Ephedrine brands and prices in Pakistan

About Ephedrine

Ephedrine is a medicine from the sympathomimetic group, which acts on the automatic part of the nervous system that controls things like heart rate and blood pressure. It raises blood pressure, mainly by briefly narrowing small blood vessels. The injection is given slowly into a vein by an anaesthetist or another doctor, usually during an operation, and is not used at home.

Who should not take it, or should take care

• It must not be given to people allergic to ephedrine or any other ingredient of the injection.
• It must not be given to people taking, or who have recently taken, a non-selective monoamine oxidase inhibitor (MAOI) antidepressant, such as phenelzine.
• It must not be given with other medicines of the same type, such as phenylephrine, pseudoephedrine or methylphenidate.
• Tell the doctor if you have heart disease or angina, high blood pressure, an aneurysm (a bulge in a blood vessel) or narrowed blood vessels.
• Tell the doctor if you have diabetes, an overactive thyroid, glaucoma, an enlarged prostate or kidney disease.
• Tell the doctor if you have ever had a stroke.
• Pregnancy: it is used for low blood pressure during a spinal anaesthetic for caesarean section, but in pregnancy it should be used only when needed. It passes to the baby, and some newborns have had a rise in blood acid levels, so the baby may be checked after birth.
• Breastfeeding: ephedrine has been found in breast milk. Your doctor may advise pausing breastfeeding for a time after the injection.
• Older people and people with kidney, liver or heart problems may be more sensitive to it and are watched more closely.

Medicines and drinks that can interact

• MAOI antidepressants such as phenelzine, moclobemide or tranylcypromine: must not be used together, as blood pressure can rise dangerously
• Other antidepressants
• Medicines of the same type: phenylephrine, pseudoephedrine, phenylpropanolamine and methylphenidate
• Oxytocin and other medicines that make the womb contract (such as ergonovine, also called ergometrine, or methylergonovine), which can cause dangerously high blood pressure after childbirth
• Ergot medicines (ergot alkaloids)
• Linezolid (an antibiotic)
• Halothane and some other anaesthetic medicines, such as propofol
• Clonidine and atropine, which can make its effect stronger
• Blood pressure medicines such as beta-blockers, alpha-blockers, reserpine, methyldopa and guanethidine
• Digoxin and other heart medicines, which may raise the risk of an uneven heartbeat
• Theophylline (for asthma), which can add to sickness, nervousness and sleep problems
• Steroid medicines, epilepsy medicines and doxapram
• Insulin and other diabetes medicines
• Appetite suppressants such as sibutramine

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Before your operation or caesarean section, tell the anaesthetist about every medicine you take, including antidepressants, cold and flu remedies, herbal products and supplements.
• Tell the team if you are pregnant, could be pregnant or are breastfeeding.
• The doctor decides how much to give; you do not need to do anything with the medicine yourself.
• Your blood pressure may be checked again after the injection. Tell the team if you feel your heart racing or a pounding headache.
• If you are an athlete, remember that ephedrine can show up in an anti-doping test.

Common questions

Why is ephedrine given during an operation?
Anaesthetics, especially spinal and epidural ones, can make blood pressure fall. Ephedrine is given into a vein to bring blood pressure back up.

Is it safe during a caesarean section?
It is commonly used for low blood pressure during a spinal anaesthetic for caesarean section. Low blood pressure that is not treated can itself cause sickness in the mother and harm to the baby. Ephedrine passes to the baby, so the baby may be checked after birth.

Why does my anaesthetist need to know about my antidepressants?
Some antidepressants, especially MAOIs, can make ephedrine raise blood pressure to dangerous levels. Others can also change how it works, so the anaesthetist needs a full list of your medicines.

Can ephedrine affect a sports doping test?
Yes. The medicine leaflets warn that ephedrine can cause a positive result in anti-doping controls.

Why might a second injection work less well?
When ephedrine is given again and again, the body can respond less each time. If this happens, the doctor can use a different medicine to raise blood pressure.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.