Pseudoephedrine is a vasoconstrictor, used in cold medicines, but in the face of its potential effects on cerebral blood vessels, their marketing authorization is being reassessed.
- Vasoconstrictors are strongly discouraged for pregnant women.
- They are also contraindicated for people with a history of stroke, convulsion or suffering from coronary insufficiency or high blood pressure.
Runny nose, headaches, coughing or sneezing: the symptoms of a cold are more or less debilitating. Many drugs are sold to speed healing, but some may be banned. In a notice published on February 10, the European Medicines Agency (EMA) announces the reassessment of medicines containing pseudoephedrine, “following concerns about the risk of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS), conditions affecting the blood vessels of the brain”.
Pseudoephedrine: what is its action against the common cold?
Pseudoephedrine is a vasoconstrictor. It stimulates nerve endings to release the chemical norepinephrine, which causes blood vessels to constrict, or narrow. “This reduces the amount of fluid released from the vessels, leading to less swelling and less mucus production in the nose.”, specifies the EMA. It is used alone or with other molecules in the treatment of cold and flu symptoms, such as headaches, fever and pain, but also to treat allergic rhinitis. In France, this substance can be found in the drugs Actifed, Dolirhume, Humex or even Rhinadvil and Nurofen colds.
Pseudoephedrine for the common cold: what are the effects on the brain?
This decision follows new data “from a small number of cases of PRES and RCVS in people using pseudoephedrine-containing drugs that have been reported in pharmacovigilance databases and medical literature“, specifies the agency. These two pathologies can cause a reduction in the blood supply in the brain and lead to significant complications, even death. The main symptoms are headaches, nausea and seizures. pseudoephedrine base have already been associated with other pathologies affecting the brain.”Drugs containing pseudoephedrine have a known risk of cardiovascular and cerebrovascular ischemic events (side effects involving cardiac and cerebral ischemia), including strokes and heart attacksrecalls the EMA. Restrictions and warnings are already included in the drug information to reduce these risks.”
What can the EMA decide regarding pseudoephedrine?
The European Medicines Agency asked its safety committee to examine the various medicines containing the substance. Depending on the studies available and the reports made, several decisions may be taken: maintaining the authorization on the market, a modification, a suspension or a total withdrawal. “The final step in the review process is the adoption by the European Commission of a legally binding decision applicable in all EU Member States.“, specifies the EMA.
Colds: what are the alternatives to pseudoephedrine?
As the ANSM reminds us, a cold heals spontaneously in seven to ten days, without treatment. Before taking medication, certain actions can help: use nasal wash solutions, drink enough, sleep with your head elevated and ventilate the rooms. At the same time, you must stop smoking and avoid rooms equipped with air conditioners, as they dry out the nasal mucous membranes.
