Caphedrine

Indications

Ephedrine hydrochloride tablets and syrup are used to relieve a blocked nose and, in some cases, to help open the airways in mild asthma or bronchospasm, although modern inhalers are usually preferred for asthma. The injection is used in hospital to treat low blood pressure during anaesthesia, for example during spinal anaesthesia for caesarean section.

How It Works

Ephedrine is a sympathomimetic medicine: it acts like the body's own adrenaline, both directly on receptors and by releasing noradrenaline. It relaxes the muscles around the airways, narrows swollen blood vessels in the nose, and raises heart rate and blood pressure.

Dosage and Administration

Adults: usually 15 to 60 mg by mouth up to three times a day, starting with the lowest dose that works, or as the doctor advises. Avoid taking the last dose late in the evening, as it can disturb sleep. Children: only on a doctor's advice, at the dose prescribed for their age. Injection: given by an anaesthetist or doctor in hospital, with blood pressure monitoring.

Interactions

• Do not take with MAO inhibitors (such as Phenelzine, Selegiline or Linezolid) or within 14 days of stopping them; dangerous high blood pressure can result.
• Other decongestants, stimulants, Theophylline and caffeine increase side effects.
• Tricyclic antidepressants and some anaesthetic gases increase the risk of irregular heartbeat.
• It can weaken the effect of blood pressure medicines and beta-blockers.
• It may lower the effect of Dexamethasone.

Contraindications

• Severe high blood pressure or serious heart disease.
• Overactive thyroid.
• Closed-angle glaucoma.
• Phaeochromocytoma (a tumour of the adrenal gland).
• Taking an MAO inhibitor now or in the last 14 days.
• Allergy to ephedrine or any ingredient of the product.

Side Effects

Common effects are nervousness, restlessness, trouble sleeping, shaking, fast or pounding heartbeat, headache, raised blood pressure, loss of appetite, nausea, and difficulty passing urine in men with an enlarged prostate.

Get urgent medical help for chest pain, a severe headache, a very fast or irregular heartbeat, fainting, being unable to pass urine, confusion or hallucinations, or signs of a serious allergic reaction.

Pregnancy and Lactation

Avoid the tablets and syrup in pregnancy unless a doctor advises them. The injection is used during childbirth anaesthesia under specialist care. It passes into breast milk and can make the baby irritable; avoid while breastfeeding unless the doctor advises it.

Precautions and Warnings

• Ask a doctor first if you have high blood pressure, heart disease, diabetes, thyroid disease, an enlarged prostate, glaucoma or kidney disease, or if you are elderly.
• Do not use for long periods; its effect can weaken over time and it can be habit-forming.
• Do not combine with other cold, slimming or stimulant products.
• It is a banned substance in competitive sport.

Overdose

Overdose can cause very high blood pressure, fast or irregular heartbeat, severe agitation, hallucinations, fits and collapse. Get emergency medical help straight away, especially if a child has swallowed it.

Therapeutic Class

Sympathomimetic (bronchodilator, nasal decongestant and vasopressor).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.