a) Symptoms
The symptoms of overdose are normally seen as nausea, vomiting, hypertension, fever, palpitations, tachycardia, restlessness, respiratory depression and convulsions. Paranoid psychosis, delusions and hallucinations may also follow Ephedrine HCLe overdosage.
b) Treatment
In severe overdosage, the stomach should be emptied by emesis and lavage. Management is by supportive symptomatic therapy.
Ischaemic heart disease
Hypertension
Thyrotoxicosis
Prostatic hypertrophy
Ephedrine HCLe has positive inotropic and chronotropic effects on the heart and its use should be avoided in patients with ischaemic heart disease.
Ephedrine HCLe increases blood pressure in man. Over the counter acquisition of sympathomimetics should always be considered in hypertensive patients whose blood pressure control has suddenly deteriorated.
Patients with hyperthyroidism may be susceptible to the effects of Ephedrine HCLe. Ephedrine HCLe may precipitate acute urinary retention in patients with prostatic hypertrophy.
None known
The most common side-effects of Ephedrine HCLe are tachycardia, anxiety, nausea, restlessness and insomnia. Tremor, dry mouth, impaired circulation to the extremities, hypertension, headache and cardiac arrhythmias may occur. Tolerance with dependence has been reported with prolonged administration.
Myocardial infarction has occurred very rarely in patients taking Ephedrine HCLe or pseudoEphedrine HCLe.
Ephedrine HCLe may act as stimulant in children with nocturnal enuresis and cause sleeplessness. It may have sedative effects in some children.
The elderly are more sensitive to the cardiovascular effects of Ephedrine HCLe.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.
Studies in mice have shown that the lethal toxicity of Ephedrine HCLe is increased by elevation of body temperature.
Ephedrine HCLe induces acute locomotor stimulatory activity in rats and mice. The estimated lethal dose in children up to 2 years of age is 200mg and for adults 2g. Fatalities are rare and single doses up to 400mg have been given without serious toxic effects.
Ephedrine HCLe tablets are indicated for the treatment or prevention of attacks of bronchospasm in asthma.
Ephedrine HCLe is a sympathomimetic agent with direct and indirect effects on adrenergic receptors.
When given by mouth in therapeutic doses, Ephedrine HCLe constricts the peripheral vessels, thus increasing blood pressure. It also relaxes bronchioles.
Ephedrine HCLe is rapidly and completely absorbed after oral administration and extensively distributed throughout the body with accumulation in the liver, lungs, kidneys, spleen and brain.
Peak plasma concentrations are attained during therapy of 65-120 ug/ml, effective bronchodilator plasma levels are in the range 35-80 ug/ml.
The plasma half-life is reported to be between 3-11 hours, with up to 95% being excreted in the urine.
Ephedrine HCLe should be given with care to patients with hyperthyroidism, diabetes mellitus, angle-closure glaucoma and renal impairment.
Ephedrine HCLe has potentially life threatening effects in its acute cardiovascular and central stimulant effects.
Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Not applicable
| Adults | 15 - 60mg three times daily | |
| Children | under 1 year 1 - 5 years 6 - 12 years | not recommended 15mg three times daily 30mg three times daily |
| Elderly | Dosage should be substantially reduced. Initial therapy should be 50% of adult dose. | |
Not applicable
