Usage
- Oxyfedrin is prescribed for the treatment of angina pectoris (chest pain due to reduced blood flow to the heart) and myocardial infarction (heart attack). It can also be used to treat heart failure and conduction defects.
- Pharmacological classification: Vasodilator, cardiotonic agent, β-adrenergic receptor partial agonist.
- Mechanism of Action: Oxyfedrin primarily acts as a vasodilator, widening blood vessels to improve blood flow to the heart. It also exhibits some cardiotonic properties, enhancing the heart’s pumping ability. It is known to be a β-adrenergic receptor partial agonist, meaning it interacts with specific receptors in the body that affect how the heart and blood vessels function.
Alternate Names
- Oxyphedrine, oxyfedrine HCl.
- Brand names vary depending on region and manufacturer. Ildamen is one example of brand name.
How It Works
- Pharmacodynamics: Oxyfedrin is a partial agonist at β-adrenergic receptors, meaning it stimulates these receptors to a lesser extent than a full agonist. This action leads to vasodilation of coronary arteries (the blood vessels supplying the heart), improving blood flow and oxygen supply to the heart muscle. It also exerts positive inotropic effects, increasing the force of heart contractions.
- Pharmacokinetics: The pharmacokinetics of oxyfedrin involve absorption, distribution, metabolism, and excretion. While specific details on absorption and distribution may vary based on administration route, it’s known that a major metabolite is norephedrine (a norepinephrine releasing agent). This suggests the drug also acts as an indirectly acting sympathomimetic. This means oxyfedrin can enhance the activity of the sympathetic nervous system, the part of the nervous system responsible for the “fight-or-flight” response. Elimination pathways are likely renal and/or hepatic. More research is needed to fully elucidate its pharmacokinetic profile.
- Mode of Action: Oxyfedrin binds to β-adrenergic receptors, especially in the heart and blood vessels. By partially activating these receptors, oxyfedrin triggers intracellular signaling cascades leading to vasodilation and increased myocardial contractility. Further research is needed for a more precise explanation of its effects on specific receptors, enzyme interactions and neurotransmitter modulation.
- Elimination Pathways: Data on specific elimination pathways are limited. Given its metabolism to norephedrine, it’s plausible that it undergoes both hepatic metabolism and renal excretion. Whether it is metabolized by CYP enzymes requires further investigation.
Dosage
Dosage information is limited, and the following is based on available fragmented data. Always consult local guidelines and resources for specific and verified dosing recommendations.
Standard Dosage
Adults:
- Oral: 8-24 mg, two to three times daily. Parenteral: 4 mg, three times daily.
- Available dosage forms include oral tablets and parenteral injections.
Children:
- Dosage information for children is not readily available. Use in pediatric populations should be under careful specialist supervision with close monitoring.
Special Cases:
- Elderly Patients: May require dosage adjustments due to potential age-related decline in organ function, especially renal function. Start with the lowest dose and titrate up as needed, closely monitoring patient response.
- Patients with Renal Impairment: Dosage reduction might be necessary depending on the degree of impairment.
- Patients with Hepatic Dysfunction: Dose modifications may be needed due to altered metabolism.
- Patients with Comorbid Conditions: Careful assessment and possible dosage adjustments are warranted in patients with conditions like diabetes or cardiovascular disease.
Clinical Use Cases
- Specific dosage recommendations for clinical use cases like intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations are unavailable in the provided resources. Such specialized applications should be guided by experienced clinicians and local protocols.
Dosage Adjustments:
- Dose adjustments should be individualized based on patient response and specific clinical conditions. Close monitoring is essential.
Side Effects
Common Side Effects
- Taste impairment (dysgeusia)
- Dizziness
Rare but Serious Side Effects
- Limited information available.
Long-Term Effects
- Limited information available.
Adverse Drug Reactions (ADR)
- Specific ADRs requiring immediate attention need further research.
Contraindications
- Hypersensitivity to oxyfedrin.
- Aortic insufficiency with marked hemodynamic changes.
- Subvalvular aortic stenosis.
- Severe hypotension, acute myocardial infarction, and severe aortic stenosis.
- Caution is advised in patients with pre-existing arrhythmias, congestive heart failure, and those on medications affecting cardiac function.
Drug Interactions
- Information about drug interactions is scarce and requires further research. Beta-blockers, other vasodilators, and antihypertensive medications may interact with oxyfedrin.
Pregnancy and Breastfeeding
- Oxyfedrin is generally not recommended during pregnancy and breastfeeding unless considered essential by a physician. Risks and benefits must be carefully evaluated. Data on fetal risk and drug excretion in breast milk are limited.
Drug Profile Summary
- Mechanism of Action: β-adrenergic receptor partial agonist, vasodilator, cardiotonic agent.
- Side Effects: Taste impairment, dizziness.
- Contraindications: Hypersensitivity, aortic insufficiency, subvalvular aortic stenosis.
- Drug Interactions: Limited information available.
- Pregnancy & Breastfeeding: Generally not recommended.
- Dosage: Adult oral: 8-24 mg two to three times daily; parenteral: 4 mg three times daily. Pediatric dosage information unavailable.
- Monitoring Parameters: Blood pressure, heart rate, ECG, patient symptoms.
Popular Combinations
- Information on commonly used drug combinations is limited.
Precautions
- Assess for allergies, pre-existing heart conditions, hepatic/renal impairment.
- Caution in elderly patients, pregnant/breastfeeding women, and children.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Oxyfedrin?
A: Adult oral: 8-24 mg two to three times daily; parenteral: 4 mg three times daily. Pediatric and special population dosing needs expert consultation.
Q2: What are the common side effects?
A: Taste impairment and dizziness are frequently reported.
Q3: Is Oxyfedrin safe during pregnancy?
A: Not generally recommended unless deemed essential by a physician. Consult specialized resources for updated guidance.
Q4: How does Oxyfedrin work?
A: It acts as a vasodilator, improving blood flow, and has some cardiotonic effects. It’s also a β-adrenergic receptor partial agonist.
Q5: What are the contraindications for Oxyfedrin?
A: Hypersensitivity, aortic insufficiency with marked hemodynamic changes, subvalvular aortic stenosis.
Q6: Does Oxyfedrin interact with other medications?
A: Data is limited. Potential interactions with beta-blockers, other vasodilators, and antihypertensives exist.
Q7: Can Oxyfedrin be used in children?
A: Information on pediatric use is scarce and requires expert consultation.
Q8: What should be monitored in patients taking Oxyfedrin?
A: Blood pressure, heart rate, electrocardiogram (ECG), and patient symptoms should be monitored closely.
Q9: How is Oxyfedrin administered?
A: Available in oral tablets and parenteral injections.
Q10: What are the long-term effects of Oxyfedrin?
A: Information on long-term effects is limited and requires further research.
Please note: This information is for educational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment. Drug information can change, and this is current as of February 16, 2025.
