Oral pseudoephedrine is a common ingredient in more than 135 over-the-counter and prescription medications. Shorter duration of use was associated with greater increases in SBP and DBP. Studies with more women had less effect on BP or HR. Higher doses and immediate-release preparations were associated with greater BP increases. The effect in patients with controlled hypertension demonstrated an SBP increase of similar magnitude (1.20 mm Hg 95% CI, 0.56 to 1.84 mm Hg). Pseudoephedrine caused a small but significant increase in SBP (0.99, mm Hg 95% CI, 0.08 to 1.90) and HR (2.83 beats/min 95% CI, 2.0 to 3.6), with no effect on DBP (0.63 mm Hg, 95% CI, –0.10 to 1.35). Twenty-four trials had extractable vital sign information (45 treatment arms 1285 patients). Study quality was assessed using the methods of Jadad, and data were synthesized using a random-effects model and weighted mean differences. The primary data extracted were systolic BP (SBP), diastolic BP (DBP), and HR. We searched MEDLINE, EMBASE, and the Cochrane Library for English-language, randomized placebo-controlled trials of oral pseudoephedrine treatment in adults.

We assessed whether pseudoephedrine causes clinically meaningful elevations in HR or BP. Oral pseudoephedrine is commonly used to treat symptoms of rhinitis and rhinorrhea, but its effect on blood pressure (BP) and heart rate (HR) remains uncertain.

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Pdf blood pressure and heart rate chart