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Comment by richardhod | Hacker News Reader

Beware pseudoephedrine. People have been known to abuse it, and it has dangers especially for those with heart issues: People with heart disease or hypertension should watch out for any legitimate drug that contains pseudoephedrine. See, pseudoephedrine doesn't just constrict the blood vessels in your nose and sinuses; it can also raise blood pressure and heart rate, setting the stage for vascular catastrophe. Over the years, pseudoephedrine has been linked to heart attacks and strokes. "Pseudoephedrine can also worsen symptoms of benign prostate disease and glaucoma," http://www.nbcnews.com/id/24777955/ns/health-health_care/t/d...

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If I recall correctly several studies have shown that phenylephrine has similar blood pressure risks. Combined with having lackluster (if any) impact on the condition it’s specifically designed to treat could actually lead to a worse impact on those with high blood pressure since you’ll take more of it, hoping it’ll finally work.

So yeah, people need to be aware that pseudoephedrine has side effects, but it’s arguably equal to if not better than the alternative that’s being pushed as “safe”.

I remember years ago I was at the gym with a work buddy and we decided to try one of the drinks offered there, since we forgot our water bottles. We had the most amazing workout. We both executed personal bests, and after the workout we felt great. Much less tired than normal. At that point, I turned to the empty bottles and found it was chocked full of pseudoephedrine. It was a little scary to us, so we never did that again.

Yes, it is a powerful drug.

That's interesting. I never gave much thought to the fact that pseudoephedrine is a stimulant and can be harmful/abused in its own right. I just know it helps me breathe when I'm congested.

I feel like the dichotomy between OTC and prescription medications tends to make me assume that prescription drugs are potentially dangerous while anything available OTC is harmless.

You used to be able to buy ephedrine at truck stops. It was widely abused as a stimulant.

Where can you buy beverages with pseudoephedrine added?

"Years ago" I'm guessing

More common would be ephedra, though this has been mostly illegal to sell as a food/drink ingredient in the US since 2004. Ephedra contains ephedrine and pseudoephedrine.

This was in the early 00's. It was banned sometime after the episode discussed.

OTC pseudoephedrine packaging makes it clear you should ask your doctor if you have high blood pressure, heart disease, enlarged prostate or several other conditions. I might prefer that it say why, but this is at least enough to get me to google it if I have reason to be concerned about any of those things.

I want to be trusted with medicine that actually works, and that means I need to take some responsibility for understanding the dosing and side effects before I take it.

You are trusted this way. Sudafed (and other pseudoephedrine meds) don't require prescriptions. You don't have to justify your purchase when you ask for them. The reason they're behind the counter is to prevent bulk purchase, since pseudoephedrine is basically a few household-chemical steps away from being methamphetamine. Despite that fact, you're still allowed to buy them for any or no reason, in quantities sufficient for any practical use.

The annoyance is that there's an ineffective medicine taking their place on the shelves in front of the counter, and no sign saying "don't bother, just ask the pharmacist for the real thing". But you know that now, so this isn't so much a problem for you.

The OP you're responding to is just saying, be careful with pseudoephedrine, independent of the law. And they're right; it's been linked to heart attacks and strokes.

Agreed. Had some irregular heartbeats with it as well that spooked me. I do love the energy boost it gives you though, it’s mildly nootropic

yes it definitely increases my vocabulary a little bit while I'm taking it heh heh. from the side effects though, it doesn't seem worth it. PPA (Phenylpropanolamine) was similar, but less speedy and spacier. Its is now banned bc it harms people with fragile vasculature.

The problem is: it actually works. Really really well. Unlike phenylephrine.

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