Ephedrine hydrochloride nasal
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Nasal drops containing ephedrine hydrochloride
Drugs List
Therapeutic Indications
Uses
Nasal congestion
Dosage
Adults
Instil one or two drops into each nostril as required up to four times a day.
Elderly
Instil one or two drops into each nostril as required up to four times a day.
Children
Children over 12 years
Instil one or two drops into each nostril as required up to four times a day.
Contraindications
Children under 12 years
Hyperexcitability
Within 2 weeks of discontinuing MAOIs
Breastfeeding
Cardiac arrhythmias
Cardiomyopathy
Cardiovascular disorder
Hypertension
Hyperthyroidism
Narrow angle glaucoma
Peripheral vascular disease
Phaeochromocytoma
Pregnancy
Recent nasal surgery
Urinary retention
Precautions and Warnings
Anaesthesia with halogenated anaesthetics
Elderly
Asthma
Benign prostatic hyperplasia
Diabetes mellitus
Renal impairment
Avoid contact with eyes
Avoid excessive use
Prolonged use may cause rebound congestion
Treatment should be for a maximum period of 7 days
Pregnancy and Lactation
Pregnancy
Use ephedrine hydrochloride with caution in pregnancy.
The manufacturer notes that this medication should not be used in pregnancy unless recommended by a doctor. Ephedrine, which crosses the placenta, has been associated with an increase in foetal heart rate.
Human teratogenicity has not been suspected, although ephedrine-like drugs are teratogenic in some animals.
The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Lactation
Use ephedrine hydrochloride with caution in breastfeeding.
The manufacturer notes that this medication should not be used in breastfeeding unless recommended by a doctor. Ephedrine hydrochloride is excreted in breast milk and irritability and sleep disturbances in the infant have been reported.
Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1
Side Effects
Anginal pain
Anorexia
Anxiety
Arrhythmias
Blood glucose disturbances
Bradycardia
Confusion
Dependence
Dermatitis
Difficulty in micturition
Dizziness
Dry mouth
Dryness of nose
Dyspnoea
Fainting
Flushing
Glaucoma (closed angle)
Hallucinations
Headache
Hyperglycaemia
Hypersalivation
Hypertension
Hypokalaemia
Impaired circulation to the extremities
Insomnia
Irritability
Irritation (localised)
Muscle weakness
Mydriasis
Nausea
Palpitations
Paranoia
Piloerection
Rebound congestion
Restlessness
Rhinitis
Sweating
Tachycardia
Thirst
Tolerance
Tremor
Urinary retention
Vasodilation
Vomiting
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: December 2016
Reference Sources
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.
Joint Formulary Committee. British National Formulary. 72nd ed. London: BMJ Group and Pharmaceutical Press; 2016.
Paediatric Formulary Committee. BNF for Children 2016-2017. London: BMJ Group, Pharmaceutical Press, and RCPCH Publications; 2016.
Summary of Product Characteristics: Ephedrine Nasal Drops 0.5%. Thornton and Ross Ltd. Revised November 2014.
Summary of Product Characteristics: Ephedrine Nasal Drops 1%. Thornton and Ross Ltd. Revised November 2014
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