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Ephedrine

By: Dr. Karin Szust

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Overview

  • Ephedrine is a potent central nervous system stimulant classified as a sympathomimetic alkaloid agent.
  • Ephedrine causes the release of the sympathetic nervous system chemical norepinephrine. The involuntary nervous system is divided into the sympathetic (flight or fight response) and parasympathetic branches. In general, these two systems oppose each other.
  • When stimulated, the sympathetic system increases heart rate, blood pressure and cardiac activity. It also dilates the bronchial tree and contracts certain smooth muscles such as that found at the neck of the bladder.
  • Ephedrine is a prescription drug and can be obtained from a veterinarian or by prescription from a veterinarian.
  • Ephedrine is also available in some states without a prescription but should not be administered unless under the supervision and guidance of a veterinarian.
  • This drug is not approved for use in animals by the Food and Drug Administration but it is prescribed legally by veterinarians as an extra-label drug.

    Brand Names and Other Names

  • This drug is registered for use in humans only.
  • Human formulations: Ephedrine® (Lilly) and various over-the-counter (OTC) products.
  • Veterinary formulations: None

    Uses of Ephedrine

  • Ephedrine is used primarily for the treatment of urinary incontinence (involuntary leakage of urine from the bladder), not related to neurologic disease.
  • Ephedrine increases sphincter tone and reduces incompetence in small animals.
  • For its bronchodilator activity, it has been used in the treatment of respiratory conditions like bronchitis in small animals; however, other drugs such as theophylline and terbutaline are more often prescribed.

    Precautions and side Effects

  • While generally safe and effective when prescribed by a veterinarian, ephedrine can cause side effects in some animals.
  • Ephedrine should not be used in animals with known hypersensitivity or allergy to the drug.
  • Ephedrine may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with ephedrine. Such drugs include phenylpropanolamine, non-steroidal anti-inflammatories, tricyclic antidepressants and monoamine oxidase inhibitors. Toxic effects may occur when ephedrine is combined with drugs the make the urine more alkaline (urinary alkalinizers). Risk of cardiac arrhythmia is greater when ephedrine is used in combination with digoxin for treatment of congestive heart failure.
  • Common side effects seen are loss of appetite, changes in behavior (hyperirritability, restlessness) and tachycardia (increased heart rate).
  • Ephedrine is contraindicated in hyperthyroidism, glaucoma, diabetes mellitus, hypertension and disorders of the cardiovascular system.

    How Ephedrine Is Supplied

  • Ephedrine capsules are available in 25 mg (OTC) or 50 mg (Rx).
  • Ephedrine solution for injection is available in 25 to 50 mg/ml concentration.

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian.
  • For treatment of urinary incontinence in dogs, ephedrine is dosed at about 2 mg per pound (4 mg/kg) or 12.5 to 50 mg by mouth, every 8 to 12 hours.
  • As a bronchodilator in dogs, ephedrine is dosed at approximately 1 mg per pound (2 mg/kg), orally, every 8 to 12 hours; a maintenance dose is about 50 percent of this.
  • For treatment of urinary incontinence in cats, ephedrine is dosed at 1 to 2 mg per pound (2 to 4 mg/kg), by mouth, every 8 to 12 hours; a lower dose is 2 to 4 mg per cat every 8 hours.
  • As a bronchodilator in cats for emergency treatment, ephedrine is dosed at 2 to 5 mg per cat by mouth.
  • Response to treatment may not be immediately evident, and it is recommended that the dosing instructions be followed carefully to achieve optimal results.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.




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