Oftaial Plus Ophthalmic Solution (Multi Dose) Price

Overview

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This medicine contains an important and useful components, as it consists of
Sodium hyaluronate , Taurineis available in the market in concentration

Name

Ephedrine Hydrochloride 0.5%

Precaution

Ephedrine hydrochloride 0.5% should be used with caution in specific populations, such as pregnant or breastfeeding women, and patients with pre-existing medical conditions. During pregnancy, the drug falls under category C, which means animal studies have shown adverse effects, but human studies are insufficient. It is recommended to avoid its use unless the potential benefits outweigh the risks. Ephedrine can pass into breast milk, so caution should be exercised when administered to breastfeeding mothers. Patients with a history of cardiovascular diseases such as hypertension, arrhythmias, or coronary artery disease should be closely monitored due to the risk of ephedrine-induced vasoconstriction and increased heart rate. Those with a history of hyperthyroidism, diabetes, or glaucoma may also face heightened risks, as the drug can increase sympathetic activity, affecting the heart and metabolic processes. Monitoring parameters include blood pressure, heart rate, and respiratory function. For those with cardiovascular issues, regular checks of the ECG and electrocardiogram monitoring may be necessary. Special care should be taken to prevent misuse of ephedrine, as it can be habit-forming or misused for its stimulant properties. Abuse potential is a concern, especially in patients with a history of substance abuse.

Indication

Ephedrine hydrochloride 0.5% is primarily indicated for the relief of nasal congestion associated with conditions like the common cold, sinusitis, and allergic rhinitis. It functions as a vasoconstrictor, helping to reduce swelling in the nasal passages, thus easing airflow and relieving congestion. This effect is mediated by the stimulation of alpha-adrenergic receptors, which causes blood vessels to constrict. Ephedrine may also be used as a bronchodilator in some cases, though it is less commonly prescribed for this purpose in modern practice. Off-label uses include treatment of hypotension, especially during anesthesia, where ephedrine's ability to increase blood pressure can be helpful. Additionally, it may be utilized to support the treatment of bronchial asthma, although other, more specific bronchodilators are generally preferred. Evidence-based guidelines emphasize its utility in symptomatic treatment rather than as a long-term therapeutic approach for chronic respiratory issues.

Contra indication

Ephedrine hydrochloride 0.5% is contraindicated in patients with hypersensitivity to ephedrine or any of its components. It should not be used in patients with severe hypertension, tachyarrhythmias, or other serious cardiovascular conditions like severe coronary artery disease, as the drug can exacerbate these conditions by increasing systemic vascular resistance and heart rate. Additionally, patients with hyperthyroidism are at risk of exacerbating symptoms due to the drug's stimulating effects on the sympathetic nervous system. The medication is also contraindicated in patients with glaucoma, particularly angle-closure glaucoma, as it may increase intraocular pressure. Ephedrine is not recommended in patients taking monoamine oxidase inhibitors (MAOIs) or other sympathomimetic agents due to the risk of severe hypertensive crises. This medication is not recommended for children under 6 years of age, as safety and efficacy in this demographic have not been established.

Side Effect

Ephedrine hydrochloride 0.5% is generally well-tolerated, but it may cause a range of side effects. Common side effects include temporary nasal irritation or dryness due to its local vasoconstrictive action. These effects are usually mild and resolve after discontinuation of the drug. Other side effects can include increased heart rate (tachycardia), hypertension, anxiety, dizziness, and nervousness, especially when used in higher doses or for extended periods. Serious side effects, though rare, may include arrhythmias, chest pain, or severe headache due to elevated blood pressure. In rare cases, patients may experience symptoms of excessive sympathetic stimulation such as insomnia, tremors, and palpitations. Chronic use or misuse of ephedrine may lead to dependency and cardiovascular complications. To mitigate side effects, it is important to follow prescribed dosage recommendations carefully, avoid concurrent use with other stimulants, and limit the duration of use to prevent overuse. Any signs of chest pain, irregular heartbeat, or severe dizziness should prompt immediate discontinuation of the drug and a consultation with a healthcare provider.

Pregnancy Category ID

3

Mode of Action

Ephedrine hydrochloride 0.5% acts primarily by stimulating the alpha-adrenergic and beta-adrenergic receptors, exerting a dual action on the sympathetic nervous system. Its alpha-adrenergic effect causes vasoconstriction, which is particularly beneficial for reducing nasal congestion. The beta-adrenergic effect results in bronchodilation, although this action is less pronounced at lower doses. Ephedrine also indirectly promotes the release of norepinephrine from sympathetic nerve endings, enhancing the overall stimulatory effect. The pharmacokinetics of ephedrine indicate that it is rapidly absorbed after administration and reaches peak plasma concentrations within 1-2 hours. It is primarily metabolized in the liver and excreted in the urine. The drug has a relatively long half-life, which supports its use for prolonged action in treating symptoms of nasal congestion. Its mechanism is advantageous in treating short-term conditions where relief from congestion is needed quickly.

Interaction

Ephedrine hydrochloride 0.5% can interact with several medications, including antidepressants, especially monoamine oxidase inhibitors (MAOIs), which can cause a potentially dangerous hypertensive crisis. Concurrent use with other sympathomimetics or stimulants (such as caffeine or amphetamines) can lead to excessive adrenergic stimulation, resulting in increased heart rate, blood pressure, and risk of arrhythmias. Patients on beta-blockers may experience reduced efficacy of ephedrine, as these drugs counteract the effects of adrenergic stimulation. Similarly, using ephedrine with antihypertensive medications (such as alpha- or beta-blockers) may reduce the effectiveness of these medications, leading to inadequate blood pressure control. Alcohol and certain foods rich in tyramine (such as aged cheeses, cured meats, and fermented products) should also be avoided, as they can increase the risk of hypertensive episodes when combined with sympathomimetic drugs. Patients should be advised to monitor for signs of high blood pressure, tachycardia, or dizziness and adjust their medication regimen accordingly.

Pregnancy Category Note

Information not available

Adult Dose

The standard adult dose of ephedrine hydrochloride 0.5% is typically administered as a nasal spray. The usual dose is 1 to 2 sprays per nostril every 4 hours, not to exceed 3-4 doses per day. In some cases, ephedrine may be used as an injectable solution in hospital settings, especially for the management of hypotension. In such instances, the recommended dose can range from 5 to 10 mg, administered every 3-4 hours, with adjustments based on clinical response. It is crucial to not exceed the maximum allowable dose due to the risk of systemic side effects like hypertension or tachycardia. Titration schedules are generally not required for nasal spray formulations, but intravenous administration requires careful monitoring to avoid overdose and adverse cardiovascular effects.

Child Dose

Ephedrine hydrochloride 0.5% is not recommended for children under the age of 6 years due to safety concerns and a lack of sufficient clinical data in this age group. For children aged 6 and older, the dose typically mirrors the adult dose, but it should always be adjusted based on the child's weight and individual clinical response. The maximum recommended dose should not exceed 2 sprays per nostril every 4 hours. Pediatric patients should be monitored closely for side effects such as increased heart rate, blood pressure, or signs of overstimulation. In general, the use of ephedrine in children should be limited to short-term treatment of nasal congestion, with careful attention to dosage and duration.

Renal Dose

For patients with renal impairment, dose adjustments for ephedrine hydrochloride 0.5% are generally not necessary when used as a nasal spray. However, for those using injectable ephedrine, renal function should be monitored regularly due to the potential for accumulation in cases of severe renal insufficiency. In such patients, dose reduction or extended dosing intervals may be considered, depending on the degree of renal impairment and the clinical context. Patients with renal dysfunction should be observed closely for signs of ephedrine toxicity, such as tachycardia, hypertension, and nervousness. Regular monitoring of creatinine levels and overall renal function is advisable during treatment.

Administration

Information not available