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RESPIRATORY SYSTEM › NASAL PREPARATIONS › DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE › Sympathomimetics, combinations excl. corticosteroids
ephedrine
R01AB05
Forms & Strengths
- Injection: 5 mg/mL, 50 mg/mL
- Nasal Solution: 0.5%, 1%
Adult Dosing
- Hypothermia or hypotension during anesthesia: IV 5-10 mg as needed, repeated every 5-10 minutes (max 50 mg)
- Nasal congestion: 2-3 drops/sprays of 0.5%-1% solution into each nostril no more than every 3-4 hours
Pediatric Dosing
- Hypotension: IV/IM 0.2-0.3 mg/kg (or 6 mg/m2) every 4-6 hours as needed
- Safety and efficacy for nasal use in children under 6 years are not established
Indications
- Treatment of acute hypotension, particularly during anesthesia
- Temporary relief of nasal congestion
Mechanism of Action
- Non-catecholamine sympathomimetic amine that acts directly on alpha- and beta-adrenergic receptors and indirectly by releasing norepinephrine from storage sites
- Produces vasoconstriction, increased heart rate, increased cardiac output, and bronchodilation
Contraindications
- Known hypersensitivity to ephedrine or other sympathomimetics
- Concurrent monoamine oxidase inhibitor (MAOI) therapy or use within the past 14 days
- Severe hypertension or coronary artery disease
- Angle-closure glaucoma
Adverse Reactions
- Cardiovascular: Hypertension, tachycardia, palpitations, arrhythmias, angina
- Central Nervous System: Nervousness, anxiety, restlessness, insomnia, dizziness, headache
- Gastrointestinal: Nausea, vomiting, anorexia
- Genitourinary: Dysuria, urinary retention in patients with prostatic hyperplasia
Drug Interactions
- MAOIs and linezolid: Risk of severe hypertensive crisis
- General anesthetics (halogenated hydrocarbons): Increased risk of severe ventricular arrhythmias
- Other sympathomimetic agents: Additive toxicity and cardiovascular stimulation
- Antihypertensives and diuretics: Ephedrine may antagonize their antihypertensive effects
Curated Content: Needs Vetting Before Put to Clinical Use