" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=134971121" alt="image 134971121 in the ncbi pubchem database" /></a><div id="LM231.Drug_Levels_and_Effects"><h2 id="_LM231_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM231.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Although the small amounts of pseudoephedrine in breastmilk are unlikely to harm the nursing infant, it may cause irritability occasionally. A single dose of pseudoephedrine decreases milk production acutely and repeated use seems to interfere with lactation. Mothers with newborns whose lactation is not yet well established or in mothers who are having difficulties producing sufficient milk should not receive pseudoephedrine. A treatment scheme has been reported for mothers with hypergalactia that uses pseudoephedrine to decrease milk supply.[<a class="bibr" href="#LM231.REF.1" rid="LM231.REF.1">1</a>]</p></div><div id="LM231.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> A single oral dose of 60 mg of pseudoephedrine in 3 women resulted in peak milk levels of less than 1 mg/L 1 hour after the dose.[<a class="bibr" href="#LM231.REF.2" rid="LM231.REF.2">2</a>] Other authors used data from this study to calculate the amount excreted in milk to be 5.5% of the weight-adjusted maternal dosage.[<a class="bibr" href="#LM231.REF.3" rid="LM231.REF.3">3</a>]</p><p>After a 60 mg oral dose of immediate-release pseudoephedrine, peak milk levels averaging 698 mcg/L occurred 1.7 hours after the dose and half-life in milk was 5.5 hours. A fully breast-fed infant would receive a dose of 4.3% (range 2.2 to 6.7%) of the maternal weight-adjusted dose.[<a class="bibr" href="#LM231.REF.3" rid="LM231.REF.3">3</a>]</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM231.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Mothers reported irritability was reported in 20% of infants exposed to pseudoephedrine in one study of breastfeeding mothers.[<a class="bibr" href="#LM231.REF.4" rid="LM231.REF.4">4</a>]</p><p>All adverse reactions in breastfed infants reported in France between January 1985 and June 2011 were compiled by a French pharmacovigilance center. Of 174 reports, pseudoephedrine was reported to cause adverse reactions in 4 infants, primarily agitation.[<a class="bibr" href="#LM231.REF.5" rid="LM231.REF.5">5</a>]</p></div><div id="LM231.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>After a single dose of pseudoephedrine 60 mg orally in 8 nursing mothers, there was a mean 24% decrease in milk production over the following 24 hours. No change in blood flow to the breast was detected that could explain the decreased milk production; there was a 13.5% decrease in serum prolactin after pseudoephedrine, but this change did not achieve statistical significance. Oxytocin levels were not measured.[<a class="bibr" href="#LM231.REF.3" rid="LM231.REF.3">3</a>]</p></div><div id="LM231.Alternate_Drugs_to_Consider"><h3>Alternate Drugs to Consider</h3><p>
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<a href="/books/n/lactmed/LM488/?report=reader">Oxymetazoline</a>
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</p></div><div id="LM231.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM231.REF.1">Johnson HM, Eglash A, Mitchell KB, et al. ABM Clinical Protocol #32: Management of hyperlactation. <span><span class="ref-journal">Breastfeed Med. </span>2020;<span class="ref-vol">15</span>:129–34.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/32031417" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32031417</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM231.REF.2">Findlay JW, Butz RF, Sailstad JM, et al. Pseudoephedrine and triprolidine in plasma and breast milk of nursing mothers. <span><span class="ref-journal">Br J Clin Pharmacol. </span>1984;<span class="ref-vol">18</span>:901–6.</span> [<a href="/pmc/articles/PMC1463694/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1463694</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/6529531" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6529531</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM231.REF.3">Aljazaf K, Hale TW, Ilett KF, et al. Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk. <span><span class="ref-journal">Br J Clin Pharmacol. </span>2003;<span class="ref-vol">56</span>:18–24.</span> [<a href="/pmc/articles/PMC1884328/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1884328</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/12848771" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12848771</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM231.REF.4">Ito S, Blajchman A, Stephenson M, et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. <span><span class="ref-journal">Am J Obstet Gynecol. </span>1993;<span class="ref-vol">168</span>:1393–9.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/8498418" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8498418</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="LM231.REF.5">Soussan C, Gouraud A, Portolan G, et al. Drug-induced adverse reactions via breastfeeding: A descriptive study in the French Pharmacovigilance Database. <span><span class="ref-journal">Eur J Clin Pharmacol. </span>2014;<span class="ref-vol">70</span>:1361–6.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/25183382" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25183382</span></a>]</div></dd></dl></dl></div></div><div id="LM231.Substance_Identification"><h2 id="_LM231_Substance_Identification_">Substance Identification</h2><div id="LM231.Substance_Name"><h3>Substance Name</h3><p>Pseudoephedrine</p></div><div id="LM231.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>90-82-4</p></div><div id="LM231.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Adrenergic Agents</p><p>Adrenergic Alpha-Agonists</p><p>Central Nervous System Stimulants</p><p>Sympathomimetics</p><p>Vasoconstrictor Agents</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501085_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">April 20, 2020</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Pseudoephedrine. [Updated 2020 Apr 20].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/LM1456/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM471/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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