Ephedrine
- Atc Codes:C01CA26#R01AA03#R01AB05#R03CA02#S01FB02
- CAS Codes:299-42-3#50906-05-3#134-72-5
- PHARMGKB ID:299-42-3#50906-05-3#134-72-5
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Belgium: Endrine; Bulgaria: Ephedrine; Cyprus: Ephedrine; Czech Republic: Ephedrin; France: Ephedrine; Germany: Caniphedrin; Greece: Ephedrine, Neo Rhinovit, Rhinolex; Hungary: Epherit; Ireland: Ephedrine; Italy: Efedri C; Malta: Ephedrine; Netherlands: Efedrine; Poland: Efrinol, Ephedrinum; Portugal: Efedrina, Spinefe; Romania: Efedrina, Ephedrine; Slovakia: Ephedrin; Spain: Efedrina; Sweden: Efedrin; UK: Ephedrine.
North America
Canada: Ephedrine, Formula S/E.
Latin America
Argentina: Efedrina, Muchan; Brazil: Efedrin, Efedrina, Unifedrine; Mexico: Tendrin.
Asia
Japan: Ephedrin, Ephedrine.
Drug combinations
Ephedrine and Antipyrine
Ephedrine and Benzoid Acid
Ephedrine and Chlorphenamine
Ephedrine and Codeine
Ephedrine and Dextromethorphan
Ephedrine and Lidocaine
Ephedrine and Naphazoline
Ephedrine and Procaine
Ephedrine and Pyrilamine
Ephedrine and Resorcine
Ephedrine and Theophylline
Ephedrine, Benzocaine, and Phenazone
Ephedrine, Butobarbital, and Theophylline
Ephedrine, Caffeine, and Theophylline
Ephedrine, Chloramphenicol, and Tripelennamine
Ephedrine, Chlorobutanol, and Tyrothricin
Ephedrine, Chlorpheniramine, and Dexamethasone
Ephedrine, Chlorpheniramine, and Dextromethorphan
Ephedrine, Isoflupredone, and Naphazoline
Ephedrine, Naphazoline, and Prednisolone
Ephedrine, Acetaminophen, Dextromethorphan, and Doxylamine
Ephedrine, Antipyrine, Diphenhydramine, and Nitrofurazone
Ephedrine, Bromhexine, Dextromethorphan, and Diphenhydramine
Ephedrine, Carbetapentane, Chlorpheniramine, and Phenylephrine
Ephedrine, Chlorpheniramine, Dextromethorphan, and Guaifenesin
Other Ephedrine combinations: Ascorbic Acid (Vitamin C); Crataegus spp.; Cuprum* acetate; Drosera spp.; Ipecac Syrup; Rutoside; Selenicereus grandiflorus; Strophanthus gratus*
Chemistry
Ephedrine: C~10~H~15~NO. Mw: 165.23. Benzenemethanol, α-[1-(methylamino)ethyl]-, [R-(R*,S*)]-. CAS-299-42-3 ((-)-ephedrine); CAS-50906-05-3 (hemihydrate).
Ephedrine Sulfate: (C~10~H~15~NO)~2~ H~2~SO~4~. Mw: 428.54. Benzenemethanol, α-[1-(methylamino)ethyl]-, [R-(R*,S*)]-, sulfate (2:1). CAS-134-72-5.
Pharmacologic Category
Sympathomimetic (Adrenergic) Agents; α- and β-Adrenergic Agonists. (ATC-Code: C01CA26; R01AA03; R01AB05; R03CA02; S01FB02).
Mechanism of action
A sympathomimetic agent which occurs naturally in plants of the genus Ephedra. Releases tissue stores of epinephrine and thereby produces α- and β-adrenergic stimulation.
Therapeutic use
Ephedrine, in fixed combination with expectorants, bronchodilators, or sedatives, is used orally as a bronchodilator in the symptomatic treatment of mild bronchial asthma and reversible bronchospasm which may occur in association with chronic bronchitis, emphysema, and COPD. Used parenterally to produce cardiac stimulation and vasoconstriction as an adjunct to correcting hemodynamic imbalances in the treatment of shock which persists after adequate fluid volume replacement. Ephedrine has also been used orally to treat mild orthostatic hypotension. Has been used to treat hypotension occurring during spinal anesthesia. Has been used parenterally to provide temporary support of ventricular rate in the treatment of bradycardia and syncopal episodes caused by atrioventricular nodal block. Has been used orally to relieve dysmenorrhea by decreasing uterine contractions but is not reliable as a uterine relaxant and may have an excitatory effect on the uterus in some patients. Has also been used to treat urinary incontinence and enuresis.
Pregnancy and lactiation implications
Unknown whether ephedrine can cause fetal harm or affect reproduction capacity when administered to pregnant women. Should therefore be used during pregnancy only when clearly needed. Parenteral ephedrine should not be used in obstetric patients when maternal systolic/diastolic blood pressure exceeds >130/80 mm Hg. Use in nursing women not recommended due to risk for infants.
Unlabeled use
Ephedrine has been used orally for the management of peripheral edema secondary to diabetic neuropathy in some type 1 diabetic patients. Due to its anorexigenic effects, ephedrine alone or combined with caffeine has been used for self-medication in the management of exogenous obesity.
Contraindications
Hypersensitivity to ephedrine or any component of the formulation. Cardiac arrhythmias. Angle-closure glaucoma. Other sympathomimetic agents.
Warnings and precautions
May cause hypertension and tachycardia. Long-term use may cause anxiety and symptoms of paranoid schizophrenia. Use with caution in cardiovascular disease such as coronary artery disease, arrhythmias, hypertension, and in patients receiving digitalis; also in diabetes mellitus, prostatic hyperplasia and/or urinary stricture, history of seizure disorder, thyroid dysfunction, unstable vasomotor symptoms. Use with extreme caution in patients taking MAOIs. Caution also in the elderly (crosses the blood-brain barrier and may cause confusion). Blood volume depletion should be corrected before I.V./I.M. therapy is instituted. Avoid as a bronchodilator. Dietary supplements containing ephedrine alkaloids have been associated with serious adverse cardiac effects. Some preparations may contain the dye tartrazine (FD&C yellow No. 5); possible allergic reactions in susceptible individuals (e.g. those sensitive to aspirin). Tolerance may develop.