ephedrine

ROUTE	ONSET	PEAK	DURATION
IV	unknown	unknown	unknown

Contraindicated in:

None.

Use Cautiously in:

Renal impairment;
OB: May risk of metabolic acidosis in neonates; use during pregnancy only if potential maternal benefit justifies potential fetal risk;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Safety and effectiveness not established in children;
Geri: Initiate therapy in older adults at lowest dose due to age-related decline in cardiac, hepatic, and renal function.

Adv. Reactions/Side Effects ⬆ ⬇

CV: bradycardia, hypertension, palpitations, tachycardia

GI: nausea, vomiting

Neuro: dizziness, restlessness

Misc: tolerance

Interactions ⬆ ⬇

Drug-drug:

Concurrent use with oxytocic drugs, including methylergonovine or ergonovine may ↑ risk of postpartum hypertension.
Clonidine, propofol, and MAO inhibitors may potential vasopressor effects.
-blockers, -blockers, and quinidine may ↓ effectiveness.
May ↓ the onset time of neuromuscular blockade with rocuronium.
May ↓ the effectiveness of epidural analgesics.
May ↑ risk of toxicity of theophylline.
May ↑ risk of arrhythmias when given concurrently with digoxin.

Route/Dosage ⬆ ⬇

IV (Adults ): 5–10 mg initially as IV bolus; may administer additional boluses, as needed, to maintain BP (max total cumulative dose = 50 mg). Rezipres: 4.7–9.4 mg initially as IV bolus; may administer additional boluses, as needed, to maintain BP (max total cumulative dose = 47 mg)

Availability ⬆ ⬇

(Generic available)

Solution for injection: 5 mg/mL; 50 mg/mL
Solution for injection (Rezipres): 4.7 mg/mL

Assessment ⬆ ⬇

Monitor heart rate and BP during therapy. May cause hypertension and tachyphylaxis.

Lab Test Considerations:

If used during delivery, monitor acid-base balance in newborn; may cause metabolic acidosis.

Implementation ⬆ ⬇

Do not confuse ephedrine with epinephrine.

IV Administration:

Rezipres 4.7 mg/mLSolution is premixed; do not dilute. Solution is clear and colorless; do not administer solutions that are cloudy, discolored, or contain particulate matter.

Patient/Family Teaching ⬆ ⬇

Explain purpose of ephedrine to patient.
Rep: Postdelivery, inform patient that newborn may be affected by previous administration. Monitor newborn for signs and symptoms of metabolic acidosis. Monitoring of infant’s acid-base status is warranted to ensure that an episode of acidosis is acute and reversible. Advise patient to notify health care professional immediately if hyperventilation in the newborn occurs.

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Akovaz, Corphedra, Emerphed, Rezipres

Code ⬆

NDC Code

0781- Sandoz Inc
- 0781-3269- Ephedrine Sulfate
  - 0781-3269-95- 10 VIAL, SINGLE-DOSE in 1 CARTON (0781-3269-95) > 1 mL in 1 VIAL, SINGLE-DOSE (0781-3269-71)

17478- Akorn, Inc.
- 17478-415- Ephedrine Sulfate
  - 17478-415-10- 10 AMPULE in 1 CARTON (17478-415-10) > 1 mL in 1 AMPULE (17478-415-01)

17478- Akorn, Inc.
- 17478-515- Ephedrine Sulfate
  - 17478-515-00- 10 AMPULE in 1 CARTON (17478-515-00) > 1 mL in 1 AMPULE

17478- Akorn, Inc.
- 17478-517- Ephedrine Sulfate
  - 17478-517-01- 10 VIAL, SINGLE-DOSE in 1 CARTON (17478-517-01) > 1 mL in 1 VIAL, SINGLE-DOSE

17478- Akorn, Inc.
- 17478-955- Ephedrine Sulfate
  - 17478-955-10- 10 AMPULE in 1 CARTON (17478-955-10) > 1 mL in 1 AMPULE

42023- Par Pharmaceutical, Inc.
- 42023-196- Corphedra
  - 42023-196-25- 25 VIAL in 1 CARTON (42023-196-25) > 1 mL in 1 VIAL (42023-196-01)

42023- Par Pharmaceutical, Inc.
- 42023-216- Ephedrine Sulfate
  - 42023-216-25- 25 VIAL in 1 CARTON (42023-216-25) > 1 mL in 1 VIAL (42023-216-01)

42023- Par Pharmaceutical, Inc.
- 42023-216- Ephedrine Sulfate
  - 42023-216-83- 25 VIAL in 1 CARTON (42023-216-83) > 1 mL in 1 VIAL

51662- HF Acquisition Co LLC, DBA HealthFirst
- 51662-1325- EPHEDRINE SULFATE
  - 51662-1325-1- 1 mL in 1 VIAL, SINGLE-DOSE (51662-1325-1)

68001- BluePoint Laboratories
- 68001-330- Akovaz
  - 68001-330-60- 25 VIAL, SINGLE-DOSE in 1 CARTON (68001-330-60) > 1 mL in 1 VIAL, SINGLE-DOSE (68001-330-59)

70121- Amneal Pharmaceuticals LLC
- 70121-1637- Ephedrine Sulfate
  - 70121-1637-5- 25 VIAL, SINGLE-DOSE in 1 CARTON (70121-1637-5) > 1 mL in 1 VIAL, SINGLE-DOSE (70121-1637-1)

70121- Amneal Pharmaceuticals LLC
- 70121-1637- Ephedrine Sulfate
  - 70121-1637-7- 10 VIAL, SINGLE-DOSE in 1 CARTON (70121-1637-7) > 1 mL in 1 VIAL, SINGLE-DOSE (70121-1637-1)

71952- Bee Right LLC
- 71952-030- Rinosan MINT Nasal Decongestant
  - 71952-030-00- 1 BOTTLE, SPRAY in 1 BOX (71952-030-00) > 30 mL in 1 BOTTLE, SPRAY

71952- Bee Right LLC
- 71952-040- Rinosan PROPO Nasal Decongestant
  - 71952-040-00- 1 BOTTLE, SPRAY in 1 BOX (71952-040-00) > 30 mL in 1 BOTTLE, SPRAY

76014- Avadel Legacy Pharmaceuticals, LLC
- 76014-005- Akovaz
  - 76014-005-25- 25 VIAL, SINGLE-DOSE in 1 CARTON (76014-005-25) > 1 mL in 1 VIAL, SINGLE-DOSE (76014-005-30)

section name header

Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇