Drug Detail:Ephedrine (Ephedrine capsules and tablets (e-fed-rin)
Drug Class: Decongestants Vasopressors
Usual Adult Dose for Adams-Stokes Syndrome
Parenteral:
- IM or subcutaneous: 25 mg to 50 mg IM or subcutaneously
- IV: 5 mg to 25 mg IV administered slowly, may repeat in 5 to 10 minutes if necessary
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Uses: For use in Stokes-Adams syndrome with complete heart block; as a central nervous system (CNS) stimulant in narcolepsy and depressive states; and in patients with myasthenia gravis
Usual Adult Dose for Depression
Parenteral:
- IM or subcutaneous: 25 mg to 50 mg IM or subcutaneously
- IV: 5 mg to 25 mg IV administered slowly, may repeat in 5 to 10 minutes if necessary
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Uses: For use in Stokes-Adams syndrome with complete heart block; as a central nervous system (CNS) stimulant in narcolepsy and depressive states; and in patients with myasthenia gravis
Usual Adult Dose for Myasthenia Gravis
Parenteral:
- IM or subcutaneous: 25 mg to 50 mg IM or subcutaneously
- IV: 5 mg to 25 mg IV administered slowly, may repeat in 5 to 10 minutes if necessary
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Uses: For use in Stokes-Adams syndrome with complete heart block; as a central nervous system (CNS) stimulant in narcolepsy and depressive states; and in patients with myasthenia gravis
Usual Adult Dose for Narcolepsy
Parenteral:
- IM or subcutaneous: 25 mg to 50 mg IM or subcutaneously
- IV: 5 mg to 25 mg IV administered slowly, may repeat in 5 to 10 minutes if necessary
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Uses: For use in Stokes-Adams syndrome with complete heart block; as a central nervous system (CNS) stimulant in narcolepsy and depressive states; and in patients with myasthenia gravis
Usual Adult Dose for Hypotension
Akovaz(TM):
- Initial dose: 5 mg to 10 mg IV bolus; administer additional boluses as needed, not to exceed a total dosage of 50 mg
Comments:
- Must be diluted prior to administration.
- Adjust dosage according to blood pressure goal (i.e., titrate to effect).
Use: For the treatment of clinically important hypotension occurring in the setting of anesthesia
Parenteral:
- IM or subcutaneous: 25 mg to 50 mg IM or subcutaneously
- IV: 5 mg to 25 mg IV administered slowly, may repeat in 5 to 10 minutes if necessary
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Use: For use as a pressor agent, particularly for the treatment of hypotension occurring during spinal anesthesia
Usual Adult Dose for Asthma - Acute
Parenteral:
- IM or subcutaneous: 25 mg to 50 mg IM or subcutaneously
- IV: 5 mg to 25 mg IV administered slowly, may repeat in 5 to 10 minutes if necessary
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Oral:
- Initial dose: 12.5 mg to 25 mg orally every 4 hours
- Maximum dose: 150 mg/day
Comments:
- Most over the counter drugs are not reviewed and approved by the US FDA, however they may be marketed if they comply with applicable regulations and policies; the US FDA has not evaluated whether this product complies.
Use: For the temporary relief of shortness of breath, tightness of chest, and wheezing due to bronchial asthma
Usual Pediatric Dose for Adams-Stokes Syndrome
Parenteral:
0.5 mg/kg or 16.7 mg/m2 of body surface area IM or subcutaneously every 4 to 6 hours
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Uses: For use as a pressor agent, particularly during spinal anesthesia when hypotension is likely to occur; for use in Stokes-Adams syndrome with complete heart block; as a CNS stimulant in narcolepsy and depressive states; and in patients with myasthenia gravis
Usual Pediatric Dose for Depression
Parenteral:
0.5 mg/kg or 16.7 mg/m2 of body surface area IM or subcutaneously every 4 to 6 hours
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Uses: For use as a pressor agent, particularly during spinal anesthesia when hypotension is likely to occur; for use in Stokes-Adams syndrome with complete heart block; as a CNS stimulant in narcolepsy and depressive states; and in patients with myasthenia gravis
Usual Pediatric Dose for Hypotension
Parenteral:
0.5 mg/kg or 16.7 mg/m2 of body surface area IM or subcutaneously every 4 to 6 hours
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Uses: For use as a pressor agent, particularly during spinal anesthesia when hypotension is likely to occur; for use in Stokes-Adams syndrome with complete heart block; as a CNS stimulant in narcolepsy and depressive states; and in patients with myasthenia gravis
Usual Pediatric Dose for Myasthenia Gravis
Parenteral:
0.5 mg/kg or 16.7 mg/m2 of body surface area IM or subcutaneously every 4 to 6 hours
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Uses: For use as a pressor agent, particularly during spinal anesthesia when hypotension is likely to occur; for use in Stokes-Adams syndrome with complete heart block; as a CNS stimulant in narcolepsy and depressive states; and in patients with myasthenia gravis
Usual Pediatric Dose for Narcolepsy
Parenteral:
0.5 mg/kg or 16.7 mg/m2 of body surface area IM or subcutaneously every 4 to 6 hours
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Uses: For use as a pressor agent, particularly during spinal anesthesia when hypotension is likely to occur; for use in Stokes-Adams syndrome with complete heart block; as a CNS stimulant in narcolepsy and depressive states; and in patients with myasthenia gravis
Usual Pediatric Dose for Asthma - Acute
Parenteral: 0.5 mg/kg or 16.7 mg/m2 of body surface area IM or subcutaneously every 4 to 6 hours
Comments:
- This product has not been found by the US FDA to be safe and effective and the product labeling has not been approved.
Oral:
12 years or older: 12.5 mg to 25 mg orally every 4 hours
- Maximum dose: 150 mg/day
Comments:
- Most over the counter drugs are not reviewed and approved by the US FDA, however they may be marketed if they comply with applicable regulations and policies; the US FDA has not evaluated whether this product complies.
Use: For the temporary relief of shortness of breath, tightness of chest, and wheezing due to bronchial asthma
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Dose Adjustments
Elderly: Elderly patients may require lower doses due to increased risk for adverse effects and increased likelihood of concomitant hepatic, renal, and/or cardiac impairment; consider close monitoring of renal function.
Precautions
Akovaz(TM):
- Safety and efficacy have not been established in patients younger than 18 years.
IM, IV, and Subcutaneous Products:
- Safety and efficacy of this drug has not been established; its limited use in pediatric patients has been inadequate to fully define the proper dosage and limitations of use.
Oral Capsule:
Safety and efficacy have not been established in patients younger than 12 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Storage requirements:
- Store vials in carton until time of use; protect from light.
- Oral Tablets: Protect from light and moisture; dispense in tight, light resistant container.
Reconstitution/preparation techniques:
- Akovaz(TM): Withdraw 50 mg (1 mL of 50 mg/mL) of Akovaz(TM) and dilute with 9 mL of 5% dextrose injection or 0.9% sodium chloride injection. Withdraw an appropriate dose of the 5 mg/mL solution prior to bolus IV administration.
Monitoring:
- Metabolic: Monitor newborns for signs/symptoms of metabolic acidosis, including monitoring of acid-base status
- Renal: Monitor renal function in patients with renal impairment and elderly patients; monitor patients with renal impairment carefully for adverse events following initial bolus dose
Patient advice:
- Contact your healthcare provider if after taking the oral formulation, symptoms are not relieved within 1 hour or worsen.
- This drug may cause nervousness, tremor, insomnia, nausea, and loss of appetite; consult your physician if symptoms persist or worsen.
