Ephedrine Tablet

30 mg
Ambee Pharmaceuticals Ltd.

Pack Size & Price:

Price not available.

Indications

Acute bronchospasm, Acute bronchospasm, Anaesthesia-induced hypotension, Nasal congestion

Therapeutic Class

Other adrenoceptor stimulants, Vasoconstrictor/Venotonic

Pharmacology

Ephedrine stimulates both α- and β-receptors, thereby causing bronchodilation, peripheral vasoconstriction and CNS stimulation. It also has stimulant action on the resp centre.

Dosage & Administration

Oral:

Acute bronchospasm:
  • Adult: 15-60 mg tid.
  • Child: 1-5 yr: 15 mg tid; 6-12 yr: 30 mg tid; >12 yr: Same as adult dose.
  • Elderly: Initial: 50% of adult dose.

Parenteral:

Reversal of spinal or epidural anaesthesia-induced hypotension:
  • Adult: 3-6 mg by slow IV inj every 3-4 min as required. Max total dose: 30 mg.
  • Child: 0.5 mg/kg or 16.7 mg/m2 4-6 hrly by SC or IM inj or alternatively, 0.75 mg/kg or 25 mg/m2 4 times daily by SC or IV inj.
  • Elderly: Same as adult dose.
Acute bronchospasm:
  • Adult: 12.5-25 mg by SC, IM or IV inj, further dosage may be given according to patient's response.

Nasal:

Nasal congestion:
  • Adult/Elderly: As 1% soln: Instill 1-2 drops into each nostril up to 4 times daily as needed.
  • Child: >12 yr: Same as adult dose.

Interaction

Increased risk of arrhythmias with TCAs, cardiac glycosides and quinidine. Increased risk of vasoconstrictor or pressor effects with ergot alkaloids and oxytocin. Increased incidence of nausea, nervousness and insomnia with theophylline. Decrease pressor effect with reserpine and methyldopa. May potentiate the stimulant effect of caffeine. May increase the clearance and prolong the half-life of dexamethasone in patients with asthma. Antagonises the antihypertensive effect of guanethidine.

Potentially Fatal: May cause hypertensive crisis with MAOIs. Increased risk of cardiac arrhythmias with β-blockers and volatile liq anaesth (e.g. halothane, cyclopropane). Additive effects and increased toxicity with other sympathomimetic drugs.

Contraindications

Coronary thrombosis, ischaemic heart disease, HTN, thyrotoxicosis, DM, prostatic hypertrophy, angle-closure glaucoma; post nasal or sinus surgery (nasal soln). Lactation. Patients taking MAOIs (or within 2 wk of withdrawal), other sympathomimetic drugs, β-blockers, and those who are given volatile anaesth.

Side Effects

Tachycardia, anxiety, nausea, restlessness, insomnia, tremor, dry mouth, impaired circulation to the extremities, HTN, headache, cardiac arrhythmia.

Pregnancy & Lactation

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 Hydrochloride Injection may accelerate the fetal heart rate when used to control maternal hypotension during spinal anaesthesia for delivery. Ephedrine Hydrochloride Injection should not be used if the maternal blood pressure is greater than 130/80 Hg.

Lactation: Ephedrine Hydrochloride is distributed into breast milk, and therefore Ephedrine Hydrochloride Injection is not recommended for use during lactation because of the risk of adverse effects in the infant.

Precautions

Patient with unstable vasomotor symptoms, history of seizure disorder. Renal impairment. Elderly. Pregnancy.

Overdose Effects

Symptoms: Nausea, vomiting, HTN, fever, palpitations, tachycardia, restlessness, resp depression, convulsions; paranoid psychosis, delusions and hallucinations may also occur.

Management: Supportive and symptomatic treatment. Induce emesis and perform gastric lavage. May give diazepam to control seizures; manage pyrexia with external cooling and dexamethasone 1 mg/kg by slow IV inj.

Storage Conditions

Store between 20-25°C. Protect from light and moisture.