Ephedrine

Ephedrineis acentral nervous systemstimulant used to treatlow blood pressureproblems (hypotension). Ephedrine is also used to treatbreathingproblems (as a bronchodilator),nasalcongestion(as adecongestant),myasthenia gravis,narcolepsy,menstrualproblems (dysmenorrhea), orurine-controlproblems.

Ephedrine is available under the following different brand names:Akovaz, andCorphedra.

Dosage Forms and Strengths

Injectable Solution

• 50mg/mL (ephedrine sulfate [38mg/mL ephedrine base])

Dosage Considerations – Should be Given as Follows:

Hypotension

• Indicated for the treatment of clinically important hypotension occurringinthe setting ofanesthesia
• Initial dose: 5-10mgintravenous(IV) bolus (must dilute)
• Administer additional boluses as needed, not to exceed a total cumulative dosage of 50 mg
• Adjust dosage according to theblood pressuregoal

Dosing Considerations

• 儿科: Safety and efficacy not established
• Geriatric: Start at the low end of the dosingrange, reflecting the greater frequency of decreasedhepatic,renal, orcardiacfunction, and of concomitantdiseaseor other drugtherapy
• Drug is substantially excreted by thekidney, and the risk of adverse reactions may be greater with impaired renal function
• Because elderly patients are more likely to have decreased renal function, carefully select dose and consider monitoring renal function

Side effects of ephedrine include:

• Anxiety
• Difficult orpainful urination
• Dizziness
• Fastheart rate
• Headache
• 心rhythm/rate variability
• Loss of appetite
• Nausea
• Nervousness
• Palpitations(thumping heart)
• 无功high blood pressure(hypertension)
• Restlessness
• Slow heart rate
• Spinningsensation(vertigo)
• Sweating
• Trouble sleeping (insomnia)
• Ventricularectopicbeats
• Vomiting
• Weight loss

This document does not contain all possible side effects and others may occur. Check with yourphysicianfor additional information about side effects.

If yourdoctorhas directed you to use thismedication, your doctor orpharmacistmay already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor,healthcare provider or pharmacist first.

• Severe Interactions of ephedrine include:
  • iobenguane I 123
  • isocarboxazid
  • linezolid
  • phenelzine
  • procarbazine
  • rasagiline
  • selegiline
  • selegiline transdermal
  • tranylcypromine
• Ephedrine has serious interactions with at least 29 different drugs.
• Ephedrine has moderate interactions with at least 263 different drugs.
• Mild Interactions of ephedrine include:
  • bendroflumethiazide
  • bumetanide
  • chlorothiazide
  • chlorthalidone
  • cyclopenthiazide
  • desmopressin
  • ethacrynic acid
  • eucalyptus
  • furosemide
  • hydrochlorothiazide
  • indapamide
  • methyclothiazide
  • metolazone
  • noni juice
  • sage
  • torsemide
• Ephedrine has moderate interactions with at least 108 different drugs.
• Mild Interactions of ephedrine include:
  • amikacin
  • digoxin
  • dimenhydrinate
  • donepezil
  • galantamine
  • gentamicin
  • kanamycin
  • neomycin
  • netilmicin
  • paromomycin
  • streptomycin
  • tacrine
  • tobramycin

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

Warnings

This medication contains ephedrine. Do not take Akovaz or Corphedra if you are allergic to ephedrine or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact aPoison Control Centerimmediately.

Contraindications

• None

药物滥用的影响

• None

Short-Term Effects

• See "What Are Side Effects Associated with Using Ephedrine?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Ephedrine?"

Cautions

• Seriouspostpartumhypertension andstrokehave been described with co-administration of a vasopressor (i.e., methoxamine,phenylephrine, ephedrine) and an oxytocic (i.e., methylergonovine, ergonovine); monitorbloodpressure ifpatienthas received both ephedrine and an oxytocic
• Repeated administration can result intoleranceand tachyphylaxis; an alternative vasopressor may be needed to mitigate unresponsiveness to treatment
• When used to prevent hypotension, ephedrine has been associated with an increasedincidenceof hypertension compared with when ephedrine is used to treat hypotension

PregnancyandLactation

Ephedrine crosses theplacenta; it is used at delivery for prevention and/or treatment ofmaternallow blood pressure (hypotension) associated with spinal anesthesia.

Fetal/neonataladverse reactions:

• Cases of potentialmetabolicacidosisin newborns at delivery with maternal ephedrine exposure have been reported in the literature
• These reports describe umbilicalarterypHof 7.2 or greater at the time of delivery
• Monitor newborn for signs and symptoms of metabolic acidosis
• Monitoring ofinfant's acid-base status is warranted to ensure that an episode of acidosis isacuteand reversible

It is unknown if ephedrine is excreted inbreast milk; consult your doctor beforebreastfeeding.