Ephedrine

What is ephedrine?

Ephedrine (brand names: Akovaz®, Corphedra®) is a medication used to treat low blood pressure due to shock or anesthesia. It has also been used to treat certain types of urinary incontinence.

Its use in cats, dogs, and horses to treat low blood pressure or urinary incontinence is off label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How is ephedrine given?

• Ephedrine is given by injection in the hospital. It may also be available as a tablet, but do not use this form unless instructed by your veterinarian.
• This medication should take effect quickly, within 1 to 2 hours.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects?

Ephedrine may cause the following side effects:

• Restlessness
• Fast heartbeat
• High blood pressure
• Lack of appetite (less common)

Serious adverse reactions may occur. If any of the following signs develop, stop giving ephedrine and contact your veterinarian immediately:

• Collapse
• Coma

Drug sensitivities can develop over time, with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment.

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately.  This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE ephedrine in pets that:

• Are allergic to it.
• Have severe heart disease or abnormal heart rhythms

USE WITH CAUTION in pets that:

• Have glaucoma
• Have enlarged prostate
• Have increased thyroid hormones
• Have diabetes mellitus
• Have general heart disease
• Have high blood pressure
• Are pregnant or nursing (safety has not been established; use a milk replacer if this medication is necessary in nursing pets)

Are there any drug interactions I should be aware of?

Several medications should be used with caution when given with ephedrine, including:

• Acepromazine
• Alpha-blockers
• Betablockers
• Cyclosporine
• Monoamine oxidase inhibitors (MAOIs)
• Sodium bicarbonate
• Theophylline
• Tricyclic antidepressants
• Urinary alkalinizers

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store ephedrine?

• Store this medication at room temperature and protect from light.
• Keep the container out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms.