EPHEDrine (Systemic)

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral, as sulfate:

Generic: 25 mg [DSC]

Solution, Injection, as sulfate:

Generic: 50 mg/mL (1 mL)

Solution, Injection, as sulfate [preservative free]:

Generic: 50 mg/mL (1 mL)

Solution, Intravenous, as sulfate:

Akovaz: 50 mg/mL (1 mL)

Generic: 50 mg/mL (1 mL)

Solution Prefilled Syringe, Intravenous, as sulfate:

Generic: 10 mg/5 mL in NaCl 0.9% (5 mL)

Solution Prefilled Syringe, Intravenous, as sulfate [preservative free]:

Generic: 100 mg/10 mL in NaCl 0.9% (10 mL); 50 mg/5 mL in NaCl 0.9% (5 mL, 10 mL)

• Akovaz

• Alpha/Beta Agonist

Releases tissue stores of norepinephrine and thereby produces an alpha- and beta-adrenergic stimulation; longer-acting and less potent than epinephrine

Absorption

IV: Rapid, complete

Metabolism

Minimally hepatic; metabolites include p-hydroxyephedrine, p-hydroxynorephedrine, norephedrine

Excretion

Urine (primarily unchanged; dependent upon urinary pH with greatest excretion in acid pH)

Hypotension, anesthesia-induced: Treatment of anesthesia-induced hypotension

Note: The use of ephedrine for the treatment of acute bronchospasm, Stokes-Adams syndrome (ie, presyncope/syncope) with complete heart block, narcolepsy, depression, or myasthenia gravis has fallen out of favor given the availability of more effective agents for these conditions.

Pediatric: IV: In a pediatric hypotension trial, ephedrine doses of 0.1 mg/kg and 0.2 mg/kg were diluted to 1 mg/mL and 2 mg/mL, respectively (Taguchi 1996).

Adult:

IV: Dilute to 5 or 10 mg/mL with D5W or NS.

IM: For PONV (off-label use), dilute with NS (Hagemann 2000).

Blood pressure, pulse, respiratory symptoms; monitor patients with renal impairment for adverse reactions.

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience tremors, insomnia, nausea, vomiting, lack of appetite, or headache. Have patient report immediately to prescriber severe headache, vision changes, angina, tachycardia, abnormal heartbeat, severe dizziness, passing out, severe anxiety, or urinary retention (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.