Pseudoephedrine, a sympathomimetic decongestant, can cause significant elevations in blood pressure and heart rate, posing a serious risk for patients with uncontrolled hypertension.
Contraindicated in uncontrolled hypertension.
Can precipitate hypertensive crisis and cardiac events.
Use alternative, non‑adrenergic decongestants.
Immediate BP monitoring and medical evaluation if taken inadvertently.
Pseudoephedrine stimulates α‑ and β‑adrenergic receptors, leading to peripheral vasoconstriction and increased cardiac output. In the setting of poorly controlled hypertension, this additional sympathetic tone can precipitate hypertensive crises, arrhythmias, and end‑organ damage.
Potential adverse events include severe hypertension (SBP >180 mmHg), hypertensive emergencies, tachyarrhythmias, myocardial ischemia, stroke, and worsening heart failure.
Avoid pseudoephedrine in patients with uncontrolled hypertension. If decongestion is essential, consider non‑sympathomimetic alternatives (e.g., saline nasal spray, antihistamines) and ensure blood pressure is optimized before any sympathomimetic use. Monitor blood pressure closely if accidental exposure occurs.
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