Cold & Flu Sudafed vs. Mucinex: What’s the Difference? By Temitope Oyeleke, PharmD Published on August 24, 2023 Medically reviewed by Mary Choy, PharmD Print Table of Contents View All Table of Contents Key Differences Uses Dosage Which Is Better? Side Effects Drug Interactions Frequently Asked Questions Sudafed and Mucinex are popular cough and cold medications that relieve congestion. However, they are part of separate drug classes and work in different ways. Sudafed contains pseudoephedrine, a decongestant that narrows the blood vessels in the nostrils to reduce swelling and promote nasal and sinus drainage. Mucinex contains guaifenesin, an expectorant that helps loosen and thin mucus in the airways, making it easier to be blown out or coughed up. Though they are both available without a prescription, Mucinex can be purchased over the counter (OTC), while Sudafed is sold behind the counter, requires an ID, and can only be purchased in limited quantities without a prescription. This article will discuss the differences and similarities between Sudafed and Mucinex. Getty Images / Smith Collection/Gado / Contributor Sudafed vs. Mucinex: Key Differences Sudafed Available as a tablet and liquid Works by narrowing blood vessels in the nostrils to reduce swelling and promote nasal and sinus drainage, relieve nasal congestion, sinus congestion and sinus pressure Available as a generic Sudafed Sinus Congestion (pseudoephedrine) in a 30 milligram (mg) tablet; Sudafed Sinus Congestion 12 Hour (pseudoephedrine) in a 120 mg ER tablet; Sudafed Sinus Congestion 24 Hour (pseudoephedrine) in a 240 mg ER tablet; Children's Sudafed Nasal Decongestant (pseudoephedrine) in a 15 mg per 5 milliliter (mL) dose (15 mg/5 mL) Sold behind the counter Nondrowsy If a product contains a D after the name (e.g., Robitussin D), then it contains a decongestant (pseudoephedrine or phenylephrine) Mucinex Available as a tablet and solution Works by thinning or loosening mucus in the airways, making it easier to cough up Available as a generic Mucinex (guaifenesin) in a 600 mg ER tablet; Mucinex Maximum Strength (guaifenesin) in a 1,200 mg ER tablet; Mucinex Fast-Max Chest Congestion oral solution (guaifenesin) in a 400 mg/20 mL dose Sold OTC May cause drowsiness (not common) Available in many combination OTC products, such as Mucinex Allergy (fexofenadine and guaifenesin) or (guaifenesin and dextromethorphan) Uses Sudafed works as a decongestant. It helps to relieve stuffiness and sinus congestion or pressure due to the common cold or seasonal allergies. Mucinex is an expectorant. It loosens mucus and thins secretions in the lungs. This can help reduce chest congestion and make coughs more productive. You may opt to use Mucinex if your symptoms are related more to chest congestion. Dosage: How to Take Sudafed vs. Mucinex Sudafed The following tables summarize the dosage recommendations for Sudafed products, including: Sudafed Sinus CongestionSudafed Sinus Congestion 12 HourSudafed Sinus Congestion 24 HourChildren's Sudafed Nasal Decongestant Typical Dosing for Sudafed Products Sudafed Sinus Congestion Sudafed Sinus Congestion 12 Hour Sudafed Sinus Congestion 24 Hour Children's Sudafed Nasal Decongestant Adults and children 12 and up Two tablets every four to six hours; do not take more than eight in 24 hours One tablet every 12 hours; do not exceed two caplets in 24 hours One tablet every 24 hours; do not exceed one tablet in 24 hours Do not use Children 6 to 11 One tablet every four to six hours; do not take more than eight in 24 hours Do not use Do not use 10 mL in dosing cup provided every four hours; do not exceed 40 mL in 24 hours Children 4 to 5 Do not use Do not use Do not use 5 mL in dosing cup every four hours; do not exceed 20 mL in 24 hours Children under 4 Do not use Do not use Do not use Do not use Mucinex Mucinex also comes in various product types, including: Mucinex extended release (ER)Mucinex Maximum StrengthMucinex Fast-Max Chest Congestion Oral Solution Typical Dosing for Mucinex Products Mucinex ER Mucinex Maximum Strength Mucinex Fast-Max Chest Congestion Oral Solution Adults and Children 12 and up One to two tablets every 12 hours; do not exceed four in 24 hours One tablet every 12 hours; do not exceed two in 24 hours 20 mL in the dosing cup provided every four hours; no more than six doses in 24 hours Children under 12 Do not use Do not use Do not use How Long Does Sudafed vs. Mucinex Take to Work? In immediate-release formulations, most Sudafed and Mucinex products start working 30 minutes after a dose. The ER formulations may take up to one hour for some products to take effect. Which Works Better? Sudafed and Mucinex are both effective at treating different cold and allergy symptoms. Sudafed can effectively relieve nasal congestion experienced in colds and allergies. At the same time, Mucinex can help loosen thin mucus in the chest and effectively treat coughs and chest congestion caused by conditions like bronchitis and pneumonia. If you are experiencing nasal congestion and need fast relief, Sudafed may be your better option. However, if you have chest congestion and need to loosen and thin mucus, Mucinex may be the more effective choice. Side Effects & Safety Precautions Side effects are possible with Sudafed and Mucinex. Moreover, there are a few safety considerations to account for when choosing which medication to take. Sudafed Possible side effects experienced with Sudafed include: Anxiety Decreased appetite Dizziness Dry mouth, nose, or throat Fast heart rate Headache High blood pressure (hypertension) Increased blood pressure Insomnia Nausea Palpitations Restlessness Tremors Urinary problems Serious side effects that may be experienced with Sudafed include: Irregular heartbeatHallucinationsHypertensionSevere skin reactionsPsychological dependence Do not take Sudafed if you: Are allergic to Sudafed or any of its ingredients Have used monoamine oxidase inhibitor (MAOI) within 14 days Are pregnant, particularly in the first trimester Have urinary retention Have angle-closure glaucoma Have coronary artery disease Uncontrolled or severe hypertension Mucinex Possible side effects experienced with Mucinex include: Dizziness Nausea/vomiting Rash Headache Diarrhea Stomach pain Serious side effects that may be experienced with Mucinex include kidney stones. Do not take Mucinex if you are allergic to Mucinex or any of its ingredients. Drug Interactions Certain drugs can interact with Sudafed, potentially increasing the risk of severely high blood pressure when taken together. These include: MAOIs, such as isocarboxazid or tranylcypromine (do not take within 14 days of each other)Migranal, Trudhesa (dihydroergotamine)Zyvox (linezolid)Akovaz (ephedrine)Sudafed PE (phenylephrine)Parlodel, Cycloset (bromocriptine) Mucinex does not have any major drug interactions. However, Mucinex DM (a combination of guaifenesin and dextromethorphan) should not be taken within 14 days of MAO inhibitors. If taking a combination product with Sudafed or Mucinex, always be aware of all ingredients and their potential interactions. Ask your healthcare provider or a pharmacist if you're unsure. Summary Sudafed and Mucinex are two popular OTC medications used to treat symptoms of cold, flu, allergies, and sinus infections. While both can help relieve congestion, they work differently. Sudafed narrows blood vessels in the nasal passages to reduce inflammation and relieve congestion. Mucinex loosens and thins mucus in the airways, making it easier to blow out or cough up. So, if you have a stuffy nose, Sudafed may be the better choice, while Mucinex may be more helpful if you have a lot of mucus buildup. It's important to read and follow the instructions on the product label and consult with a healthcare provider or pharmacist if you have any questions. Frequently Asked Questions Can I take Sudafed or Mucinex while pregnant? No. If you are pregnant, it's important to talk to a healthcare professional before taking any medication.Sudafed is not recommended during pregnancy, especially during the first trimester, because it may harm the growing fetus.Mucinex is considered safe during pregnancy, as there is no scientific evidence of fetal harm. However, you should still discuss this with your healthcare provider before taking it while pregnant. Can I take Sudafed or Mucinex for a sinus infection? Sinus infections are caused by fluid accumulation in the sinuses that allows germs to grow. While most infections resolve on their own, antibiotics may be necessary in some cases.To help relieve symptoms of sinus pain and pressure, your healthcare provider may recommend a warm compress, analgesics, decongestant, intranasal steroids, saline nasal spray, or inhaling steam. Research shows that intranasal steroids are more effective than decongestants in relieving sinus pressure in sinus infections. Mucinex may help loosen nasal mucus, but its use in sinus infections is not backed by research. Are there other available OTC decongestants I can take? Sudafed PE (phenylephrine) is an OTC decongestant that relieves sinus congestion, sinus pressure, and nasal congestion. It is less effective than Sudafed because it is broken down in the gut and liver, resulting in less absorption into the bloodstream. It comes in tablets, liquid, and nasal forms. It is not available in ER formulations like Sudafed.Some OTC products are also available under the Sudafed PE brand and contain phenylephrine combined with pain relievers, expectorants, or cough suppressants. 17 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. DailyMed. Label: Sudafed Sinus Congestion- pseudoephedrine hydrochloride tablet, film coated. Głowacka K, Wiela-Hojeńska A. Pseudoephedrine-benefits and risks. Int J Mol Sci. 2021;22(10):5146. doi: 10.3390/ijms22105146. DailyMed. Label: Mucinex- guaifenesin tablet, extended release. Food and Drug Administration. Legal requirements for the sale and purchase of drug products containing pseudoephedrine, ephedrine, and phenylpropanolamine. DailyMed. Label: Sudafed Sinus Congestion 12 Hour- pseudoephedrine hydrochloride tablet, film coated, extended release. DailyMed. Sudafed Sinus Congestion 24 Hour- pseudoephedrine hydrochloride tablet, film coated, extended release. DailyMed. Label: Children's Sudafed Nasal Decongestant- pseudoephedrine hydrochloride solution. DailyMed. Label: Mucinex Maximum Strength- guaifenesin tablet, extended release. DailyMed. Label: Mucinex Fast-Max Chest Congestion Honey and Berry Flavor- guaifenesin solution. Guaifenesin. Ciccone C.D.(Ed.), (2016). Davis's Drug Guide for Rehabilitation Professionals. McGraw Hill. Albrecht HH, Dicpinigaitis PV, Guenin EP. Role of guaifenesin in the management of chronic bronchitis and upper respiratory tract infections. Multidiscip Respir Med. 2017;12:31. doi:10.1186/s40248-017-0113-4 Assimos DG, Langenstroer P, Leinbach RF, Mandel NS, Stern JM, Holmes RP. Guaifenesin- and ephedrine-induced stones. J Endourol. 1999;13(9):665-667. doi:10.1089/end.1999.13.665 DailyMed. Label: Mucinex DM- dextromethoprhan hydrobromide, guaifenesin tablet, extended release. Centers for Disease Control and Prevention. Sinus infection (sinusitis). Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(2 Suppl):S1-S39. doi:10.1177/0194599815572097 DailyMed. Label: Sudafed PE Sinus Congestion- phenylephrine hydrochloride tablet, film coated. Hendeles L, Hatton RC. Oral phenylephrine: an ineffective replacement for pseudoephedrine? J Allergy Clin Immunol. 2006;118(1):279-80. doi:10.1016/j.jaci.2006.03.002 By Temitope Oyeleke, PharmD Oyeleke is a Maryland-based clinical pharmacist. 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