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ephedrine

R01AA03

Forms & Strengths

Injection: 50 mg/mL
Nasals solution: 0.5%, 1%

Adult Dosing

Hypotension during anesthesia: IV 5 mg to 10 mg as needed, repeated every 5 minutes up to 50 mg max.
Nasal congestion: 2-3 drops/sprays of 0.5% to 1% solution into each nostril every 3-4 hours as needed.

Pediatric Dosing

Hypotension during anesthesia (Children >1 year): IV 0.1 to 0.3 mg/kg every 4 to 6 minutes as needed.
Nasal congestion (Children >6 years): 2-3 drops of 0.25% to 0.5% solution into each nostril every 4 hours.

Indications

Treatment of acute hypotension secondary to spinal or other anesthesia
Temporary relief of nasal congestion associated with rhinitis, sinusitis, and common cold

Mechanism of Action

Non-catecholamine sympathomimetic amine that acts directly on alpha- and beta-adrenergic receptors and indirectly by releasing norepinephrine from storage sites, leading to increased cardiac output, vasoconstriction, and bronchodilation.

Contraindications

Known hypersensitivity to ephedrine or other sympathomimetics
Concurrent monoamine oxidase inhibitor (MAOI) therapy or within 14 days
Severe hypertension or severe coronary artery disease
Narrow-angle glaucoma

Adverse Reactions

Tachycardia, palpitations, hypertension
Anxiety, restlessness, nervousness, insomnia
Tremor, dizziness, headache
Nausea, vomiting, decreased appetite
Urinary retention in patients with prostatic hyperplasia

Drug Interactions

MAOIs: May cause severe hypertensive crisis
General anesthetics (halogenated hydrocarbons): Increased risk of ventricular arrhythmias
Oxytocic drugs: Severe postpartum hypertension
Guanethidine or reserpine: Decreased pressor response to ephedrine
Alpha- and beta-blockers: Antagonism of ephedrine's pharmacological effects

Curated Content: Needs Vetting Before Put to Clinical Use