Can you take sudafed decongestant and ibuprofen together

If you are looking for a combination product to help with the symptoms of congested sinuses, then you could try Sudafed sinus pressure and pain tablets, containing the painkiller ibuprofen 200mg and a decongestant pseudoephedrine 30mg.

Our resident pharmacist Rita Ghelani offers her expert advice on how Sudafed sinus pressure and pain tablets help with the symptoms of cold and blocked sinuses, how to they work and the possible side effects.

What are Sudafed sinus pressure and pain tablets used for?

Relieving symptoms of colds and flu, such as headache, sore throat, aches and pains, fever, blocked nose and sinus congestion and pain.

How do Sudafed sinus pressure and pain tablets work?

Sudafed sinus pressure and pain tablets contain painkiller ibuprofen and pseudoephedrine hydrochloride.

Ibuprofen is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID). It relieves mild to moderate pain, inflammation and fever.

Ibuprofen works by blocking the action of an enzyme in the body called cyclo-oxygenase (COX). COX is involved in making substances called prostaglandins, in response to injury and in certain diseases and conditions. The prostaglandins cause pain, swelling and inflammation. Ibuprofen reduces inflammation and pain by reducing the production of these prostaglandins.

Ibuprofen brings down a fever by reducing the production of prostaglandins in the brain. Fever is associated with an increase in prostaglandins in the brain, which cause the body temperature to increase.

Pseudoephedrine works by causing the blood vessels in the linings of the nasal passages and sinuses to contract and narrow. This decreases blood flow into the linings of the nose and sinuses, which reduces the feeling of congestion and also reduces the production of mucus.

Dosage instructions for Sudafed sinus pressure and pain tablets

• Adults and adolescents over 12 years of age should take one or two tablets up to three times a day as needed to relieve symptoms.
• Leave at least four hours between doses.
• Do not take more than six tablets in 24 hours.
• The tablets should preferably be taken with or after food.
• This medicine should be used for the shortest possible time to relieve symptoms. If your symptoms persist despite treatment or get worse, get medical advice from your doctor or pharmacist. Do not use this medicine for more than 10 days without consulting a doctor.

Sudafed sinus pressure and pain tablets should not be taken by

• Children under 12 years of age.
• People who have ever had an allergic reaction after taking aspirin or other NSAIDs such as diclofenac (for example an asthma attack, itchy rash, nasal inflammation (rhinitis) or swelling of the lips, tongue and throat).
• People with an active peptic ulcer or bleeding in the gut; those who've had two or more episodes of this in the past; and people who have ever experienced bleeding or perforation in the gut as a result of taking an NSAID.
• People with severe kidney failure or liver failure.
• People with severe heart failure, heart disease or high blood pressure (hypertension).
• People with an overactive thyroid gland (hyperthyroidism).
• People with a tumour of the adrenal gland (phaeochromocytoma).
• People with diabetes.
• People with closed angle glaucoma.
• Men with an enlarged prostate gland.
• People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days.
• People taking any other NSAID painkillers, including COX-2 inhibitors such as celecoxib.
• Ibuprofen is not recommended for women who are trying to get pregnant because it can temporarily reduce female fertility.

Sudafed sinus pressure and pain tablets should be used with caution by

• Elderly people.
• People with a history of asthma or allergies.
• People with a history of disorders affecting the stomach or intestines, such as ulceration or bleeding, or inflammatory bowel disease such as Crohn's disease or ulcerative colitis.
• People with kidney or liver problems.
• People with a history of heart disease or stroke.
• Smokers.
• People with high cholesterol levels.
• People with blood circulation problems such as Raynaud's disease.
• People with blood clotting problems or taking anticoagulant medicines.
• People with diseases affecting connective tissue, such as systemic lupus erythematosus.

Is it safe to take Sudafed sinus pressure and pain tablets if pregnant?

Sudafed sinus pressure and pain is not recommended for use during pregnancy, particularly in the third trimester. In the third trimester the ibuprofen may delay labour, increase the length of labour and cause complications in the new-born baby. Get advice from your doctor, pharmacist or midwife if you need to treat cold and flu symptoms while you are pregnant.

Is it safe to take Sudafed sinus pressure and pain tablets if breastfeeding?

Sudafed sinus pressure and pain is best avoided by mothers who are breastfeeding, because decongestants such as pseudoephedrine can temporarily decrease the production of breast milk. Ask your doctor or pharmacist for further advice.

Possible side effects of Sudafed sinus pressure and pain tablets

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that may be associated with Sudafed sinus pressure and pain. Just because a side effect is stated here doesn't mean that all people using this medicine will experience that or any side effect.

• Disturbances of the gut such as nausea, vomiting, diarrhoea, indigestion or abdominal pain. These can mainly be avoided by taking the medicine with food or milk.
• Headache.
• Skin rashes.
• Dry mouth.
• Dizziness.
• Increased heart rate (tachycardia).
• Palpitations.
• Ulceration or bleeding in the stomach or intestines. This is more likely in elderly people. If any signs of bleeding from the stomach or bowels are experienced, such as vomiting blood and/or passing black/tarry/bloodstained stools, you should stop taking this medicine and consult your doctor immediately.
• Liver or kidney disorders.
• Difficulty sleeping (insomnia).
• Difficulty passing urine (urinary retention).
• Anxiety, restlessness or tremor.
• Seeing or hearing things that aren't really there (hallucinations).
• Allergic reactions such as narrowing of the airways (bronchospasm), swelling of the lips, throat or tongue (angioedema), itchy blistering rash or anaphylactic shock. Stop taking this medicine and get immediate medical advice if you think you've had an allergic reaction.

For more information about the possible side effects of Sudafed, read the information provided with the medicine or talk to your doctor or pharmacist. You can find a copy of this here

If you think you have experienced a side effect after taking Sudafed sinus pressure and pain tablets you can report using the yellow card website.

Can I take Sudafed sinus pressure and pain tablets with other medicines?

If you're already taking any other medicines, check with your pharmacist before taking Sudafed sinus pressure and pain tablets.

Painkillers with Sudafed sinus pressure and pain tablets

Do not take these tablets with other medicines that contain ibuprofen, as this can easily result in exceeding the maximum recommended daily dose of ibuprofen. Many cold and flu remedies and over-the-counter painkillers contain ibuprofen, so be sure to check the ingredients of any other medicines before taking them with this one. Ask your pharmacist for further advice. It is okay to take paracetamol with this medicine if needed.

Don't take Sudafed sinus pressure and pain tablets with painkilling doses of aspirin or any other oral NSAID, for example diclofenac or naproxen, as this increases the risk of side effects on the stomach and intestines. People taking selective inhibitors of COX-2 such as celecoxib or etoricoxib should avoid this medicine for the same reason.

Other cold & flu remedies with Sudafed sinus pressure and pain tablets

You should not use this medicine with other cough, cold and flu or decongestant medicines, unless they have been specifically recommended by your pharmacist.

Other medicine interactions with Sudafed sinus pressure and pain tablets

Avoid taking this medicine if you're already taking any of the following medicines because the combination may increase your blood pressure:

• appetite suppressants
• amphetamine-like stimulants, including methylphenidate, dexamfetamine and modafinil
• other decongestants (often found in other non-prescription cough and cold remedies)
• the antibiotic linezolid
• tricyclic antidepressants, such as amitriptyline.

If you're taking medicines for high blood pressure you shouldn't take this medicine as well, because the pseudoephedrine may make your blood pressure medicine less effective.

You're more at risk of ulceration or bleeding in your gut if you take ibuprofen with corticosteroids such as prednisolone. There may also be an increased risk of bleeding in the gut if you take ibuprofen with other medicines that can increase the risk of bleeding, such as those below. If you're taking one of these, you shouldn't take Sudafed sinus pressure and pain tablets unless advised to by your doctor:

• anti-blood-clotting (anticoagulant) medicines such as warfarin, dabigatran, apixaban, edoxaban, rivaroxaban, heparin and low molecular weight heparins such asenoxaparin
• antiplatelet medicines to reduce the risk of blood clots or 'thin the blood', such as dipyridamole, clopidogrel, prasugrel, low-dose aspirin
• erlotinib
• ginko biloba (a herbal remedy)
• SSRI antidepressants, such as fluoxetine, paroxetine, citalopram
• venlafaxine.

There may be an increased risk of side effects on the kidneys if ibuprofen is taken in combination with any of the following medicines:

• ACE inhibitors, such asenalapril
• ciclosporin
• diuretics, such as furosemide (ibuprofen may also reduce the effectiveness of diuretic medicines)
• tacrolimus.

Ibuprofen may reduce the removal of the following medicines from the body and so may increase the blood levels and risk of side effects of these medicines:

• digoxin
• lithium
• methotrexate.

If ibuprofen is taken with quinolone antibiotics, such as ciprofloxacin or norfloxacin there may be an increased risk of seizures (fits), particularly if you suffer from epilepsy.

Last updated 21.11.2019

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