Efedrina
Ephedrine
Ephedrine sulfate
También conocido como: Enurace · Ephedrine sulphate · Ephedrine hydrochloride · Ephedrini hydrochloridum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Treatment of bronchospasm (maintenance therapy) | 1-2 mg/kg PO q8-12h | PO | q8-12h | — | 🌎 NA |
| Treatment of bronchospasm | 2 mg/kg PO q8-12h | PO | q8-12h | — | 🌎 NA |
| Treatment of urinary incontinence | 5-15 mg (total dose) PO q8h | PO | q8h | — | 🌎 NA |
| Treatment of urinary incontinence | 1.2 mg/kg PO q8h or 5-15 mg (total dose) PO q8h | PO | q8h | — | 🌎 NA |
| Treatment of hypotension associated with anesthesia | 0.03-0.1 mg/kg IV bolus | IV | Once, may repeat in 5 minutes | — | 🌎 NA |
| Treatment of hypotension associated with anesthesia | 0.1-0.25 mg/kg IV bolus | IV | Once | — | 🌎 NA |
| Treatment of hypotension associated with anesthesia | 0.1-0.2 mg/kg IV bolus | IV | Once | 15-60 minutes | 🌎 NA |
| Treatment of hypotension associated with anesthesia | 0.15-0.25 mg/kg IV boluses OR CRI at 5-10 micrograms/kg/minute | IV | To effect or CRI | — | 🌎 NA |
| Hypotension during anaesthesia | Dose not specified in monograph | IV/IM | As needed (effects wane after 2-3 doses) | Perioperative | 🌍 EU |
| Urinary incontinence | Dose not specified in monograph | PO | Not specified | Long-term | 🌍 EU |
- Treatment of hypotension associated with anesthesia: Dilute 5 mg in 10 mL of saline and give the lower dosage first as sinus tachycardia may accompany the higher dose.
- Treatment of hypotension associated with anesthesia: For relatively short procedures in ASA I or II patients when hypotension is not responsive to 1 or 2 crystalloid boluses.
- Treatment of hypotension associated with anesthesia: Dilute into 5 mL of a balanced electrolyte solution or saline and give small increment IV boluses until desirable blood pressure achieved.
- Hypotension during anaesthesia: Assists in bradycardia. Tachyphylaxis occurs rapidly.
- Urinary incontinence: Exclude polyuria before treatment. Can be used with phenylpropanolamine.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Treatment of bronchospasm (emergency treatment) | 2-5 mg PO | PO | Once | — | 🌎 NA |
| Treatment of urinary incontinence | 2-4 mg (total dose) PO q8h | PO | q8h | — | 🌎 NA |
| Treatment of urinary incontinence | 2-4 mg/kg PO q6-12h or 2-4 mg (total dose) PO q8h | PO | q6-12h or q8h | — | 🌎 NA |
| Treatment of urinary incontinence | 2-4 mg per cat PO q8-12h | PO | q8-12h | — | 🌎 NA |
| Treatment of hypotension associated with anesthesia | 0.15-0.25 mg/kg IV boluses OR CRI at 5-10 micrograms/kg/minute | IV | To effect or CRI | — | 🌎 NA |
| Hypotension during anaesthesia | Dose not specified in monograph | IV/IM | As needed | Perioperative | 🌍 EU |
| Nasal congestion (cat 'flu') | Dose not specified in monograph | topical | Not specified | Short-term | 🌍 EU |
- Treatment of hypotension associated with anesthesia: Dilute into 5 mL of a balanced electrolyte solution or saline and give small increment IV boluses until desirable blood pressure achieved.
- Hypotension during anaesthesia: Use with caution.
- Nasal congestion (cat 'flu'): Proposed for treatment of nasal congestion; may be of some benefit.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La efedrina es una amina simpaticomimética no catecolamínica. En medicina veterinaria, se utiliza principalmente para el manejo de la incompetencia del mecanismo del esfínter uretral (USMI) en perros y gatos, aunque a menudo se prefiere la fenilpropanolamina (PPA) debido a una menor incidencia de efectos secundarios en el SNC.
Adicionalmente, sirve como vasopresor inyectable para combatir la hipotensión inducida por la anestesia y como broncodilatador para afecciones respiratorias.
Perla clínica: Debido a que la efedrina atraviesa la barrera hematoencefálica con mayor facilidad que muchos otros simpaticomiméticos, puede causar una estimulación del SNC de leve a moderada, la cual se manifiesta como inquietud o agitación en algunos pacientes.
Mecanismo de acción
Ephedrine is a mixed-acting sympathomimetic.
- Indirect Action (Primary): It enters the sympathetic nerve terminal and promotes the release of stored norepinephrine into the synaptic cleft.
- Direct Action (Secondary): It directly stimulates α- and β-adrenergic receptors.
Key Pathways:
- α1-receptors → Smooth muscle contraction → Increased internal urethral sphincter tone (improving continence) and peripheral vasoconstriction (increasing blood pressure).
- β1-receptors → Positive inotropic and chronotropic effects on the heart → Increased cardiac output.
- β2-receptors → Smooth muscle relaxation → Bronchodilation.
Note: Because it relies heavily on endogenous norepinephrine stores, repeated frequent dosing can deplete these stores, leading to tachyphylaxis (diminished response over time).
Seguridad y advertencias
Contraindicaciones
- Severe cardiovascular disease
- Cardiac arrhythmias
- Pregnancy
- Lactation
- Glaucoma
Efectos adversos
- Irritability
- Tachycardia
- Hypertension
- Anorexia
- Tachyphylaxis (decreased response to subsequent doses)
- Panting
- Mydriasis (dilated pupils)
- CNS stimulation (restlessness, agitation)
- Atrial fibrillation
- Vasoconstriction
- Reduction of intestinal wall motility and tone
Precauciones
Use with caution in patients with glaucoma, prostatic hypertrophy, hyperthyroidism, diabetes mellitus, cardiovascular disorders, or hypertension.
When administered IV, the administration rate should be carefully controlled (in humans, not to exceed 10 mg/minute; scale appropriately for veterinary patients).
Pregnancy/Nursing: FDA Category C. Excreted in milk and may have deleterious effects on nursing animals. Consider milk replacer if use is absolutely necessary in a nursing dam.
Interacciones farmacológicas
Phenothiazines block alpha-adrenergic receptors; concomitant use can lead to unopposed beta-activity causing vasodilation and increased cardiac rate.
May negate the therapeutic effects of ephedrine.
Increased risk of arrhythmias. Propranolol may be administered should these occur.
Concomitant use may diminish the effects of both drugs.
Increased risk of arrhythmias if used concurrently.
Should not be given within two weeks of receiving MAOIs; severe hypertension and hyperpyrexia are possible.
Should not be administered together as increased toxicity may result.
May reverse the pressor effects of ephedrine.
May increase the risk for theophylline toxicity.
May decrease the pressor effects of ephedrine.
May reduce urinary excretion of ephedrine and prolong its duration of activity, potentially requiring dosage adjustments.
Synergistic effects, increasing the risk of adverse cardiovascular and CNS stimulation.
Enhances the sensitivity of the myocardium to the arrhythmogenic effects of ephedrine.
Concomitant use can cause severe cardiac arrhythmias.
Concomitant use can cause severe cardiac arrhythmias.
May cause severe hypertension when given concurrently.
Concomitant use with tricyclic antidepressants can cause arrhythmias.
Concomitant use with MAO inhibitors may cause severe hypertension.
Can be used in conjunction for urinary incontinence, but increases sympathetic load.
Monitorización
- Clinical effectiveness (resolution of incontinence, improved blood pressure, or bronchodilation)
- Behavioral changes (restlessness, irritability)
- Heart rate and rhythm (ECG during anaesthesia)
- Resolution of urinary incontinence
- Signs of CNS stimulation or excessive panting
Farmacocinética
Absorción
Rapidly absorbed after oral or parenteral administration.
Distribución
Thought to cross both the blood-brain barrier and the placenta.
Metabolismo
Metabolized in the liver.
Eliminación
Excreted unchanged in the urine. Urine pH may significantly alter excretion characteristics.
Sobredosis
Clinical signs of overdosage may consist of an exacerbation of adverse effects (restlessness, tachycardia).
In a very large overdose, severe cardiovascular signs (hypertension leading to rebound hypotension, bradycardias to tachycardias, and cardiovascular collapse) or CNS effects (ranging from severe stimulation to coma) can be seen.
Treatment:
- If the overdose was recent, empty the stomach using usual precautions.
- Administer activated charcoal and a cathartic.
- Treat clinical signs supportively as they occur.
Productos disponibles
Formulaciones
- Capsules
- 10 mg tablet
- 15 mg tablet
- 30 mg tablet
- 50 mg tablet
- 3 mg/ml solution for injection
- 30 mg/ml solution for injection
- 0.5% nasal drops
- 1% nasal drops
Veterinario
- Enurace 10 mg, 15 mg, 30 mg, 50 mg tablets
Etiquetado para humanos
- Ephedrine Sulfate Capsules: 25 mg
- Ephedrine Sulfate Injection: 50 mg/mL in 1 mL single-dose vials & preservative free in 1 mL single-dose amps
- Ephedrine hydrochloride 3 mg/ml, 30 mg/ml solutions for injection
- Ephedrine 0.5%, 1% nasal drops
Estado regulador
POM-V classification in the UK/EU.
POM-V, POM.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store ephedrine sulfate products in tight, light-resistant containers at room temperature unless otherwise directed. When used parenterally, ephedrine sulfate is usually administered directly and not diluted.
Información para el cliente
- La constancia es clave: Para que este medicamento sea efectivo contra la incontinencia urinaria, debe administrarse exactamente como lo indique su veterinario. Las dosis omitidas anularán su efecto y el goteo podría reaparecer.
- Paciencia: Puede tomar varios días para que el beneficio completo del medicamento se haga evidente.
- Efectos secundarios: Debido a que este medicamento actúa como un estimulante, puede hacer que su mascota se sienta "nerviosa". Comuníquese con su veterinario si su mascota muestra cambios continuos en su comportamiento (inquietud, irritabilidad, caminar de un lado a otro) o si la incontinencia persiste o aumenta.
- Horario: Para evitar alteraciones del sueño, intente no administrar la última dosis del día justo antes de acostarse, a menos que se le indique lo contrario.
- Apetito: Es posible que note una disminución temporal en el apetito de su mascota.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.