Pure ephedrine hcl 25mg

Dosage Formulations

• Ephedrine sulfate oral tablet: 25 mg
• Ephedrine hydrochloride intravenous solution: 23.5 mg/5 mL
• Ephedrine sulfate intravenous solution: 5 mg/mL; 50 mg/mL

For treatment of asthma, 25 mg tablets are used every four hours as needed, and the maximum dose should not exceed 150 mg in 24 hours. For adults, bolus dose recommendations are at 5 to 10 mg, and intramuscular doses for a prolonged desired effect are at 25 to 50 mg

Ephedrine requires dilution before intravenous use. In treating hypotension, cardiovascular effects via the indirect mechanism depend on adequate native norepinephrine stores. Tachyphylaxis will develop with prolonged and repeated use as this depletes endogenous norepinephrine stores. For this reason, it is administered in intravenous boluses when used intravenously and rarely as a continuous infusion.

Specific Patient Populations

Patients with Renal Impairment: According to the manufacturer’s prescribing information,  Ephedrine and its metabolite are excreted in the urine. In patients with kidney disease, excretion of ephedrine is affected with a corresponding increase in elimination half-life, which will lead to the slow elimination of ephedrine and consequently prolonged pharmacological effect and potential adverse reactions. Therefore, monitor patients with renal impairment carefully after the initial bolus dose for adverse events.

Patients with Hepatic Impairment: no dosage adjustments have been provided in the package insert.

Pregnancy Considerations: Though ephedrine is frequently used in obstetric patients just before and during delivery, there is insufficient data to support using the drug in earlier stages of pregnancy, and no animal reproductive studies have been performed, making it is a category C drug in pregnancy. Ephedrine should be given to a pregnant woman only if indicated.

Breastfeeding Considerations: A single published case report indicates that ephedrine is present in human breast milk. Nonetheless, no information is available on the effects of ephedrine on the breastfed infant or the effects on milk production. Clinicians should consider the risk-benefit analysis for the mother’s clinical requirement for ephedrine and adverse reactions on the breastfed child from ephedrine. Administration to the nursing women is not recommended as there is a higher-than-usual risk for infants according to the package insert.

Pediatric Populations: The FDA has not formally established safety and effectiveness in pediatric populations.

Adverse Effects

Ephedrine may produce palpitations, headache, dizziness, nausea, vomiting, restlessness, and anxiety in the conscious patient. Ephedrine is also arrhythmogenic, and clinicians should be cautious when administering patients predisposed to arrhythmias or taking other arrhythmogenic medications, particularly digitalis. When used long-term, the catecholamine excess can result in contraction band necrosis of the myocardium, which predisposes the heart to ventricular arrhythmias.

Another common effect of ephedrine is an alteration in the time until the onset and duration of action of other drugs. This effect is most notable during induction when giving ephedrine for a hypotensive patient before rocuronium.pure ephedrine hcl 25mg