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Sympathomimetic Vasopressor

Ephedrine (IV — Anaesthesia)

Brand names: Ephedrine

Intravenous ephedrine is a sympathomimetic agent used in anaesthesia to treat hypotension, particularly that associated with spinal or epidural anaesthesia.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It has mixed action, directly stimulating alpha and beta adrenoceptors and indirectly releasing noradrenaline, raising blood pressure, heart rate and cardiac output.

Prescribing in practice

  • It should be given by titrated increments with continuous blood pressure monitoring, as it can cause hypertension, tachycardia and arrhythmias, especially with excessive dosing.
  • Tachyphylaxis can develop with repeated dosing, so a vasopressor with a different mechanism may be needed if the response diminishes.
  • It can interact dangerously with monoamine oxidase inhibitors, producing a hypertensive crisis, and should be used cautiously in cardiovascular disease and hyperthyroidism.

Monitoring

Monitor blood pressure, heart rate and ECG continuously during and after administration.

Counselling the patient

  • Inform the team that the patient may experience a transient rise in heart rate and blood pressure.
  • Check for current or recent monoamine oxidase inhibitor use before giving.

Evidence & guidelines

Its use for anaesthesia-related hypotension reflects long-standing established practice and product information.

Reference: OAA (Obstetric Anaesthetists Association) Guidelines; NICE NG121 (Caesarean Section); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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