Sudafed and Alcohol

Estimated reading time: 33 minute(s)

Cold and flu are very common medical issues, and millions of people catch them on a day-to-day basis. Regardless of the time and nature, many of these people rely on medications like Sudafed to find quick relief. This medication is commonly available over the counter and contains pseudoephedrine, which can quickly clear up congestion and provide relief and comfort.

Because of its easy OTC availability, most people consider Sudafed a safe drug that they can slip into their daily life without considering it. However, it is imperative to remember that the medication carries a risk of interacting with various substances, alcohol being on top of them. Sudafed and alcohol is a combination every health expert strongly discourages because of the multiple risks it brings to the user’s health. Hence, everyone who commonly catches the flu and needs to rely on medications like Sudafed must familiarize themselves with these risks and try to avoid them as much as possible.

An Overview of Sudafed

Sudafed is a brand name for a pharmaceutical chemical called pseudoephedrine. This medication is readily available over the counter, and millions of people use it to get relief from sinus pressure or a stuffy nose caused by the common cold and flu. Additionally, many people find relief in Sudafed from other breathing illnesses, such as bronchitis, allergies, and hay fever. The medication works magically for most users by narrowing the blood vessels and decreasing congestion and swelling. Many people might be familiar with pseudoephedrine associated with methamphetamine, an illicit stimulant substance. Pseudoephedrine is a primary ingredient of meth, and because of its increased use in meth production, many drug authorities have now classified pseudoephedrine as a controlled substance.

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Sudafed is, however, generally safe to use with mild side effects, such as rapid heartbeat, sleep disturbances, sweating, high blood pressure, and blurry vision. These side effects can vary depending on dosage as the medication comes in 12-hour and 24-hour dosages. An additional dosage of 60 mg is also available that users can repeat every four to six hours as needed. Despite being linked to mild side effects when used alone, Sudafed can lead to many serious dangers and risks when combined with other substances, such as alcohol.

Can You Drink Alcohol While Taking Sudafed?

While alcohol and Sudafed do not have any specific drug interactions, taking them together can worsen the overall health and put the user at various risks. For starters, taking alcohol while using Sudafed can intensify the side effects of the latter, meaning a user may experience heightened anxiety, dizziness, and palpitations. On top of the discomfort associated with colds and flu, these individuals will also experience other bad effects related to alcohol and even interfere with healing and recovery.

Hence, experts highly discourage people from combining Sudafed with alcohol and advise them to have an alcohol-free period until they safely come off the medication. Following are some important points to remember while taking Sudafed with any other substance, including alcohol:

  • Seek professional medical advice before taking Sudafed or other over-the-counter drugs for certain nasal issues with alcohol, especially if you experience recurring health problems
  • Always check with the doctor about the best time to start Sudafed safely if you have been drinking heavily for the past few days
  • If your congestion does not go away within a week, even after taking Sudafed, consult with a physician regarding further management

Can You Mix Sudafed and Alcohol: The Possible Risks?

Assuming Sudafed is an over-the-counter medication, most people render it safe for everyday use. However, it is crucial to remember that combining it with alcohol can lead to various side effects and risks. Mentioned below are some risk factors that may compel a user to avoid using this combination in the future.

Stimulants like Sudafed can mask the feeling of intoxication

Sudafed contains pseudoephedrine which acts like a stimulant inside the body. Combining stimulants with alcohol can be dangerous as these medications often mask the symptoms of intoxication. As a result, it may be difficult for a person to realize that they have consumed too much alcohol, and they may keep drinking it, putting themselves at risk of the following:

  • Violence or increased aggression
  • Accidents and injuries
  • Alcohol poisoning

Sudafed and alcohol may induce dizziness and drowsiness      

Alcohol and Sudafed can cross-react to cause certain side effects, such as increased dizziness, drowsiness, or both.

Alcohol can weaken the immune system

Drinking a large quantity of an alcoholic beverage on a single occasion can mess with the body’s immunity, decreasing its ability to fight infections. This immune system impairment can persist for up to 24 hours following alcohol consumption. In other words, people using Sudafed to fight viral or bacterial infections may have to keep fighting the congestive symptoms for much longer due to alcohol constantly disturbing their immunity. The situation worsens as alcohol simultaneously decreases Sudafed’s effectiveness, as mentioned above.

Alcohol can decrease the efficacy of Sudafed

Using alcohol with Sudafed can make the latter less effective in treating nasal congestion. Moreover, alcohol on its own can contribute to the worsening of nasal congestion at the same time. Research has confirmed that heavy and non-heavy acute alcohol consumption can reduce how open an individual’s nose is. What this means is people using Sudafed with alcohol may struggle longer and harder before their congestion finally clears up.

Drinking with Sudafed can worsen nasal symptoms

In many people, alcohol consumption can trigger an issue called alcohol-linked nasal symptoms or ANS. Females are at a higher risk of experiencing this condition than men. Moreover, people with breathing diseases like asthma are more likely to acquire it. ANS occurs because alcohol can cause swelling of the blood vessels found in the nose, making it difficult to breathe. Moreover, the dehydrating effects of alcohol can thicken the mucus, leading to more nasal congestion.

The combination can lead to an overdose

People who routinely mix Sudafed with alcohol are putting themselves at risk of an overdose. This is because stimulants like Sudafed can mask the feelings of intoxication, and a user may continue consuming either of the substances to a dangerously high level. Following are some symptoms of an overdose:

  • Fast heart rate
  • Seizures
  • Increased blood pressure
  • Anxiety
  • Restlessness
  • Dizziness

Sudafed and Alcohol Interactions: Who is at the Highest Risk?

In general, Sudafed is a safe medication that most people can use without experiencing any side effects. However, mixing it with alcohol makes it potentially dangerous, and the following groups of people must be particularly cautious while considering this combination:

Pregnant Females

It is common knowledge that alcohol is strictly prohibited during pregnancy. However, few people know that Sudafed itself may be contraindicated during these circumstances. Animal studies have proven that using this decongestant during pregnancy can likely harm the fetus. Unfortunately, human trials investigating the use of pseudoephedrine in pregnant females are limited, so experts do not have much insight to offer. However, they generally advise using Sudafed and other similar medications only if their benefits outweigh the possible risk for the mother and the growing fetus.

Breastfeeding Mothers

Both alcohol and Sudafed are likely to affect breastfeeding females. While alcohol can easily pass into the breast milk and eventually to the baby’s body, the amount of Sudafed that can cross this barrier is negligible. However, this medication carries the tendency to interrupt daily milk production. Research proves that a 60 mg dose of any medication containing pseudoephedrine can cut down a mother’s milk supply by up to 24 percent.

Older Adults

Most older adults have malfunctioning organs, specifically the liver and kidneys. Because of these organ impairments, these individuals must be very cautious while using Sudafed and alcohol either alone or together, as the risks associated with them can be significantly higher. Other symptoms that this particular age group can experience due to this combination include the following:

  • Hallucinations
  • Seizures
  • Central nervous system depression
  • Death

People with Certain Medical Conditions

Having certain pre-existing medical conditions can make the use of Sudafed and alcohol more dangerous for both young and older adults. Hence, it is imperative to talk to your doctor about using Sudafed if you have one or more of the following conditions:

  • High blood pressure
  • Heart disease
  • Type 2 diabetes mellitus
  • Blood vessel disease
  • Glaucoma or a high risk of glaucoma
  • Psychiatric conditions
  • Prostate enlargement
  • Overactive thyroid gland
  • Psychiatric conditions

Sudafed and Alcohol: What Else Can Interact with this Medication?

While it is established that combining Sudafed with alcohol may not be a safe idea, plenty of other medications can cause risks to the user if combined with anything containing pseudoephedrine. Some of these medications include the following:

Monoamine Oxidase Inhibitors (MAOIs)

This category of drugs includes antidepressant medications, such as phenelzine and isocarboxazid. Ideally, a person who has taken one of these medications must not take Sudafed or other drugs with similar chemicals for the next two weeks to avoid any unnecessary risks.


This medication is indicated for managing unusual heart rhythms and heart failure and may not be safe to combine with Sudafed.

Tricyclic Antidepressant Medications

Also known as TCAs, tricyclic antidepressant medications include imipramine, doxepin, and amitriptyline. Observe caution before combining these medications with Sudafed.

Ergot Alkaloids

These medications, such as ergotamine, are usually helpful in managing migraine and may not be safe to combine with Sudafed.

Suppose an individual is unsure about combining Sudafed with any of the medications they are already taking. In that case, it is better to consult a doctor or pharmacist to ensure safety. Ensure to give them complete history and inform them about any of the following medications that they are currently on or have been taking recently:

  • All prescription medications
  • All non-prescription medications
  • Herbal remedies
  • Supplements
  • Vitamins


How long after taking phenylephrine can I drink alcohol?

How long after taking a dose of Sudafed or pseudoephedrine you can safely drink alcohol depends on the type of medication you take. For example, if you have taken Sudafed 12 Hour formulation, it will stay in the system for half a way before you require another dose. What this means is taking alcohol within at least the next 12 hours of having Sudafed 12 Hours is unsafe. In the case of Sudafed 24-Hour formulation, you may need to skip at least one whole day before you can consider consuming alcohol without raising any safety concerns.

Can phenylephrine and alcohol cause addiction?

Because pseudoephedrine works as a stimulant in the body, many people commonly abuse it to feel euphoria. Eventually, these people develop a dependence on it. If they start drinking alcohol alongside their Sudafed use, the effects of dependence become worse and much quicker, eventually leading to a full-blown addiction. This case, also known as dual diagnosis, can be very alarming as it increases the severity of overall side effects and damage to health and can make a person more vulnerable to an overdose.

Why do people use Sudafed?

Sudafed is commonly prescribed to handle the common cold, flu, sinusitis, and the symptoms of asthma and bronchitis. However, many people be tempted to use this medication without any legit medical reasons to get high.

Are there any other decongestants that I can safely use while drinking alcohol?

Unfortunately, scientists do not have enough information regarding the relationship between the use of decongestants and alcohol. Hence, a person should always check with their doctor or pharmacist before combining the two. Mixing alcohol with any medication, including OTC drugs like decongestants, can lead to various side effects that may worsen quickly. Some other examples of decongestants apart from Sudafed include the following, and caution should be observed while mixing it with any alcoholic beverage:

  • Xylometazoline
  • Oxymetazoline
  • Phenylephrine
  • Naphazoline
  • Propylhexedrine

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