Parenteral Manual

EPHEDrine sulfate

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
EPHEDRA, EPHEDRINUM
Classification: 
Sympathomimetic
Original Date: 
August 2005
Revised Date: 
January 2017
Indications: 
  • Maintenance of blood pressure in the treatment of shock
Reconstitution and Stability: 
  • Stable at room temperature; protect from light
  • DO NOT use darkened solutions or solutions containing a precipitate
  • Available as 50 mg/mL ampoules and vials
Compatibility: 

- Solutions Compatible: dextrose up to D10W, 0.9 % NaCl, dextrose-saline combinations, ringer's solution, ringer's lactate

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: propofol

- Incompatible: hydrocortisone, phenobarbital, thiopental

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC YES
Usual dilution: undiluted
IM YES
Usual dilution: undiluted
IV Push

YES
Infusion time: over at least 1 minute
IV Intermittant Infusion NO
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric(<12 years): 

  • 3 mg/kg/day IM/SC/IV ÷ Q 4-6 hours

Adolescent/Adult (>12 years):     

  • 10-50 mg IM/SC, may repeat a second dose Maximum: 150 mg/day
  • 10-25 mg IV; may repeat with a second dose in 5-10 minutes prn Maximum: 150 mg/day
Potential hazards of parenteral administration: 
  • Arrhythmias, ventricular fibrillation, hypertension, palpitations, angina
  • Confusion, delirium, headache, restlessness, tremor, dizziness
  • Excessive parenteral dosage may produce tachycardia, hypotension and possible cerebrovascular bleeding
Notes: 
  • Use with caution in patients with cardiac disease, hypertension, hyperthyroidism, diabetes, narrow angle glaucoma and patients anaesthetized with cyclopropane, halothane or patients taking digoxin
  • Increased cardiac irritability and arrhythmias with halothane and cyclopropane anesthesia
  • Onset of action by the intramuscular route is more rapid (within 10 to 20 minutes) than by subcutaneous injection
  • Pressor and cardiac effects usually persist for one hour following SC or IM administration of 25-50 mg
  • Blood volume should be corrected with blood, plasma and fluids before using ephedrine
  • Hypoxia, hypercapnia and acidosis may reduce the effectiveness and increase the incidence of side effects of ephedrine
  • Monitor vital signs

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