Ephedrine Hydrochloride

Ephedrine Hydrochloride is used to treat the low blood pressure commonly seen following spinal anesthesia. It raises blood pressure by narrowing the blood vessels of the heart.

Ephedrine Hydrochloride is administered under the supervision of a doctor. Your doctor will decide the dose and duration of the medicine for you. You should continue all your other medicines that are advised by the doctor for your long-term treatment even after this injection.

Ephedrine Hydrochloride works on the blood vessels and increases the blood flow to heart and lungs, thereby improving the disease condition.

• Hypotension following spinal anesthesia: Used to reverse hypotension induced by spinal or epidural anaesthesia.

Vasoconstrictor/Venotonic, Adrenoceptor stimulants

Sympathomimetic (Alpha & Beta agonist)

Ephedrine is a stimulant drug, belonging to a group of medicines known as sympathomimetics. Specifically it is both an alpha and beta adrenergic agonist. In addition, Ephedrine enhances the release of norepinephrine, a strong endogenous alpha agonist. When administered, Ephedrine will notably increase the activity of the central nervous system, as well as have a stimulatory effect on other target cells.

Ephedrine has both alpha- and beta-adrenergic activity 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 respiratory center and dilates the pupil without affecting light reflexes.

Adult Dose:

• Oral (Acute bronchospasm): 15-60 mg tid; Max: 150 mg/day.
• Oral (Diabetic neuropathic oedema): 30-60 mg 3 times/day.
• Parenteral (Spinal/epidural anaesthesia-induced hypotension): 3-6 mg by slow IV inj every 3-4 min; Max total dose: 30 mg.
• Elderly Oral: Initial: 50% of adult dose.

Child Dose:

• Oral (Acute bronchospasm): 1-5 yr: 15 mg tid; 6-12 yr: 30 mg tid; >12 yr: Same as adult dose.
• Parenteral: 0.5 mg/kg or 16.7 mg/m2 4-6 hrly (SC/IM) or 0.75 mg/kg or 25 mg/m2 4 times daily (SC/IV).

Your doctor or nurse will give you this medicine. Kindly do not self administer.

If you miss a dose of Ephedrine Hydrochloride, please consult your doctor.

Common Side Effects:

• Systemic hypertension (high blood pressure)
• Insomnia (difficulty in sleeping)

Other Side Effects:

• Nausea, vomiting, anorexia
• Tachycardia (sometimes bradycardia), arrhythmias, anginal pain
• Vasoconstriction with hypertension, vasodilation with hypotension
• Dizziness, flushing
• Dyspnoea, headache, anxiety, restlessness
• Confusion, psychoses, insomnia, tremor
• Difficulty in micturition, urine retention
• Sweating, hypersalivation
• Changes in blood-glucose concentration
• Angle-closure glaucoma (very rare)

Precautions:

• Ephedrine Hydrochloride does not usually affect your ability to drive.
• It is usually given as a slow injection into your veins by a doctor or healthcare professional.
• Use with caution in patients with hyperthyroidism, diabetes mellitus, ischemic heart disease, hypertension, renal impairment, or angle-close glaucoma.
• In patients with prostatic enlargement, Ephedrine may increase difficulty with micturition.
• Increased fetal heart rate reported with parenteral Ephedrine during pregnancy.
• Irritability and disturbed sleep have been reported in breast-fed infants.

Contraindications:

• Hypersensitivity
• Hypertension
• Thyrotoxicosis
• Benign Prostatic Hyperplasia (BPH)
• Lactation
• Coronary thrombosis

Drug Interactions:

• Reduces antihypertensive effect of bethanidine and guanethidine.
• May increase clearance of dexamethasone.
• Increased incidence of adverse effects with theophylline.
• Potentially Fatal: Severe HTN when combined with MAOIs or within 2 wk of discontinuance.
• Increased risk of arrhythmias with cardiac glycosides, quinidine or tricyclic antidepressants.
• Increased vasoconstriction or pressor effects with ergot alkaloids or oxytocin.

Food Interactions: It is not known whether it is safe to consume alcohol with Ephedrine Hydrochloride. Consult your doctor.

Use in Pregnancy: Category C. Animal studies have shown adverse effects on the fetus and there are no controlled studies in women. Should be given only if potential benefit justifies potential risk to the fetus.

Use in Lactation: Ephedrine Hydrochloride is distributed into breast milk, therefore it is not recommended for use during lactation.

Pediatric Use: Pediatric dosage provided above. Safety in children under 1 year has not been established.

Geriatric Use: Elderly oral dose: Initial 50% of adult dose. Parenteral dose same as adult.

Renal Impairment: Limited information available on the use of Ephedrine Hydrochloride in patients with kidney disease. Consult your doctor.

Hepatic Impairment: Limited information available on the use of Ephedrine Hydrochloride in patients with liver disease. Consult your doctor.

Overdose: When given in sufficiently large doses, Ephedrine gives rise to minor reactions such as giddiness, headache, nausea, vomiting, sweating, palpitations, difficulty in micturition, tremors, anxiety, restlessness and insomnia. Some patients may exhibit these symptoms even with the usual therapeutic dosage.

Storage: Store in a cool, dry place, protected from light. Keep all medicines out of reach of children.

Ephedrine Hydrochloride