Botanical origin of Ephedrine
Ephedra sinica in Chinese
Ephedra nebroidensis found in Pakistan
Mixed action adrenergic agonist
Ephedrine is a mixed action adrenergic agonist.It not only releases stored nor epinephrine from nerve endings, but also directly stimulate the alpha and beta receptors. Its actions are similar to epinephrine but less potent.
Ephedrine is a chemically non catecholamine so it is a poor substrate for COMT and MAO. Ephedrine has longer duration of action. It can be administered orally.
Biotransformation (metabolism) of Ephedrine
It is eliminated unchanged in the urine. Ephedrine is potent stimulator of CNS, but less potent than amphetamine.
Half life 3-6 hours
Pharmacological actions of Ephedrine
Pharmacological actions of Ephedrine on EYE
Ephedrine stimulates the alpha receptor of eye and causes mydriasis. Light and reflex accommodation is not effected.
Pharmacological actions of Ephedrine on Cardiovascular system
Ephedrine increase the force of contraction of heart by activating beta 1 receptors of heart .Heart rate and cardiac out put are increased which raised the systolic blood pressure .The diastolic blood pressure is also raised due to activation of alpha 1 receptors in peripheral blood vessels.
Pharmacological actions of Ephedrine on Respiratory system
Beta 2 receptors activation causes bronchodilatation. It also decreases the bronchial secretions as ephedrine constricts the blood vessels of bronchial mucosa by acting on alpha 1 receptors.
Other actions of Ephedrine
Ephedrine increases the alertness; decreases fatigue, and prevent sleep. It also improves athletic performance.
Ephedrine also acts as a nasal decongestant due to local vasoconstriction action.
WARNING: This drug should not be used in combination with other stimulant products (e.g., caffeine), other cough-and-cold products, or as a dietary supplement for the purpose of weight loss or body building. Doing so may increase your risk of unlikely but potentially fatal side effects including: stroke, heart attack, seizures, or severe mental disorders (see Side Effects section and Precautions section). In addition, dietary supplements containing ephedrine should not exceed 8 mg as a single ephedrine dose, 24 mg of ephedrine per day (24 hours), or be given for longer than 7 days, as recommended by the FDA. Exceeding the recommended ephedrine dose increases your risk of the side effects noted above. For detailed information, consult your pharmacist. Check all product labels carefully to see if they contain ephedrine or ephedra/ma huang.
USES: Ephedrine is a central nervous system stimulant used to treat breathing problems (as a bronchodilator), nasal congestion (as a decongestant), low blood pressure problems (orthostatic hypotension), or myasthenia gravis.
OTHER USES: This drug has also been used to treat certain sleep disorders (narcolepsy), menstrual problems (dysmenorrhea), or urine-control problems (incontinence or enuresis).
HOW TO USE: Take this medication by mouth usually every 4 hours as needed; or as directed by your doctor. The dosage is based on your medical condition and response to therapy. For prescription ephedrine, do not exceed 150 mg per day in adults or 75 mg per day in children. Do not combine prescription ephedrine with ephedrine/ephedra/ma huang from dietary supplement products, since they are the same medicine. Use this medication exactly as prescribed. Do not increase your dose, take it more frequently, or use it for a longer period of time than prescribed because this drug can be habit-forming and you may increase for your risk for serious side effects. When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well. Your doctor may recommend "drug holidays" where your medication is stopped temporarily. Doing so may help this medication work more effectively.
SIDE EFFECTS: Nervousness, anxiety, dizziness, headache, nausea, loss of appetite, or trouble sleeping may occur. If any of these effects persist or worsen, notify your doctor promptly. Tell your doctor immediately if any of these serious side effects occur: chest pain, unusually fast or irregular heartbeat, vomiting, tremor/shakiness, sweating, severe weight loss, difficult or painful urination, stomach pain. Tell your doctor immediately if any of these unlikely but serious side effects occur: severe mental/mood changes, fever, trouble breathing, one-sided weakness, confusion, vision problems, slurred speech. If you notice other effects not listed above, contact your doctor or pharmacist.
PRECAUTIONS: This medication is not recommended for use if you have the following medical conditions: glaucoma (closed-angle type), certain psychiatric conditions (e.g., psychoneurosis). Tell your doctor your medical history, especially of: heart problems (e.g., arrhythmias, chest pain), blood vessel problems (e.g., stroke or TIA), diabetes, over-active thyroid (hyperthyroidism), prostate problems, high blood pressure (hypertension), kidney problems, any allergies. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. It is not known whether this drug passes into breast milk. Due to the potential risk to the infant, breast-feeding while using this drug is not recommended.
DRUG INTERACTIONS: This drug is not recommended for use with other adrenalin-like drugs (e.g., caffeine, epinephrine, methylphenidate, pseudoephedrine). Also, avoid taking any MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine) for at least 2 weeks before or after using this drug. Ask your doctor or pharmacist for more details. Tell your doctor of all prescription and nonprescription medication you may use, especially: beta-blockers (e.g., metoprolol, propranolol), other blood pressure medicine (e.g., guanethidine, methyldopa, reserpine, or alpha-blockers such as prazosin and terazosin), tricyclic antidepressants (e.g., amitriptyline, desipramine), "water pills" (e.g., furosemide, hydrochlorothiazide), digoxin, atropine, theophylline, oxytocin, certain anesthetics used in surgery (e.g., cyclopropane, halothane), certain herbal/natural medications (e.g., ma huang, St John's wort). Check the labels on all your medicines (e.g., cough-and-cold products, diet aids, natural products) because they may contain ingredients that could increase your heart rate or blood pressure. The use of ephedrine with these products is not recommended. Do not start or stop any medicine without doctor or pharmacist approval.
OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: seizures, cold sweats, vision problems (dilated pupils).
NOTES: Do not share this medication with others, it is against the law. Laboratory and/or medical tests (e.g., blood pressure) will be performed to monitor your progress.
MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
STORAGE: Store at room temperature between 59 and 86 degrees F (15 and 30 degrees C) away from light.