ephedrine

Oral ephedrine is an over-the-counter oral drug used as a dietary supplement, and treating nasal congestion and bronchospasm due to asthma.

• Ephedrine directly stimulates alpha and beta-adrenergic receptors and increases the release of norepinephrine.
• Its actions include relaxation of bronchioles, increased heart rate and contractility, and increased blood pressure.
• It also causes blood vessels in the nasal passages to shrink (vasoconstrict). Vasoconstriction reduces nasal congestion by preventing fluid from draining from blood vessels into the lining of the nasal passages.
• Ephedrine is also a central nervous system stimulant used illegally for weight loss and for performance enhancement diet supplements.

Common side effects include:

• Nausea
• Vomiting
• Tremor
• Headache
• Dizziness

Possible serious side effects include:

• High blood pressure
• Palpitations
• Fast heart beat
• Seizures
• Death

• A dose of 12.5 to 25 mg orally every 4 hours, not to exceed 150 mg in 24 hour has be used for treating bronchospasm.
• The dose for treating nasal congestion in adults is 25 to 50 mg every 6 hours.

• Ephedrine should not be combined with monoamine oxidase inhibitors (MAOIs). Combining MAOIs with ephedrine can cause an acute hypertensive episode. Examples of MAOIs include rasagiline (Azilect), selegiline (Eldepryl, Zelapar), isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate)

• Ephedrine has not been adequately studied in pregnant women or in women who are breastfeeding.