Not actual size.
Not actual size.
Ephedrine Sulfate Injection is an alpha- and beta-adrenergic agonist and a norepinephrine-releasing agent that is indicated for the treatment of clinically important hypotension occurring in the setting of anesthesia.1
Ephedrine Sulfate Injection is available as a single-dose, 10-mL vial that contains
 | Ready-to-use formulation does not require compounding, diluting, or mixing, which may reduce waste and chance of preparation error2 |
| | Two-year shelf life3* may offer enhanced inventory management |
| | Available through your wholesaler |
| | Compatible with most automated dispensing machines |
| | Aligns with medication strategies of ASHP Guidelines on Preventing Medication Errors in Hospitals2 |
| * | When stored at the recommended storage condition of 20°–25°C (68°–77°F); protect from light.1,3 |
INDICATIONS AND USAGE
Ephedrine Sulfate Injection is indicated for the treatment of clinically important hypotension occurring in the setting of anesthesia.
IMPORTANT SAFETY INFORMATION FOR EPHEDRINE SULFATE INJECTION
WARNINGS AND PRECAUTIONS
PRESSOR EFFECT WITH CONCOMITANT OXYTOCIC DRUGS
Serious postpartum hypertension has been described in patients who received both a vasopressor (i.e., methoxamine, phenylephrine, ephedrine) and an oxytocic (i.e., methylergonovine, ergonovine). Some of these patients experienced a stroke. Carefully monitor the blood pressure of individuals who have received both ephedrine and an oxytocic.
TOLERANCE AND TACHYPHYLAXIS
Data indicate that repeated administration of ephedrine can result in tachyphylaxis. Clinicians treating anesthesia-induced hypotension with Ephedrine Sulfate Injection should be aware of the possibility of tachyphylaxis and should be prepared with an alternative pressor to mitigate unacceptable responsiveness.
RISK OF HYPERTENSION WHEN USED PROPHYLACTICALLY
When used to prevent hypotension, ephedrine has been associated with an increased incidence of hypertension compared with when ephedrine is used to treat hypotension.
ADVERSE REACTIONS
Most common adverse reactions during treatment with ephedrine sulfate were nausea, vomiting, and tachycardia.
DRUG INTERACTIONS
Interactions that Augment the Pressor Effect
Oxytocin and oxytocic drugs, clonidine, propofol, monoamine oxidase inhibitors (MAOIs), and atropine
Carefully monitor the blood pressure of individuals who have received both ephedrine and these drugs.
Interactions that Antagonize the Pressor Effect
α-adrenergic antagonists, β-adrenergic receptor antagonists, reserpine, quinidine, mephentermine
Carefully monitor the blood pressure of individuals who have received both ephedrine and any of these drugs.
Other Drug Interactions
Guanethidine: Ephedrine may inhibit the neuron blockage produced by guanethidine, resulting in loss of antihypertensive effectiveness. Monitor patient for blood pressor response and adjust the dosage or choice of pressor accordingly.
Rocuronium: Ephedrine may reduce the onset time of neuromuscular blockade when used for intubation with rocuronium if administered simultaneously with anesthetic induction. Be aware of this potential interaction. No treatment or other interventions are needed.
Epidural anesthesia: Ephedrine may decrease the efficacy of epidural blockade by hastening the regression of sensory analgesia. Monitor and treat the patient according to clinical practice.
Theophylline: Concomitant use of ephedrine may increase the frequency of nausea, nervousness, and insomnia. Monitor patient for worsening symptoms and manage symptoms according to clinical practice.
Cardiac glycosides: Giving ephedrine with a cardiac glycoside, such as digitalis, may increase the possibility of arrhythmias. Carefully monitor patients on cardiac glycosides who are also administered ephedrine.
OVERDOSAGE
Overdose of ephedrine can cause a rapid rise in blood pressure. In the case of an overdose, careful monitoring of blood pressure is recommended. If blood pressure continues to rise to an unacceptable level, parenteral antihypertensive agents can be administered at the discretion of the clinician.
Please see Full Prescribing Information for Ephedrine.
References: 1. Ephedrine Sulfate Injection. Prescribing Information. Endo USA, Inc. 2. American Society of Health-System Pharmacists. ASHP guidelines on preventing medication errors in hospitals. Am J Health-Syst Pharm. 2018;75(19):1493-1517. 3. Data on file. DOF-EH-01. Endo USA, Inc.; July 31, 2023.