Ephedrine is a medication and stimulant. It is often used to prevent low blood pressure during spinal anesthesia. It has also been used for asthma, narcolepsy, and obesity but is not the preferred treatment. It is of unclear benefit in nasal congestion. It can be taken by mouth or by injection into a muscle, vein, or just under the skin. Onset with intravenous use is fast, while injection into a muscle can take 20 minutes, and by mouth can take an hour for effect. When given by injection it lasts about an hour and when taken by mouth it can last up to four hours.
Ephedrine and Pseudoephedrine
Ephedrine and pseudoephedrine are mixed α-adreno receptor agonists that act through direct and indirect mechanisms to release norepinephrine from the postganglionic sympathetic neuron and increase blood pressure. Both medications cross the blood–brain barrier, resulting in dose-dependent and dose-limiting side effects of anxiety, restlessness, nervousness, and tachycardia.
Pseudoephedrine, a stereoisomer of ephedrine, may have less β-adreno receptor agonist activity than ephedrine and fewer central sympathomimetic effects. As with other sympathomimetic agents, these medications should not be given within several hours of bedtime to prevent severe supine hypertension. Typical doses of pseudoephedrine are 30 to 60 mg three times daily, and for ephedrine, 25 to 50 mg three times daily.
Do not use ephedrine if:
You are allergic to this medication.
- you do not have a diagnosis of asthma
- You are allergic to this medication.
- you have a diagnosis of asthma but use prescription asthma medications
- if you have ever been hospitalized for asthma
- You are taking a monoamine oxidase (MAO) inhibitor (eg, phenelzine) now or have taken an MAO inhibi tor in the last 14 days. If you do not know if your prescription drug contains an MAO inhibitor, ask your health care provider before taking this product.
- you have high blood pressure, heart disease, an irregular heartbeat, thyroid disease, diabetes, or difficulty in urination due to enlargement of the prostate gland or other severe heart problems
Contact your doctor or health care provider before using ephedrine if any of these apply to you.
Ephedrine Sulfate Injection, USP is indicated in the treatment of allergic disorders, such as bronchial asthma. The drug has long been used as a pressor agent, particularly during spinal anesthesia when hypotension frequently occurs. In Stokes-Adams syndrome with complete heart block, ephedrine has a value similar to that of epinephrine. It is indicated as a central nervous system stimulant in narcolepsy and depressive states. It is also used in myasthenia gravis.
Ephedrine promotes modest short-term weight loss, specifically fat loss, but its long-term effects are unknown. In mice, ephedrine is known to stimulate thermogenesis in the brown adipose tissue, but because adult humans have only small amounts of brown fat, thermogenesis is assumed to take place mostly in the skeletal muscle.
Ephedrine also decreases gastric emptying. Methylxanthines such as caffeine and theophylline have a synergistic effect with ephedrine with respect to weight loss. This led to creation and marketing of compound products. One of them, known as the ECA stack, contains ephedrine with caffeine and aspirin. It is a popular supplement taken by bodybuilders seeking to cut body fat before a competition
DOSAGE AND ADMINISTRATION
The usual parenteral dose is 25 to 50 mg given subcutaneously or intramuscularly. Intravenously, 5 to 25 mg may be administered slowly, repeated in 5 to 10 minutes, if necessary.
The usual subcutaneous or intramuscular dose is 0.5 mg/kg of body weight or 16.7 mg/square meter of body surface every 4 to 6 hours. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Possible side effects of ephedrine
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most common side effects persist longer than one hours or become worse: Dizziness; headache; nausea; nervousness; tremor; loss of appetite; restlessness; sleeplessness; stomach irritation.
Seek medical attention right away if any of these severe side effects occur: Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating.This is not a complete list of all side effects that may occur.