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REZIPRES

EPHEDRINE HYDROCHLORIDE

Manufacturer: Dr. Reddy's Laboratories Inc

Score: 141.0

Quick Summary

REZIPRES is an alpha- and beta-adrenergic agonist and a norepinephrine-releasing agent used for the treatment of clinically important hypotension occurring in the setting of anesthesia. It is available in various dosages and forms, including 47 mg/mL, 9.4 mg/mL, and 4.7 mg/mL solutions for intravenous injection. The recommended initial dose is 4.7 mg to 9.4 mg administered by intravenous bolus, with additional boluses as needed, not to exceed a total dosage of 47 mg. REZIPRES has several potential interactions with other drugs, including those that augment or antagonize its pressor effect, and should be used with caution in patients with certain medical conditions, such as pregnancy, pediatric, and geriatric populations.

Key Clinical Findings and Indications

  • Treatment of clinically important hypotension occurring in the setting of anesthesia
  • Alpha- and beta-adrenergic agonist and a norepinephrine-releasing agent
  • Increases blood pressure, heart rate, and cardiac output

Important Safety Information

Warning

Tachyphylaxis to the pressor effects of ephedrine may occur with repeated administration

Contraindications

Adverse Reactions

  • Nausea
  • Vomiting
  • Tachycardia
  • Palpitations
  • Reactive hypertension
  • Bradycardia
  • Ventricular ectopics
  • R-R variability
  • Dizziness
  • Restlessness

Dosing Recommendations

General Guidance

Adjust dosage according to the blood pressure goal (i.e., titrate to effect)

Clinically important hypotension occurring in the setting of anesthesia

Adult Dose

4.7 mg to 9.4 mg administered by intravenous bolus, with additional boluses as needed, not to exceed a total dosage of 47 mg

Pediatric Dose

Not established

Special Population Considerations

Pregnancy

  • Available data from randomized studies, case series, and reports of ephedrine sulfate use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
  • Monitor newborn for signs and symptoms of metabolic acidosis

Nursing Mothers

Pediatric Use

  • Safety and effectiveness in pediatric patients have not been established
  • Increased incidence of mortality noted in juvenile rats administered intravenous bolus doses of 60 mg/kg ephedrine sulfate

Geriatric Use

  • Clinical studies of ephedrine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects
  • Dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range

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