Ephedrine is a sympathomimetic which stimulates both alpha and beta adrenergic receptors, and also releases noradrenaline from storage site. The main effects of therapeutic doses of Ephedrine are relaxation of bronchial smooth muscle, cardiac stimulation and increased systolic and usually diastolic blood pressure via an increase in cardiac output and peripheral vasoconstriction. Ephedrine also decreases intestinal tone and motility, relaxes the bladder wall, contracts the sphincter muscle, relaxes the detrusor muscle, and decreases uterine activity. Ephedrine also has central nervous system stimulant effects. Tachyphylaxis to the effects of Ephedrine may also occur after use for a short while possibly due to the depletion of noradrenaline stores.
Adult: 15-60 mg tid.
Child: 1-5 yr: 15 mg tid; 6-12 yr: 30 mg tid; >12 yr: Same as adult dose.
Elderly: Initial: 50% of adult dose.
Reversal of spinal or epidural anaesthesia-induced hypotension:
Adult: 3-6 mg by slow IV inj every 3-4 min as required. Max total dose: 30 mg.
Child: 0.5 mg/kg or 16.7 mg/m2 4-6 hrly by SC or IM inj or alternatively, 0.75 mg/kg or 25 mg/m2 4 times daily by SC or IV inj.
Elderly: Same as adult dose.
Adult: 12.5-25 mg by SC, IM or IV inj, further dosage may be given according to patient’s response.
Adult/Elderly: As 1% soln: Instill 1-2 drops into each nostril up to 4 times daily as needed.
Child: >12 yr: Same as adult dose.