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Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:
- clonidine (Catapres)
- oxytocin and oxytocic drugs like oxytocin (Pitocin), methylergonovine (Methergine), carboprost (Hemobate)
- propofol (Diprivan)
- monoamine oxidase inhibitors such as tranylcypromine (Parnate), phenelzine (Nardil), selegiline (Eldepryl, Zelapar), isocarboxazid (Marplan), and rasagiline (Azilect)
- alpha antagonists
- beta blockers such as
- metoprolol (Toprol XL, Lopressor)
- carvedilol (Coreg)
- bisoprolol (Zebeta)
- betaxolol (Kerlone)
- nebivolol (Bystolic)
- propranolol (Inderal, Pronol)
- quinidine (Cardioquin)
- mephentermine (Wyamine Sulfate Injection)
- guanethidine (Esimil)
- rocuronium (Zemuron)
- epidural anesthesia
- theophylline (Theobid)
- digoxin (Lanoxin)
This is not a complete list of Akovaz drug interactions. Ask your doctor or pharmacist for more information.
Serious side effects have been reported with Akovaz including the following:
- High blood pressure when given with oxytocic drugs. Serious postpartum hypertension has been described in patients who received both a vasopressor (i.e., methoxamine, phenylephrine, ephedrine) and an oxytocic (i.e., methylergonovine, ergonovine). Blood pressure should be carefully monitored when receiving both ephedrine and an oxytocic.
- Tolerance with repeated administration of ephedrine. Akovaz can have a much smaller effect when given multiple times, rendering it less effective.
- High blood pressure when used to prevent low blood pressure. Ephedrine has been associated with an increased incidence of low blood pressure compared with when ephedrine is used to treat low blood pressure.
Do not take Akovaz if you are allergic to Akovaz or to any of its ingredients.
Akovaz and Lactation
Tell your doctor if you are breastfeeding or plan to breastfeed.
Limited published literature reports that ephedrine is present in human milk. However, no information is available on the effects of the drug on the breastfed infant or the effects of the drug on milk production.
Akovaz Dosage and Administration
General Dosage and Administration Instructions
Akovaz (ephedrine sulfate injection) must be diluted before administration as an intravenous bolus to achieve the desired concentration. Dilute with normal saline or 5% dextrose in water.
Inspect parenteral drug products visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Dosing for the Treatment of Clinically Important Hypotension in the Setting of Anesthesia
The recommended dosages for the treatment of clinically important hypotension in the setting of anesthesia is an initial dose of 5 to 10 mg administered by intravenous bolus. Administer additional boluses as needed, not to exceed a total dosage of 50 mg.
- Adjust dosage according to the blood pressure goal (i.e., titrate to effect).
Prepare a 5 mg/mL Solution for Bolus Intravenous Administration
For bolus intravenous administration, prepare a solution containing a final concentration of 5 mg/mL of Akovaz (ephedrine sulfate injection):
- Withdraw 50 mg (1 mL of 50 mg/mL) of Akovaz (ephedrine sulfate injection) and dilute with 9 mL of 5% Dextrose Injection or 0.9% Sodium Chloride Injection.
- Withdraw an appropriate dose of the 5 mg/mL solution prior to bolus intravenous administration.
PRINCIPAL DISPLAY PANEL - NDC 76014-005-30 - 1 mL Vial Label
PRINCIPAL DISPLAY PANEL - NDC 76014-005-30 - Alternate 1 mL Vial Label (Éclat Pharmaceuticals)
Ephedrine Breastfeeding Warnings
Use should be avoided. Excreted into human milk: Yes Comments: Irritability and disturbance of sleep in breastfed infants have been reported.