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Ephedrine

Ephedrine

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By Medicover Hospitals / 29 Nov 2020
Home | Medicine | Ephedrine

What is Ephedrine

Ephedrine is a drug and stimulant. It is used to avoid low blood pressure during spinal anaesthesia. It is not recommended treatment for asthma, narcolepsy, and obesity. The benefits of nasal congestion are uncertain.


  1. Ephedrine uses
  2. Ephedrine side effects
  3. Precautions
  4. Ephedrine Overdosage
  5. Contraindictions
  6. Ephedrine storage
  7. Ephedrine vs Phenylephrine
  8. Frequently Asked Questions
  9. Citations

Ephedrine Uses:


  • Ephedrine is a prescription drug used during anaesthesia to relieve the effects of low blood pressure (hypotension). Ephedrine can be used with other drugs or alone.
  • Ephedrine belongs to Alpha/Beta-Adrenergic Agonists, a class of drugs.

  • It is not known if ephedrine in children is safe and reliable.

  • Ephedrine Side effects

  • Ephedrine's typical side effects typically occur with higher doses and include:
    • Jitters
    • Nervousness
    • Scarcity
    • Fear
    • Sickness
    • Dizziness
    • The sensation of spinning (vertigo)
    • Headache
    • Twitching
    • Nausea
    • Appetite Loss
    • Sleeping Trouble (insomnia)
    • Fast Heart Rate
    • Palpitations
    • Sweating
    • Vomiting
    • Loss of weight
    • Frequent urination or painful urination
    • Loss of appetite
    • Chest pain

    Administration and Dose


    To adults

  • The normal parenteral dosage administered subcutaneously or intramuscularly is 25 to 50 mg. 5 to 25 mg intravenously can be administered slowly, repeated, if necessary, within 5 to 10 minutes.
  • Kids

  • The normal subcutaneous or intramuscular dosage is 0.5 mg body weight per kg.Until administration, parenteral drug products should be visually inspected for particulate matter and discolouration whenever the solution and container allows.
  • How Supplied

  • Injection of Ephedrine Sulfate, USP, 50 mg/dl, 1 mL per vial, NDC 55390-875-015
  • Filled with 25 bottles per carton. Protecting them from light.
  • How ephedrine should be taken:

  • As instructed by your doctor, use this drug. For exact dosing instructions, consult the label on the medicine. For exact dosing instructions, consult the label on the medicine.
  • With or without food, ephedrine can be used. If there is a stomach disturbance, take it with food to decrease stomach irritation.
  • Take it as soon as possible if you miss a dose of Ephedrine and are taking it daily. Skip the missed dose if it is almost time for your next dose, and go back to your daily dosing schedule. Do not use 2 doses at a time.

  • Interactions of Medications

  • Concurrent use of ephedrine sulfate with general anaesthetics can cause cardiac arrhythmias, particularly cyclopropane or halogenated hydrocarbons or digital glycosides, as these medicines can make the myocardium responsive to the effects of ephedrine sulfate.
  • The hypotensive effect of guanethidine, bethanidine, and debrisoquine can be inhibited by therapeutic doses of ephedrine sulfate by displacing adrenergic blockers from their position of an action in sympathetic neurons. The effect in humans is seen by the sudden increase in blood pressure as a relative or absolute blockade of the antihypertensive drug. Extreme hypotension may be caused by concomitant use of Ephedrine Sulfate Injection, USP, and Oxytocics.

  • Precautions:


    General:
  • In patients with heart disease, angina, diabetes, hyperthyroidism, prostatic hypertrophy or hypertension, and patients undergoing digitalis, extra caution should be taken while administering Ephedrine Sulfate Injection, USP. Prolonged use can produce a syndrome that resembles a state of anxiety. Ephedrine sulfate tolerance may develop, but temporary discontinuation of the medication restores its original efficacy
  • Class C of Pregnancy
  • Ephedrine Sulfate Injection, USP, has not been performed in animal reproduction research. It is still not clear if the medication can cause fetal damage when given to a pregnant woman or can impair the ability to reproduce. USP Ephedrine Sulfate Injection should only be administered to a pregnant woman if this is clearly stated.
  • The effect of Ephedrine Sulfate Injection, USP, on the infant or on the later growth and development of the child when the medication is administered to the mother just before or during labor is not known.
  • The pressure effect of ephedrine sulfate can be potentiated by monoamine oxidase inhibitors, potentially resulting in a hypertensive crisis. USP Ephedrine Sulfate Injection should not be given during or within 14 days of MAO inhibitor administration.
  • The Mothers in Nursing Ephedrine sulfate is excreted in breast milk. Owing to the higher than average risk for children, use by nursing mothers is not recommended.

  • Over dose:

    The Symptoms

  • Convulsions are the primary manifestation of ephedrine sulfate toxicity. The following signs and symptoms can occur during acute poisoning: nausea, vomiting, chills, cyanosis, irritability, nervousness, fever, suicidal actions, tachycardia, dilated pupils, blurred vision, opisthotonos, spasms, seizures, pulmonary edema, breathlessness, coma, and respiratory failure. The patient may have hypertension initially, followed later by anuria-accompanied hypotension.
  • Treatment

  • Artificial respiration should be administered if the respiration is shallow or cyanosis is present. There are contraindicated vasopressors. Blood pressure should be preserved during cardiovascular failure.
  • Antidote

  • For hypertension, 5 mg of saline-diluted phentolamine mesylate may be administered intravenously slowly, or 100 mg may be administered orally. Diazepam or paraldehyde can regulate convulsions. Cool applications and 1 mg/kg of dexamethasone, given slowly intravenously, can regulate pyrexia.

  • Contraindictions

    It is unusual to have allergic reactions to ephedrine sulfate. Hypersensitivity, if recognized, is a particular contraindication. Ephedrine sulfate can also be hypersensitive to other sympathomimetics in patients who are hypersensitive.

    Important information


    • Dizziness can be caused by ephedrine. Until you know how you respond to ephedrine, do not drive, operate machinery, or do something else that may be harmful. Your ability to drive or perform other potentially risky activities can be diminished by using ephedrine alone, with some other drugs, or with alcohol.
    • Check with your doctor if your symptoms do not improve within 7 days or you experience a high fever.
    • Ask your pharmacist or doctor about the right time to take this drug if you have trouble sleeping.
    • Do not take medication for food or appetite management if you are taking ephedrine.
    • Read the ingredients before you start taking some new prescription or nonprescription drug to see if it also contains ephedrine. Contact your doctor or pharmacist if this is the case or if you are unsure.
    • Diabetes patients - Blood sugar may be impaired by ephedrine. Take a close look at the blood sugar level and ask your doctor before changing the diabetes drug dosag
    • Use this drug in the elderly with caution because they may be more vulnerable to its effects.
    • Use ephedrine in children with severe caution. Security and efficiency were not verified.
    • Pregnancy and breast-feeding: It is unclear whether the fetus will be affected by this drug. If you become pregnant while taking ephedrine, discuss the benefits and risks of ephedrine use during pregnancy with your doctor. In breast milk, ephedrine is excreted. Check with your doctor or pharmacist to address the risks to your baby if you are or will be breast-feeding while you are using ephedrine
  • Do not take ephedrine if:
    • You are allergic to this substance
    • You may not have an asthma diagnosis.
    • You have an asthma diagnosis, but use prescription asthma medicines.
    • If you've been hospitalized for asthma before,
    • You are actually taking an inhibitor of monoamine oxidase (MAO) (e.g. phenelzine) or you have been taking an inhibitor of MAO for the past 14 days. Ask your health care provider before taking this medication if you do not know if your prescription drug contains an inhibitor of MAO.
    • You have high blood pressure, heart disease, irregular heartbeat, thyroid disease, diabetes, or trouble urinating due to prostate gland enlargement or other serious issues with your heart.
    • If any of this applies to you, notify your doctor or health care provider before using ephedrine.

    Storage

    Hold this drug at room temperature, between 59 degrees F and 77 degrees F (15 and 25 degrees C). Keep away from sun, noise, and humidity. Do not store in the bathroom. Keep ephedrine out of children's reach and away from pets.


    Ephedrine vs Phenylephrine


    Ephedrine
    Phenylephrine
    Infusion dose 4mg / minute Infusion dose 50 mcg / minute
    Formula: C10H15NO Formula: C9H13NO2
    The onset of action: IV (seconds), IM (10 min to 20 min), by mouth (15 min to 60 min) The onset of action: Very rapid (IV); within 20 min (by mouth)
    Metabolism: minimal liver Metabolism: Liver
    Bioavailability: 85% Bioavailability: 38% through GI tract

    Frequently Asked Questions:

    Ephedrine is a prescription drug used during anesthesia to relieve the effects of low blood pressure (Hypotension). Ephedrine can be used with other drugs or alone.
    Ephedrine can improve heart rate, contractility, cardiac performance, and peripheral resistance due to its direct sympathomimetic effects. Increases in both heart rate and blood pressure are also normal findings after the ingestion of ephedrine.
    The doses of ephedrine used in a study differ, with low intakes of less than 20 mg per day, moderate intakes of 40-90 mg per day, and large doses of 100-150 mg per day.
    High blood pressure, heart attacks, muscle disorders, seizures, strokes, irregular heartbeat, loss of consciousness, and death are related to ephedra use. If ephedra is used in high doses or in the long term, these side effects may be more likely.
    A quickened heartbeat and elevated blood pressure can cause Ephedra. Side effects include heart palpitations, vomiting, and nausea. More than 800 harmful reactions have been documented when the herb is used. These include heart attacks, strokes, sudden deaths, and seizures.

    Citations:

  • Ephedrin, https://link.springer.com/article/10.2165/00007256-200434130-00002
  • Effects of Ephedrine, https://europepmc.org/article/med/11474345