Key Message
Current evidence suggests that pseudoephedrine, in combination with acetaminophen, is effective compared to placebo in providing temporary symptom relief from nasal congestion due to upper respiratory tract infections or cold-like symptoms. No comparative evidence exists that has evaluated single-ingredient pseudoephedrine against combination therapy of pseudoephedrine and acetaminophen. The safety profile remains uncertain: adverse events appear to be minor when administered acutely with greater risk of serious adverse events over long-term use. Evidence-based guidelines generally recommend the use of decongestant, limited as adjuncts to provide temporary symptom relief, in patients with non-infectious rhinitis/ rhinosinusitis or allergic rhinitis. Several of the identified guidelines caution its use in patients with hypertension, ischemic heart disease, glaucoma, prostatic hypertrophy and/or diabetes mellitus.