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Ephedrine

    DEA Class;  Rx

    Common Brand Names; Akovaz, Corphedra, Emerphed, Rezipres

    • Alpha/Beta Adrenergic Agonists

    Injectable alpha- and beta-adrenergic agonist and norepinephrine-releasing agent
    Used for the treatment of clinically important hypotension occurring in the setting of anesthesia
    Less effective than epinephrine in acute bronchospasm; not recommended in asthma

    Indicated for the treatment of clinically important hypotension occurring in the setting of anesthesia.

     
     
    • Gastrointestinal disorders: Nausea, vomiting
    • Cardiac disorders: Tachycardia, palpitations (thumping heart), reactive hypertension, bradycardia, ventricular ectopics, heart rhythm/rate variability
    • Nervous system disorders: Dizziness
    • Psychiatric disorders: Restlessness

    Serious postpartum hypertension and stroke reported with coadministration of a vasopressor (ie, methoxamine, phenylephrine, ephedrine) and an oxytocic (ie, methylergonovine, ergonovine); monitor BP if patient has received both ephedrine and an oxytocic

    Repeated administration may cause tachyphylaxis; an alternative vasopressor may be needed to mitigate unresponsiveness to treatment

    An increased incidence of hypertension has occurred when used for prevention compared with treatment of hypotension

    Available data of use in pregnant females have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes

    A single published case report indicates that ephedrine is present in human milk

    No information is available on its effects on breastfed infants or on milk production

    Adults

    47 mg ephedrine hydrochloride (38 mg ephedrine base) or 50 mg ephedrine sulfate (38 mg ephedrine base) IV total dose.

    Geriatric

    47 mg ephedrine hydrochloride (38 mg ephedrine base) or 50 mg ephedrine sulfate (38 mg ephedrine base) IV total dose.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Ephedrine sulfate

    injectable solution, as sulfate

    • 50mg/mL (Akovaz, Corphedra, generics)

    • 50mg/10mL (5mg/mL) (Emerphed); equivalent to ephedrine base 3.8mg/mL

    injectable solution, as hydrochloride (Rezipres)

    • 47mg/mL; equivalent to ephedrine base 38mg/mL

    • 47mg/5mL (9.4mg/mL); equivalent to ephedrine base 7.7mg/mL

    • 23.5mg/5mL (4.7mg/mL); equivalent to ephedrine base 3.8mg/mL