Ectasule, Ephedsol, Vatronol
Classifications: alpha- and beta-adrenergic agonist; bronchodilator; Therapeutic: bronchodilator
Prototype: Epinephrine HCl
Pregnancy Category: C
25 mg capsules; 50 mg/mL injection; 0.25% nasal spray; 1% nasal gel
Both indirect- and direct-acting sympathomimetic amine. Thought to act indirectly by releasing tissue stores of norepinephrine
and directly by stimulation of alpha-, beta1-, and beta2-adrenergic receptors. Like epinephrine, contracts dilated arterioles of nasal mucosa, thus reducing engorgement and edema
and facilitating ventilation and drainage.
Ephedrine relaxes bronchial smooth muscle by the stimulation of beta2-receptors, relieving mild bronchospasm, improving air exchange and increasing vital capacity.
Temporary relief of congestion of hay fever, allergic rhinitis, and sinusitis; and in treatment and prophylaxis of mild cases
of acute asthma and in patients with chronic asthma requiring continuing treatment. Also has been used for its CNS stimulant
actions in treatment of narcolepsy, to improve respiration in narcotic and barbiturate poisoning, to combat hypotensive states,
especially those associated with spinal anesthesia; in management of enuresis or impaired bladder control; as adjunct in treatment
of myasthenia gravis; as mydriatic; to relieve dysmenorrhea; and for temporary support of ventricular rate in Adams-Stokes
syndrome; for peripheral edema secondary to type I diabetic neuropathy.
History of hypersensitivity to ephedrine or other sympathomimetics; narrow-angle glaucoma; angina pectoris, coronary insufficiency,
chronic heart disease, uncontrolled hypertension, cardiac arrhythmias, cardiomyopathy; hypovolemia; concurrent MAOI therapy;
pregnancy (category C), lactation.
Hypertension, arteriosclerosis, closed-angle glaucoma; diabetes mellitus; hyperthyroidism; prostatic hypertrophy.
Route & Dosage
|Bronchodilator, Nasal Decongestant
Adult: PO 2550 mg q34h prn (max: 150 mg/24 h) IM/IV/SC 12.525 mg
Child: PO >2 y, 23 mg/kg/d in 46 divided doses; 612 y, 6.2512.5 mg q4h (max: 75 mg/24 h)
Adult: PO 25 mg 14 times/d (max: 150 mg/24 h) IM/SC/IV 1050 mg IM/SC or 1025 mg slow IV, may repeat in 510 min if necessary (max: 150 mg/24 h)
Child: PO/IM/SC/IV 3 mg/kg/d in 46 divided doses (max: 75 mg/24 h)
Adult: PO 25 mg t.i.d. or q.i.d.
Adult: PO 25 mg h.s.
Geriatric: PO 2550 mg q6h.
Adult: Intranasal 24 drops or a small amount of jelly in each nostril no more than q.i.d. for 34 consecutive days
- Administer last dose a few hours before bedtime, if possible, to minimize insomnia.
- Store at 15°30° C (59°86° F) in tightly closed, light-resistant containers unless otherwise
directed by the manufacturer.
- Have patient clear nose before instilling drops. Instruct patient to blow gently with both nostrils open. Generally, nose
drops are instilled with head in lateral, head-low position to avoid entry of drug into throat. Check with physician.
PREPARE: Direct: Give undiluted.
ADMINISTER: Direct: Direct IV at a rate of 10 mg or fraction thereof over 3060 sec.
INCOMPATIBILITIES Solution/additive: Hydrocortisone, pentobarbital, phenobarbital, secobarbital, thiopental. Y-site: Thiopental.
- Store in tightly closed, light-resistant containers. Do not use liquid formulation unless it is absolutely clear.
Adverse Effects (≥1%)CNS:
anxiety, tremulousness, giddiness. CV:
Palpitation, tachycardia, precordial pain, cardiac arrhythmias. GU:
Difficult or painful urination, acute urinary retention (especially older men with prostatism). GI:
Nausea, vomiting, anorexia. Body as a Whole:
Sweating, thirst, overdosage: euphoria, confusion, delirium, convulsions, pyrexia, hypertension, rebound hypotension, respiratory
Fixed-drug eruption. Topical use: burning, stinging,
dryness of nasal mucosa
, sneezing, rebound congestion.
Diagnostic Test Interference
Ephedrine is generally withdrawn at least 12 h before sensitivity tests are made to prevent false-positive reactions.
InteractionsDrug: mao inhibitors
, tricyclic antidepressants
, furazolidone, guanethidine
may increase alpha-adrenergic effects (headache, hyperpyrexia, hypertension); sodium bicarbonate
elimination of ephedrine, increasing its CNS
effects; epinephrine, norepinephrine
compound sympathomimetic effects; effects of alpha and beta blockers
and ephedrine antagonized.
Readily absorbed from GI tract. Peak:
15 min1 h. Duration:
Bronchodilation 24 h; cardiac & pressor effects up to 4 h PO and 1 h IV
Widely distributed; crosses bloodbrain barrier and placenta; distributed into breast milk. Metabolism:
Small amounts metabolized in liver. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Supervise continuously patients receiving ephedrine IV. Take baseline BP and other vital signs. Check BP repeatedly during
first 5 min, then q35min until stabilized.
- Monitor I&O ratio and pattern, especially in older male patients. Encourage patient to void before taking medication (see
- Monitor for systemic effects of nose drops that can occur because of excessive dosage from rapid absorption of drug solution
through nasal mucosa. This is most likely to occur in older adults.
Patient & Family Education
- Note: Ephedrine is a commonly abused drug. Learn adverse effects and dangers; take medication ONLY as prescribed.
- Do not take OTC medications for coughs, colds, allergies, or asthma unless approved by physician. Ephedrine is a common ingredient
in these preparations.