Ephedrine Hydrochloride and Rosuvastatin

• Generic Name: ephedrine
• Dosage Forms: n.a.
• Other Brand Names: Akovaz

Used parenterally for treatment of clinically important hypotension in the setting of anesthesia.

Increases systolic and mean arterial BP when administered as a direct IV (“bolus”) injection following development of hypotension in patients receiving neuraxial and/or general anesthesia. Such effects observed across a variety of surgical settings, including obstetric surgery in pregnant women undergoing cesarean delivery with neuraxial anesthesia.

Although ephedrine historically considered the vasopressor of choice in obstetric anesthesia, some evidence suggests that phenylephrine may provide more favorable fetal acid-base balance. Experts currently recommend either IV ephedrine or phenylephrine for treatment of hypotension during neuraxial anesthesia; however, consideration should be given to selection of phenylephrine in the absence of maternal bradycardia because of improved fetal acid-base status in uncomplicated pregnancies.

IM use of ephedrine also evaluated in this setting; however, results have been equivocal.

Bronchospasm

Used orally as a bronchodilator for symptomatic treatment of asthma.

Used in fixed-combination with guaifenesin as self-medication for the temporary relief of mild symptoms of intermittent asthma (e.g., wheezing, chest tightness, shortness of breath).

Use of an OTC bronchodilator may be appropriate in patients with mild symptoms of intermittent asthma; however, those with more severe asthma (i.e., persistent asthma) or worsening asthma (symptoms not relieved within 60 minutes or with maximum recommended dosages, increasing frequency of asthma attacks) should consult a clinician for other treatment options.

While oral ephedrine was once widely used in the treatment of asthma, the drug generally has been replaced by more selective and rapid-acting agents (e.g., inhaled β2-adrenergic agonists).

CNS Conditions

Has been used in the treatment of narcolepsy or depressive states; however, cardiovascular effects of the drug limit usefulness in these conditions.

Obesity

Previously used for self-medication in the management of obesity.

Dietary supplements containing ephedrine alkaloids are no longer commercially available in the US.

Nasal Congestion

Has been used as a nasal decongestant, but of doubtful value when used for this condition.

Myasthenia Gravis

Has been used in patients with myasthenia gravis; however, randomized controlled studies are needed to evaluate potential benefit.

Misuse and Abuse

Has been misused and abused by athletes, bodybuilders, weight lifters, and others, including high school- and college-aged individuals engaged in sports.

Dietary supplements containing ephedrine alkaloids are no longer commercially available in the US.

Ephedrine has been used in clandestine synthesis of methamphetamine and methcathinone. Federal restrictions to reduce the potential for misuse (diversion) and abuse of ephedrine include limiting the amount that can be purchased to 3.6 g per day or 9 g per month, requiring storage behind the counter or in a locked cabinet, requiring purchasers to provide approved photographic identification, and requiring retail distributors to maintain a written or electronic logbook of purchases for at least 2 years. Additional requirements have been enacted in some states; follow state requirements if such requirements are more stringent than federal restrictions.

• Generic Name: rosuvastatin
• Dosage Forms: n.a.
• Other Brand Names: Crestor, Ezallor Sprinkle

Rosuvastatin is used together with diet to lower blood levels of "bad" cholesterol (low-density lipoprotein, or LDL), to increase levels of "good" cholesterol (high-density lipoprotein, or HDL), and to lower triglycerides (a type of fat in the blood).

Rosuvastatin is also used to treat hereditary types of high cholesterol (hypercholesterolemia): The heterozygous type (inherited from one parent) or the homozygous type (inherited from both parents).

For the heterozygous type, rosuvastatin can be used in children who are at least 8 years old. For the homozygous type, rosuvastatin can be used in children as young as 7 years old.

The Ezallor brand of rosuvastatin is for use only in adults.

Crestor is also used in adults to slow the progression of atherosclerosis (a build-up of plaque in blood vessels that can block blood flow).

Crestor is also used to lower the risk of stroke, heart attack, and other complications in men 50 years and older or women 60 years and older who have coronary heart disease or other risk factors.

Rosuvastatin may also be used for purposes not listed in this medication guide.