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SENSORY ORGANS › OPHTHALMOLOGICALS › MYDRIATICS AND CYCLOPLEGICS › Sympathomimetics excl. antiglaucoma preparations
ephedrine
S01FB02
Forms & Strengths
- Tablets 25 mg, 50 mg
- Injectable solution 1 mg/mL (IV/IM)
- Ophthalmic solution 0.5 % (eye drops)
Adult Dosing
- IV/IM 25‑50 mg q 3‑4 h, max 300 mg/24 h
- Oral 25‑50 mg q 4‑6 h, max 300 mg/24 h
- Ophthalmic 1‑2 drops per eye for mydriasis, effect 30‑45 min
Pediatric Dosing
- 0.5 mg/kg per dose IV/IM, max 6 mg per dose
- Oral 0.5 mg/kg q 4‑6 h, max 6 mg/dose
- Ophthalmic not recommended under 2 y
Indications
- Pre‑operative/operative hypotension
- Bronchial asthma as adjunct bronchodilator
- Nasal decongestion (systemic)
- Ophthalmic mydriasis for examination
Mechanism of Action
- Indirect sympathomimetic; displaces norepinephrine from storage vesicles
- Stimulates α‑ and β‑adrenergic receptors
- Increases heart rate, contractility, vasoconstriction, bronchodilation
Contraindications
- Severe hypertension or uncontrolled hypertension
- Pheochromocytoma
- Hyperthyroidism
- Narrow‑angle glaucoma
- Recent myocardial infarction or severe CAD
- MAO‑inhibitor therapy
- Pregnancy (high‑dose) and lactation – caution
Adverse Reactions
- Tachycardia, palpitations
- Elevated blood pressure, hypertension crises
- Anxiety, insomnia, tremor
- Headache, dizziness
- Arrhythmias, especially with cardiac disease
- Hyperglycemia, especially in diabetics
- Urinary retention
Drug Interactions
- MAO inhibitors – risk of hypertensive crisis
- β‑blockers – attenuate cardiovascular effects
- Other sympathomimetics (e.g., pseudoephedrine) – additive pressor effect
- Tricyclic antidepressants – increase pressor response
- Antihypertensives – antagonize ephedrine action
- Lithium – may increase lithium levels
- Anesthetics (volatile agents) – may potentiate arrhythmias
Curated Content: Needs Vetting Before Put to Clinical Use