G-Ephedrine Injection 25 mg/5 ml 25 mg/5 ml Uses, Dosage, Side Effects & Price

Brand Name	G-Ephedrine
Type	Injection
Weight	25 mg/5 ml
Generic	Ephedrine Hydrochloride
Manufacturer	Gonoshasthaya Pharma Ltd.

Introduction

Ephedrine was first described in western literature in 1888, as a naturally occurring component of the ephedra plant, along with pseudoephedrine. Ephedrine is an adrenergic receptor agonist used for its vasoconstrictive, positive chronotropic, and positive inotropic effects. Ephedrine and phenylephrine are still commonly used to treat hypotension but their use in other indications has decreased due to the development of more selective adrenergic agonists.

Uses

Ephedrine is an alpha and beta-adrenergic agonist indicated to treat hypotension under anesthesia, allergic conditions, bronchial asthma, and nasal congestion.

Ephedrine intravenous injections are indicated to treat hypotension under anesthesia, ephedrine injections by multiple routes are indicated to treat allergic conditions such as bronchial asthma, ephedrine nasal spray is and OTC medication used as a decongestant.

Associated Conditions

Allergic Disorder
Bronchial Asthma
Common Cold
Cough
Depression
Fever
General Anesthesia Induced Hypotension
Headache
Joint Pain
Myasthenia Gravis
Narcolepsy
Nasal Congestion
Rhinorrhoea
Sore Throat
Dry cough

Pharmacodynamics

Ephedrine is a sympathomimetic amine that activates adrenergic receptors, increasing heart rate and blood pressure, and causing bronchodilation. The therapeutic window is wide as patients can be given doses of 5mg up to 50mg. Patients should be counselled regarding the pressor effects of sympathomimetic amines and the risk of tachyphylaxis.

Mechanism of Action

Ephedrine is a direct and indirect sympathomimetic amine. Ephedrine activates adrenergic α and β-receptors as well as inhibiting norepinephrine reuptake, and increasing the release of norepinephrine from vesicles in nerve cells. These actions combined lead to larger quantities of norepinephrine present in the synapse, for longer periods of time, increasing stimulation of the sympathetic nervous system. Ephedrine's stimulation of α-1 receptors causes constriction of veins and a rise in blood pressure, stimulation of β-1 adrenergic receptors increase cardiac chronotropy and inotropy, stimulation of β-2 adrenergic receptors causes bronchodilation.

Absorption

Oral ephedrine reaches an average C_max of 79.5ng/mL, with a T_max of 1.81h, and a bioavailability of 88%.

Volume of Distribution

Oral ephedrine has an average volume of distribution of 215.6L.

Protein Binding

(-) Ephedrine is 4.9±0.3% bound to human serum albumin and (+) Ephedrine is 6.9±1.4% bound to human serum albumin.

Route of Elimination

Ephedrine is mainly eliminated in the urine. Approximately 60% is eliminated as the unmetabolized parent compound, 13% as benzoic acid conjugates, and 1% as 1,2-dihydroxypropylbenzene.

Half Life

Oral ephedrine has a plasma elimination half life of approximately 6 hours, but there is a large degree of inter-patient variability.

Clearance

Oral ephedrine has a clearance of 23.3L/h but there is a high degree of inter-patient variability.

Toxicity

Patients experiencing an overdose of ephedrine will present with rapidly increasing blood pressure. Manage overdose with blood pressure monitoring, and possibly the administration of parenteral antihypertensives. The LD₅₀ in mice after oral administration is 785mg/kg, after intraperitoneal administration if 248mg/kg, and after subcutaneous administration is 425mg/kg.

Food Interactions

No interactions found.

Dosage

To reverse hypotension induced by spinal or epidural anaesthesia 3 to 6 mg (or at most 9 mg) G-Ephedrine Injection 25 mg/5 ml is given by slow intravenous injection and repeated every 3 to 4 minutes as required; the maximum total dose is 30 mg. Ephedrine has also been given by intramuscular or subcutaneous injection.