Ephedrine information from DrugsUpdate
P - Caution when used during pregnancy
L - Contraindicated in lactation
Ephedrine (EPH) is a sympathomimetic amine commonly used as a stimulant, appetite suppressant, concentration aid, decongestant, and to treat hypotension associated with anaesthesia. Ephedrine is similar in structure to the (semi-) synthetic derivatives amphetamine and methamphetamine. Chemically, it is an alkaloid derived from various plants in the genus Ephedra (family Ephedraceae). It is most usually marketed in the hydrochloride and sulfate forms.
Pharmacodynamics
Pharmacokinetics
Ephedrine has both α- and β-adrenergic acitivity with pronounced stimulating effects on the CNS. It increases cardiac output, induces peripheral vasoconstriction, bronchodilation, reduces intestinal tone and motility, and relaxes the bladder while contracting the sphincter muscle. It also has stimulant action on the resp center and dilates the pupil witho affecting light reflexes.
Absorption
Readily and completely absorbed form the GIT (oral).
Metabolism
Hepatic.
Excretion
Via urine (largely as unchanged, small amounts of metabolites); 3-6 hrs (elimination half-life).
Ephedrine Indications / Ephedrine Uses
Information Not Available
Ephedrine Adverse Reactions / Ephedrine Side Effects
Anxiety, tachycardia, tremor, dry mouth, hypertension, cardiac arrhythmias, impaired circulation to the extremities, nervousness, insomnia, palpitations. Difficulty in micturition in patients with prostatic enlargement. Nasal drops: Local irritation, rebound nasal congestion and drug-induced rhinitis on prolonged use.
Potentially Fatal: Delusions, hallucinations. Seen with hypersensitivity and overdosage. Acute CNS and CVS stimulation presenting as vomiting, fever, hypertension, psychosis. Cardiac arrhythmias.
Precautions
Sulfite Sensitivity
Use nasal decongestant form of drug with caution
Asthma
Use drug with caution.
Hypertension
Drug may cause severe hypertension, resulting in intracranial hemorrhage, angina, or potentially fatal arrhythmias, especially in patients with organic heart disease or those receiving drugs that sensitize myocardium.
Labor
Do not use when maternal BP exceeds 130/80 mmHg; use during delivery may cause acceleration of fetal heart rate.
Overdosage
Symptoms
Convulsions, nausea, vomiting, chills, cyanosis, irritability, nervousness, fever, suicidal behavior, tachycardia, dilated pupils, blurred vision, opisthotonos, spasms, pulmonary edema, gasping respirations, coma, respiratory failure, personality changes, hypertension with anuria.
Special Precautions
Ischaemic heart disease, hyperthyroidism, diabetes mellitus, hypertension, angle-closure glaucoma, renal impairment; prostatic enlargement; pregnancy, elderly.
Other Drug Interactions
Reduces antihypertensive effect of bethanidine and guanethidine. May increase clearance of dexamethasone. Increased incidence of adverse effects when used with theophylline.
Potentially Fatal: Severe HTN when combined with MAOIs or withi 2 wk of discontinuance of MAOI treatment. Increased risk of arrhythmias with cardiac glycosides, quinidine or tricyclic antidepressants. Increased vasoconstriction or pressor effects with ergot alkaloids or oxytocin.
Other Interactions
Information Not Available
Dosage
Oral
Diabetic neuropathic oedema
Adult: 30-60 mg tid.
Child:
Intravenous
Reversal of spinal or epidural anaesthesia-induced hypotension
Adult: 3-6 mg or up to 9 mg in a 3 mg/mL soln given as slow Inj repeated every 3-4 min, as needed.
Max Dosage: 30 mg.
Food(before/after)
May be taken with or without food.
List of Contraindications
Ephedrine and Pregnancy
Caution when used during pregnancy.
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Ephedrine and Lactation
Contraindicated in lactation
Ephedrine and Children
Information Not Available
Ephedrine and Geriatic
Information Not Available
Ephedrine and Other Contraindications
Hypersensitivity. Hypertension, thyrotoxicosis, BPH. Lactation.
Storage
Intravenous
Store at 15-25°C.
Oral
Store at 15-25°C.
Lab interference
Intravenous
Store at 15-25°C.
Oral
Store at 15-25°C.
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