Ephedrine

 Risk Factor: C
 Class: AUTONOMICS / Sympathomimetics (Adrenergics)

Contents of this page:

Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers

Fetal Risk Summary

Ephedrine is a sympathomimetic used widely for bronchial asthma, allergic disorders, hypotension, and the alleviation of symptoms caused by upper respiratory infections. It is a common component of proprietary mixtures containing antihistamines, bronchodilators, and other ingredients. Thus it is difficult to separate the effects of ephedrine on the fetus from other drugs, disease states and viruses. Ephedrine-like drugs are teratogenic in some animal species, but human teratogenicity has not been suspected (1,2).

The Collaborative Perinatal Project monitored 50,282 mother-child pairs, 373 of whom had 1st trimester exposure to ephedrine (3, pp. 34556). For use anytime during pregnancy, 873 exposures were recorded (3, p. 439). No evidence for a relationship to large categories of major or minor malformations or to individual defects was found. However, an association in the 1st trimester was found between the sympathomimetic class of drugs as a whole and minor malformations (not life-threatening or major cosmetic defects), inguinal hernia, and clubfoot (3, pp. 34556).

Ephedrine is routinely used to treat or prevent maternal hypotension following spinal anesthesia (4,5,6 and 7). Significant increases in fetal heart rate and beat-to-beat variability may occur, but these effects may have been the result of normal reflexes following hypotension-associated bradycardias. A recent study, however, has demonstrated the placental passage of ephedrine with fetal levels at delivery approximately 70% of the maternal concentration (8). The presence of ephedrine in the fetal circulation is probably a major cause of the fetal heart rate changes.

Breast Feeding Summary

A single case report has been located describing adverse effects in a 3-month-old nursing infant of a mother consuming a long-acting preparation containing 120 mg of d-isoephedrine and 6 mg of dexbrompheniramine (9). The mother had begun taking the preparation on a twice-daily schedule 1 or 2 days prior to onset of the infant's symptoms. The infant exhibited irritability, excessive crying, and disturbed sleeping patterns that resolved spontaneously within 12 hours when breast feeding was stopped.

References

1. Nishimura H, Tanimura T. Clinical Aspects of The Teratogenicity of Drugs. New York, NY:American Elsevier, 1976:231.
2. Shepard TH. Catalog of Teratogenic Agents. 3rd ed. Baltimore, MD:Johns Hopkins University Press, 1980:1345.
3. Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA:Publishing Sciences Group, 1977.
4. Wright RG, Shnider SM, Levinson G, Rolbin SH, Parer JT. The effect of maternal administration of ephedrine on fetal heart rate and variability. Obstet Gynecol 1981;57:7348.
5. Antoine C, Young BK. Fetal lactic acidosis with epidural anesthesia. Am J Obstet Gynecol 1982;142:559.
6. Datta S, Alper MH, Ostheimer GW, Weiss JB. Method of ephedrine administration and nausea and hypotension during spinal anesthesia for cesarean section. Anesthesiology 1982;56:6870.
7. Antoine C, Young BK. Fetal lactic acidosis with epidural anesthesia. Am J Obstet Gynecol 1982;142:559.
8. Hughes SC, Ward MG, Levinson G, Shnider SM, Wright RG, Gruenke LD, Craig JC. Placental transfer of ephedrine does not affect neonatal outcome. Anesthesiology 1985;63:2179.
9. Mortimer EA Jr. Drug toxicity from breast milk? Pediatrics 1977;60:7801.
   
   

Questions and Answers

Kidney complications due to diet/ephedrine pill use...or...pregnant?

I would go to the doctor about this...but right now I don't have insurance because I haven't worked long enough at my current job. Anyways..I pop ephedrine pills sometimes , although I used to take them all the time with no complications. Well now, it seems as though I stomach sticks out a lil below my belly button..& I've always had a flat stomach being skinny. At the same time it could be that I'm pregnant, although I've had light "period" like bleeding each month since I had unprotected sex..(yah I regret it!) but sh*t happens...anyways I've heard from other people that you can still have your period while pregnant..& test negative on tests. The last test I took..last Friday, it showed a VERY faint line (cross) on a EPT test. Like I said it all could be from kidney problems or something, but I have no problems urinating..my back hurts though. If pregnant..where does the "bump" start to show..right under the belly button? I'm just a lil worried that's all :(

On the test, what is it supposed to do if your are pregnant? I bought the ones that had two lines for pregnant, one for not. If the cross means your pregnant, then you just might be. Did you take it in the morning or at night? The best time to take one is at night. Yes it is very true that you can still have your period and be pregnant and the tests will come out negative. If you don't have insurance, go to planned parenting or The hospital. Planned parenting tests you for free, I do believe, and the hospital here charges you $15. The hospital does blood work, so they will know for sure if you are pregnant or not. Good luck and I hope it turns out for the best.

I am 19 weeks pregnant, can i take sudafed it contains chlorpheniramine 4mg and pseudo ephedrine 60mg?

No. No. No. Never take any medicine without talking to your doctor. I've had horrible congestion my whole pregnancy and I was told not to take that stuff. You can take a non-medicated saline spray as many times a day as you need to, and that helps (although it's gross). I use a brand called Simply Saline. It is drug and preservative free so it's completely safe to use during pregnancy as often as you need, and it sprays like an aerosol can so it's easy to use. Costs about $6 and lasts me a week using it four or five times a day. If you can't afford that or if you need something a little stronger, my doctor said you can make your own sinus irrigator by mixing 1 qt water, 1 tablespoon salt and 1 table spoon baking soda in a bottle and shooting it up into your sinuses with a baby nasal aspirator (those bulby things you use to suck the snot out of them).

does ephedrine stop the effect of birth control?

I was thinking about getting Lipodrene to help me lose some weight because i've read great reviews.I know things like antibiotics stop the effectiveness of the birth control pill, but I was wondering if ephedrine has any effect like that because I don't want to get pregnant!

No, it doesn't. Since Primatene tablets contain ephedrine, I went to http://www.primatenetablets.com/products... and read the label. No warnings about birth control pills. Oh, and you might want to make sure the Lipodrene you're buying actually contains ephedrine. If it says "ephedra extract" or "ephedra alkaloids", then it doesn't contain ephedrine.

Are there withdrawal symptoms with Ephedrine?

I HAVE BEEN TAKING EPHEDRINE FOR 11 YEARS- OTHER THAN WHEN I WAS PREGNANT. I STOPPED TAKING IT ABOUT 1 WEEK AGO AFTER VOWING TO GET MORE HEALTHY AFTER LOSING BOTH PARENTS.

NOW I AM DIZZY ALL THE TIME AND VERY AGITATED. HAS ANYONE EVER HEARD OF WITHDRAWAL SYMPTONS ASSOCIATED WITH EPHEDRINE?

My friend had really bad withdrawals from it and it took her about a year to feel normal again. She felt dizzy, nauseous and got really bad headaches. You should speak to your doctor about this.