Side Effects of Ephedrine (oral)

Ephedrine is a central nervous system stimulant used to treat bronchospasm due to asthma and nasal congestion. It is also used illegally for weight loss and for performance enhancement diet supplements. 

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. 

Ephedrine 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.

Drug interactions of ephedrine include monoamine oxidase inhibitors (MAOIs), for example, rasagiline, selegiline, isocarboxazid, phenelzine, and tranylcypromine, because combining MAOIs with ephedrine can cause an acute hypertensive episode. 

Ephedrine has not been adequately studied in pregnant women or in women who are breastfeeding. Consult your doctor.

What are the common side effects of ephedrine?

Common side effects of ephedrine include

• nausea,
• vomiting,
• tremor,
• headache, and
• dizziness.

What are the serious side effects of ephedrine?

Serious side effects of ephedrine include

• high blood pressure,
• palpitations,
• fast heartbeat,
• seizures, and
• death.

Drug Abuse And Dependence

Prolonged abuse of Ephedrine Sulfate Injection, USP can lead to symptoms of paranoid schizophrenia. When this occurs, patients exhibit such physical signs as

• tachycardia,
• poor nutrition and hygiene,
• fever,
• cold sweat and
• dilated pupils.

Some measure of tolerance may develop with prolonged or excessive use but addiction does not occur. Temporary cessation of medication and subsequent readministration restores its effectiveness.

• Concurrent use of ephedrine sulfate with general anesthetics, especially cyclopropane or halogenated hydrocarbons or digitalis glycosides may cause cardiac arrhythmias, since these medications may sensitize the myocardium to the effects of ephedrine sulfate.
• Therapeutic doses of ephedrine sulfate can inhibit the hypotensive effect of guanethidine, bethanidine, and debrisoquin by displacing the adrenergic blockers from their site of action in the sympathetic neurons.
• The effect in man is seen as a relative or a complete blockade of the antihypertensive drug by a sudden rise in blood pressure.
• Concomitant use of Ephedrine Sulfate Injection, USP and oxytocics may cause severe hypotension.
• Monoamine oxidase inhibitors may potentiate the pressor effect of ephedrine sulfate, possibly resulting in a hypertensive crisis.
• Ephedrine Sulfate Injection, USP should not be administered during or within 14 days following the administration of MAO inhibitors.

With large doses of ephedrine sulfate most patients will experience

• nervousness,
• insomnia,
• vertigo,
• headache,
• tachycardia,
• palpitation and
• sweating.

Some patients have

• nausea,
• vomiting and
• anorexia.

Vesical sphincter spasm may occur and result in difficult and painful urination. Urinary retention may develop in males with prostatism.

Precordial pain and cardiac arrhythmias may occur following administration of Ephedrine Sulfate Injection, USP.