Summary
- Sudafed® (pseudoephedrine) is a stimulant decongestant that narrows blood vessels to relieve nasal swelling but can raise heart rate, blood pressure, and cause jitteriness or insomnia.
- Alcohol and Sudafed® have competing effects on the body. Sudafed® is a stimulant, while alcohol is a depressant—they can alter or mask each other’s symptoms.
- Mixing the two may increase the risk of overdose or acute psychosis, with symptoms like hallucinations or disorganized thinking—especially in sensitive individuals.
- Some health agencies claim the combination is safe in moderation, but potential side effects make caution the better choice, particularly if you’re sick or already dehydrated.
- Nasal sprays may provide safer relief from decongestion in people who choose to drink alcohol. However, skipping alcohol altogether is best during illness.
Sudafed® (pseudoephedrine) is a stimulant commonly used as a decongestant used to treat symptoms of the common cold, flu, or seasonal allergies. But while it’s available over the counter, that doesn’t mean it’s safe to take under every circumstance—especially if you’re also planning to drink.
Below, we break down how pseudoephedrine works in the body, how it may interact with alcohol, and what the potential risks are. If you’re concerned about your alcohol use or need help cutting back, our confidential 24/7 national hotline can connect you with treatment programs and recovery support near you.
How Sudafed® Works in the Body
Sudafed® contains pseudoephedrine, a sympathomimetic amine that acts primarily on the adrenergic receptor system. Specifically, it stimulates α-adrenergic receptors in the nasal mucosa to produce vasoconstriction—the narrowing of blood vessels. This reduces blood flow to swollen nasal tissues and helps relieve congestion. However, because pseudoephedrine is a systemic vasoconstrictor and stimulant, it also causes the blood vessels throughout the rest of your body to become tighter.
Common Side Effects of Pseudoephedrine
Pseudoephedrine can cause side effects such as:
- Increased heart rate (tachycardia)
- Elevated blood pressure
- Jitteriness or restlessness
- Insomnia
Use in Other Drugs
It’s also worth noting that pseudoephedrine is the primary ingredient used to make methamphetamine (commonly known as meth)—an addictive and illicit street drug. It’s actually possible to make meth from Sudafed® and other over-the-counter medications that include pseudoephedrine, which has created controversy about whether these drugs should still be on pharmacy shelves or whether they should require prescriptions.
How Alcohol Interacts with Sudafed®
The pseudoephedrine in Sudafed® is a stimulant, but alcohol is a depressant. It can cause you to become drowsy and sedated—but if you consume too much, this can lead to loss of consciousness, coma, or even death.
Increased Risk of Overdose
Mixing stimulants with depressants is also dangerous. Some people might mistakenly assume that taking these two types of substances at the same time could cancel out or “balance” their effects—but this is not true. In fact, it can change or hide the effects of one or both drugs, which can lead you to think it’s safe to take more and increase your risk of an accidental overdose.
Overdosing on stimulants or depressants can be very dangerous. Too many stimulants can make your heart rate or blood pressure dangerously high, while too many depressants can slow down your breathing.
Potential Psychosis
According to some research, mixing pseudoephedrine with ethyl alcohol also carries a risk of acute psychosis. During psychosis, you lose touch with reality—and could experience negative symptoms like:
- Delusions
- Hallucinations
- Disorganized thought
- Disorganized behavior
Every psychotic episode also comes with a risk of putting yourself or others in danger—so this is an outcome you want to be careful to avoid.
How Likely Is Sudafed® to Interact Negatively with Alcohol?
Drugs affect people differently—so it’s impossible to predict who will experience the problems listed above and who won’t. Some healthcare agencies in countries like the UK say that it is generally safe to take pseudoephedrine if you drink alcohol, but that does not mean you cannot experience unwanted outcomes.
We recommend caution if you drink alcohol and are also looking for a way to relieve cold or allergy symptoms. You should never mix alcohol with any stimulant recreationally—this can be extremely dangerous.
Alternatives for Cold & Allergy Relief While Drinking
Although the patient information for Sudafed® does not specifically mention that it should not be taken with alcohol, the risks presented in this article are still possible. You may want to speak to your healthcare provider or a pharmacist about safer alternatives.
Saline sprays and even some steroid nasal sprays are usually safe to use for people who drink alcohol. These are also effective for relieving congestion in many people.
It’s best to avoid most other decongestant medications if you drink alcohol, including atopical decongestants like oxymetazoline and antihistamines like loratadine or cetirizine. Although these may have fewer interactions with alcohol, you could still experience problems like dehydration, fatigue, and immune suppression.
Bottom line: if you’re feeling sick, it may be best to skip drinking altogether until you recover. Alcohol makes your health worse.
Takeaway: Sudafed® & Alcohol May Not Mix Well
While occasional use of Sudafed® with small amounts of alcohol may not cause immediate harm in healthy individuals, it can still increase your risk of side effects—including accidental overdose and acute psychosis. And drinking alcohol always comes with health risks, even if you’re not taking any medication.
To reduce your risk:
- Avoid drinking while taking Sudafed®, especially in large quantities.
- Read all the warning labels on your cold and allergy medications.
- Ask your doctor or pharmacist if you’re unsure about combining alcohol with any medication.
And if alcohol use is interfering with your health or recovery from illness, you don’t have to manage it alone. Call our 24/7 confidential hotline to explore support options, treatment referrals, and recovery programs that can help.