Alcaloïde d’Éphédrine, Belcho, Cao Mahuang, Desert Herb, Efedra, Éphédra, Éphédra Américain, Éphédra Chinoise, Ephedra distachya, Ephedra equisetina, Éphédra Européen, Ephedra gerardiana, Ephedra intermedia, Ephedra shennungiana, Ephedra sinensis, Ephedra sinica, Ephedra Sinisa, Ephedra vulgaris, Ephedrae Herba, Éphèdre, Ephedrine, Éphédrine, Ephedrine Alkaloid, Épitonin, Herbal Ecstasy, Joint Fir, Ma Huang, Ma-Huang, Mahuang, Mahuanggen (ma huang root), Muzei Mahuang, Popotillo, Raisin de Mer, Sea Grape, Teamster's Tea, Thé de Désert, Yellow Astringent, Yellow Horse, Zhong Mahuang.<br/><br/>
Overview InformationEphedra is an herb. Usually, the branches and tops are used to make medicine, but the root or whole plant can also be used. Ephedra is banned in the U.S. due to safety concerns.
Mormon tea and ephedra are often confused. Mormon tea or American ephedra comes from Ephedra nevadensis, and ephedra or ma huang comes primarily from Ephedra sinica. Mormon tea lacks the chemicals (notably ephedrine) that give ephedra its effects and potentially serious side effects.
Ephedra is used for weight loss and obesity and to enhance athletic performance. It is also used for allergies and hay fever; nasal congestion; and respiratory tract conditions such as bronchospasm, asthma, and bronchitis. It is also used for colds, flu, swine flu, fever, chills, headache, inability to sweat, joint and bone pain, and as a “water pill” to increase urine flow in people who retain fluids.
There has been a lot of debate about the safety of ephedra and legal wrangling over its status. In June 1997, the FDA proposed restrictions on the ephedrine content of dietary supplements, new warning labels for products that contain the active ingredients in ephedra, and a ban on combination products containing ephedra and other natural stimulants, such as guarana and cola nut, both of which contain significant amounts of caffeine. These proposals were dropped after the link between ephedra use and serious adverse effects was challenged by the General Accounting Office (GAO) and the dietary supplement industry. According to the Dietary Supplement Health and Education Act of 1994, FDA must prove a supplement is unsafe before it can be withdrawn from the market. The FDA reviewed numerous adverse event reports involving ephedra-containing products, with 140 of the reports receiving in-depth clinical review by FDA and outside experts. Findings from experts outside the FDA support the FDA's initial finding that ephedra is likely the cause of many of the events noted in the reports.
On December 30, 2003, the FDA announced the ban of ephedra products in the U.S., effective April 2004. In April 2005, the dietary supplement industry successfully challenged the FDA ban on ephedra. A year after the ban on ephedra began, a federal judge in Utah struck down the FDA's action saying that FDA didn't prove that low doses of ephedra are harmful. In August 2006, an appeals court reversed the Utah judge's decision and upheld the FDA's ban of ephedra-containing dietary supplements.
Ephedra use is banned by the National Collegiate Athletic Association, International Olympic Committee, and National Football League.
Ephedra is sometimes marketed as a recreational drug "herbal ecstasy." The FDA has announced that ephedra products marketed as recreational drugs are unapproved and that misbranded drugs can be taken by the authorities.
How does it work?Ephedra contains a chemical called ephedrine. Ephedrine stimulates the heart, the lungs, and the nervous system.
Uses & Effectiveness
Possibly Effective for
- Obesity. Ephedra can produce modest weight loss when used with exercise and a low-fat diet, but it can cause serious side effects, even in healthy people who follow product dosage directions. Taking ephedra seems to produce weight loss of approximately 0.9 kg (about 2 pounds) per month for up to 6 months. It is not known if weight loss continues beyond this time frame or if weight returns after ephedra is discontinued.
Caffeine may provide additional weight loss. The combination of ephedra, cola nut, and willow bark may also cause modest weight loss in overweight and obese people. Early research suggests that a specific combination product containing ephedra, guarana, and 17 other vitamins, minerals, and supplements (Metabolife 356) might help reduce weight by approximately 2.7 kg (about 6 pounds) over 8 weeks when used with a low-fat diet and exercise. Taking 90 mg of ephedra in combination with caffeine from 192 mg of cola nut per day for six months seems to cause a modest weight reduction (5.3 kg or about 12 pounds) in overweight people with a body mass index (BMI) between 25 and 40. This combination, along with limiting fat intake to 30 percent of calories and moderate exercise, also seems to reduce body fat, lower “bad” low-density lipoprotein (LDL) cholesterol, and raise “good” high-density lipoprotein (HDL) cholesterol. However, even in carefully screened and monitored otherwise healthy adults, ephedra combinations can cause small changes in blood pressure and heart rate. There are serious concerns about the safety of these products since they combine significant amounts of the stimulants ephedra and caffeine and are often taken without monitoring for harmful side effects.
Possibly Ineffective for
- Exercise performance. Some research suggests that taking ephedra with caffeine is no more effective than taking caffeine alone for improve exercise performance.
Insufficient Evidence for
- Asthma and other breathing disorders.
- Nasal congestion.
- Other conditions.
Side Effects & SafetyDo not take products that contain ephedra or its active ingredients. Ephedra is LIKELY UNSAFE for adults and children. Ephedra can cause severe life-threatening or disabling conditions in some people. Ephedra use is linked to high blood pressure, heart attacks, muscle disorders, seizures, strokes, irregular heartbeat, loss of consciousness, and death. These side effects might be more likely if ephedra is used in high doses or long-term. Doses greater than 32 mg per day might more than triple the risk for bleeding within the brain (hemorrhagic stroke). The risk for serious side effects seems to be greater than any potential benefit. Ephedra is banned in the U.S.
Ephedra can also cause less serious side effects including dizziness, restlessness, anxiety, irritability, heart pounding, headache, loss of appetite, nausea, vomiting, and others.
Do not use ephedra with other stimulants such as caffeine. This might increase the chance of having side effects, including life-threatening ones. Sources of caffeine include coffee, tea, kola nut, guarana, and mate.
Special Precautions & Warnings:Pregnancy and breast-feeding: Ephedra is LIKELY UNSAFE. Ephedra has been linked to several cases of severe side effects. Do not use it.
Chest pain (angina): Ephedra can stimulate the heart and this could make chest pain worse. Don’t use it.
Irregular heartbeat or long QT interval syndrome: Ephedra can stimulate the heart and might make irregular heartbeat worse. Do not use it.
Anxiety: Large doses of ephedra might make anxiety worse. Do not use it.
Diabetes: Ephedra might interfere with blood sugar control, and could raise high blood pressure and increase circulation problems in people with diabetes. Do not use it.
A movement disorder called essential tremor: Ephedra might make essential tremor worse. Do not use it.
High blood pressure: Ephedra might make high blood pressure worse. Do not use it.
Overactive thyroid and related conditions: Ephedra might stimulate the thyroid and make the symptoms of overactive thyroid worse. Do not use it.
Kidney stones: Ephedra and its active ingredient ephedrine can cause kidney stones. Do not use ephedra or ephedrine.
Narrow-angle glaucoma: Ephedra might make this condition worse. Do not use it.
An adrenal gland tumor (pheochromocytoma): Ephedra might make the symptoms of this condition worse. Do not use it.
Seizure disorders: Ephedra might bring on a seizure or make one worse in some people who are prone to seizures. Of the 33 cases of seizures reported to the FDA over 7 years that were linked to dietary supplements, 27 cases involved ephedra.
Do not take this combination
Medications that can cause an irregular heartbeat (QT interval-prolonging drugs) interacts with EPHEDRA
Ephedra can increase the speed of your heartbeat. Taking ephedra along with medications that can cause an irregular heartbeat might cause serious side effects including heart attack.<br/><br/> Some medications that can cause an irregular heartbeat include amiodarone (Cordarone), disopyramide (Norpace), dofetilide (Tikosyn), ibutilide (Corvert), procainamide (Pronestyl), quinidine, sotalol (Betapace), thioridazine (Mellaril), and many others.
Methylxanthines interacts with EPHEDRA
Ephedra can simulate the body. Methylxanthines also stimulate the body. Taking ephedra along with methylxanthines might cause side effects such as jitteriness, nervousness, a fast heartbeat, high blood pressure, and anxiety.<br/><br/> Methylxanthines include aminophylline, caffeine, and theophylline.
Stimulant drugs interacts with EPHEDRA
Stimulant drugs speed up the nervous system and can make you feel jittery and speed up your heartbeat. Ephedra can also speed up the nervous system. Taking ephedra along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with ephedra.<br/><br/> Some stimulant drugs include diethylpropion (Tenuate), epinephrine, phentermine (Ionamin), pseudoephedrine (Sudafed), and many others.
Be cautious with this combination
Dexamethasone (Decadron) interacts with EPHEDRA
The body breaks down dexamethasone (Decadron) to get rid of it. Ephedra might increase how quickly the body breaks down dexamethasone (Decadron). Taking ephedra along with dexamethasone (Decadron) might decrease the effectiveness of dexamethasone (Decadron).
Ergot Derivatives interacts with EPHEDRA
Ephedra can increase blood pressure. Ergot derivatives can also increase blood pressure. Taking ephedra with ergot derivatives might increase blood pressure too much.<br/><br/> Some of these ergot derivatives include bromocriptine (Parlodel), dihydroergotamine (Migranal, DHE-45), ergotamine (Cafergot), and pergolide (Permax).
Medications for depression (MAOIs) interacts with EPHEDRA
Ephedra contains chemicals that stimulate the body. Some medications used for depression can increase these chemicals. Taking ephedra with these medications used for depression might cause serious side effects including fast heartbeat, high blood pressure, seizures, nervousness, and others.<br/><br/> Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.
Medications for diabetes (Antidiabetes drugs) interacts with EPHEDRA
Ephedra might increase blood sugar. Diabetes medications are used to lower blood sugar. By increasing blood sugar, ephedra might decrease the effectiveness of diabetes medications. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.<br/><br/> Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Medications used to prevent seizures (Anticonvulsants) interacts with EPHEDRA
Medications used to prevent seizures affect chemicals in the brain. Ephedra may also affect chemicals in the brain. By affecting chemicals in the brain, ephedra may decrease the effectiveness of medications used to prevent seizures.<br/><br/> Some medications used to prevent seizures include phenobarbital, primidone (Mysoline), valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), phenytoin (Dilantin), and others.
The appropriate dose of ephedra depends on several factors such as the user’s age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for ephedra. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
- Alahuhta, S., Rasanen, J., Jouppila, P., Jouppila, R., and Hollmen, A. I. Ephedrine and phenylephrine for avoiding maternal hypotension due to spinal anaesthesia for caesarean section. Effects on uteroplacental and fetal haemodynamics. Int.J.Obstet.Anesth. 1992;1(3):129-134. View abstract.
- Astrup, A., Breum, L., Toubro, S., Hein, P., and Quaade, F. The effect and safety of an ephedrine/caffeine compound compared to ephedrine, caffeine and placebo in obese subjects on an energy restricted diet. A double blind trial. Int.J.Obes.Relat Metab Disord. 1992;16(4):269-277. View abstract.
- Astrup, A., Lundsgaard, C., Madsen, J., and Christensen, N. J. Enhanced thermogenic responsiveness during chronic ephedrine treatment in man. Am J Clin Nutr 1985;42(1):83-94. View abstract.
- Astrup, A., Toubro, S., Cannon, S., Hein, P., and Madsen, J. Thermogenic synergism between ephedrine and caffeine in healthy volunteers: a double-blind, placebo-controlled study. Metabolism 1991;40(3):323-329. View abstract.
- Atkinson RL. The herbal ephedra and caffeine debate continues. Int J Obes Relat Metab Disord 2002;26:589.
- Ayorinde, B. T., Buczkowski, P., Brown, J., Shah, J., and Buggy, D. J. Evaluation of pre-emptive intramuscular phenylephrine and ephedrine for reduction of spinal anaesthesia-induced hypotension during Caesarean section. Br.J.Anaesth. 2001;86(3):372-376. View abstract.
- Barker, W. D. and Antia, U. A study of the use of Ephedra in the manufacture of methamphetamine. Forensic Sci Int 3-2-2007;166(2-3):102-109. View abstract.
- Blanck, H. M., Khan, L. K., and Serdula, M. K. Use of nonprescription weight loss products: results from a multistate survey. JAMA 8-22-2001;286(8):930-935. View abstract.
- Blau, J. J. Ephedrine nephrolithiasis associated with chronic ephedrine abuse. J Urol. 1998;160(3 Pt 1):825. View abstract.
- Bruno, A., Nolte, K. B., and Chapin, J. Stroke associated with ephedrine use. Neurology 1993;43(7):1313-1316. View abstract.
- Capwell, R. R. Ephedrine-induced mania from an herbal diet supplement. Am J Psychiatry 1995;152(4):647. View abstract.
- Chen, W. L., Tsai, T. H., Yang, C. C., and Kuo, T. B. Acute effects of ephedra on autonomic nervous modulation in healthy young adults. Clin.Pharmacol.Ther. 2010;88(1):39-44. View abstract.
- Chen, W. L., Tsai, T. H., Yang, C. C., and Kuo, T. B. Effects of ephedra on autonomic nervous modulation in healthy young adults. J.Ethnopharmacol. 8-9-2010;130(3):563-568. View abstract.
- Chen, Z. X. and Hu, G. H. [Effect of modified shegan mahuang decoction on cytokines in children patients with cough and variant asthma]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 2010;30(2):208-210. View abstract.
- Chen-Scarabelli, C., Hughes, S. E., Landon, G., Rowley, P., Allebban, Z., Lawson, N., Saravolatz, L., Gardin, J., Latchman, D., and Scarabelli, T. M. A case of fatal ephedra intake associated with lipofuscin accumulation, caspase activation and cleavage of myofibrillary proteins. Eur J Heart Fail. 2005;7(5):927-930. View abstract.
- Cockings, J. G. and Brown, M. Ephedrine abuse causing acute myocardial infarction. Med J Aust 8-18-1997;167(4):199-200. View abstract.
- Cui, J. F., Niu, C. Q., and Zhang, J. S. [Determination of six Ephedra alkaloids in Chinese Ephedra (Ma Huang) by gas chromatography]. Yao Xue.Xue.Bao. 1991;26(11):852-857. View abstract.
- Daly, P. A., Krieger, D. R., Dulloo, A. G., Young, J. B., and Landsberg, L. Ephedrine, caffeine and aspirin: safety and efficacy for treatment of human obesity. Int J Obes.Relat Metab Disord. 1993;17 Suppl 1:S73-S78. View abstract.
- Direkwattanachai, C., Phanichyakarn, P., and Srianujatra, S. Sustained release theophylline and ephedrine therapy in chronic asthma. J Med Assoc Thai 1986;69 Suppl 2:31-37. View abstract.
- du, Boisgueheneuc F., Lannuzel, A., Caparros-Lefebvre, D., and De Broucker, T. [Cerebral infarction in a patient consuming MaHuang extract and guarana]. Presse Med 2-3-2001;30(4):166-167. View abstract.
- Ducros, L., Bonnin, P., Cholley, B. P., Vicaut, E., Benayed, M., Jacob, D., and Payen, D. Increasing maternal blood pressure with ephedrine increases uterine artery blood flow velocity during uterine contraction. Anesthesiology 2002;96(3):612-616. View abstract.
- Dulloo, A. G. Herbal simulation of ephedrine and caffeine in treatment of obesity. Int.J.Obes.Relat Metab Disord. 2002;26(5):590-592. View abstract.
- Faurschou, M. and Svendsen, U. G. [The bronchodilating effect of ephedrine tablets in bronchial asthma]. Ugeskr.Laeger 11-15-1993;155(46):3784-3785. View abstract.
- Friedrich, H. and Wiedemeyer, H. [Quantitative determination of the tannin-precursors and the tannins in Ephedra helvetica (author's transl)]. Planta Med 1976;30(3):223-231. View abstract.
- Furukawa, T. and Kuroda, M. [Effects of ephedrine, tyramine and norepinephrine on the blood pressure response to dopamine]. Nippon Yakurigaku Zasshi 1974;70(3):377-384. View abstract.
- Gardner R, Hansen A, and Eewing P. Unexpected fatality in a child from accidental consumption of antiasthmatic preparation containing ephedrine, theophylline and phenobarbital. Texas State J Med 1950;46:516-520.
- Gardner, S. F., Franks, A. M., Gurley, B. J., Haller, C. A., Singh, B. K., and Mehta, J. L. Effect of a multicomponent, ephedra-containing dietary supplement (Metabolife 356) on Holter monitoring and hemostatic parameters in healthy volunteers. Am J Cardiol. 6-15-2003;91(12):1510-3, A9. View abstract.
- Gotz, M. [Long-term out-patient treatment of children with asthma with a theophylline-ephedrine-hydroxyzine combination (author's transl)]. Padiatr.Padol. 1975;10(4):466-473. View abstract.
- Greenway, F. L., De Jonge, L., Blanchard, D., Frisard, M., and Smith, S. R. Effect of a dietary herbal supplement containing caffeine and ephedra on weight, metabolic rate, and body composition. Obes.Res. 2004;12(7):1152-1157. View abstract.
- Gurley, B. J., Wang, P., and Gardner, S. F. Ephedrine-type alkaloid content of nutritional supplements containing Ephedra sinica (Ma-huang) as determined by high performance liquid chromatography. J Pharm Sci 1998;87(12):1547-1553. View abstract.
- Hackman, R. M., Havel, P. J., Schwartz, H. J., Rutledge, J. C., Watnik, M. R., Noceti, E. M., Stohs, S. J., Stern, J. S., and Keen, C. L. Multinutrient supplement containing ephedra and caffeine causes weight loss and improves metabolic risk factors in obese women: a randomized controlled trial. Int J Obes.(Lond) 2006;30(10):1545-1556. View abstract.
- Hall, P. A., Bennett, A., Wilkes, M. P., and Lewis, M. Spinal anaesthesia for caesarean section: comparison of infusions of phenylephrine and ephedrine. Br.J.Anaesth. 1994;73(4):471-474. View abstract.
- Hallas, J., Bjerrum, L., Stovring, H., and Andersen, M. Use of a prescribed ephedrine/caffeine combination and the risk of serious cardiovascular events: a registry-based case-crossover study. Am J Epidemiol. 10-15-2008;168(8):966-973. View abstract.
- Hasani-Ranjbar, S., Nayebi, N., Larijani, B., and Abdollahi, M. A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity. World J Gastroenterol. 7-7-2009;15(25):3073-3085. View abstract.
- Hikino, H., Konno, C., Takata, H., and Tamada, M. Antiinflammatory principle of Ephedra Herbs. Chem Pharm Bull (Tokyo) 1980;28(10):2900-2904. View abstract.
- Hioki, C., Yoshimoto, K., and Yoshida, T. Efficacy of bofu-tsusho-san, an oriental herbal medicine, in obese Japanese women with impaired glucose tolerance. Clin.Exp.Pharmacol.Physiol 2004;31(9):614-619. View abstract.
- Hirabayashi, Y., Saitoh, K., Fukuda, H., Mitsuhata, H., and Shimizu, R. Coronary artery spasm after ephedrine in a patient with high spinal anesthesia. Anesthesiology 1996;84(1):221-224. View abstract.
- Hughes, S. C., Ward, M. G., Levinson, G., Shnider, S. M., Wright, R. G., Gruenke, L. D., and Craig, J. C. Placental transfer of ephedrine does not affect neonatal outcome. Anesthesiology 1985;63(2):217-219. View abstract.
- Jiang, M. H., Liu, L., Wang, Q. A., Zhan, W. X., and Shu, H. D. [Effects of ephedrine and its analogs on beta-adrenoceptors of rat lung cell membranes]. Zhongguo Yao Li Xue.Bao. 1987;8(4):318-320. View abstract.
- Jonderko, K. and Kucio, C. Effect of anti-obesity drugs promoting energy expenditure, yohimbine and ephedrine, on gastric emptying in obese patients. Aliment.Pharmacol Ther 1991;5(4):413-418. View abstract.
- Kim, H. J., Park, J. M., Kim, J. A., and Ko, B. P. Effect of herbal Ephedra sinica and Evodia rutaecarpa on body composition and resting metabolic rate: a randomized, double-blind clinical trial in Korean premenopausal women. J.Acupunct.Meridian.Stud. 2008;1(2):128-138. View abstract.
- Konno, C., Mizuno, T., and Hikino, H. Isolation and hypoglycemic activity of ephedrans A, B, C, D and E, glycans of Ephedra distachya herbs. Planta Med 1985;(2):162-163. View abstract.
- LaPorta, R. F., Arthur, G. R., and Datta, S. Phenylephrine in treating maternal hypotension due to spinal anaesthesia for caesarean delivery: effects on neonatal catecholamine concentrations, acid base status and Apgar scores. Acta Anaesthesiol.Scand. 1995;39(7):901-905. View abstract.
- Lee, A., Ngan Kee, W. D., and Gin, T. A quantitative, systematic review of randomized controlled trials of ephedrine versus phenylephrine for the management of hypotension during spinal anesthesia for cesarean delivery. Anesth.Analg. 2002;94(4):920-6. View abstract.
- Levisky, J. A., Karch, S. B., Bowerman, D. L., Jenkins, W. W., Johnson, D. G., and Davies, D. False-positive RIA for methamphetamine following ingestion of an Ephedra-derived herbal product. J Anal.Toxicol. 2003;27(2):123-124. View abstract.
- Liu YM and Sheu SJ. Determination of Ephedrine alkaloids by capillary electrophoresis. J Chromatog 1992;600:370-372.
- Loughrey, J. P., Walsh, F., and Gardiner, J. Prophylactic intravenous bolus ephedrine for elective Caesarean section under spinal anaesthesia. Eur J Anaesthesiol. 2002;19(1):63-68. View abstract.
- Lyons, H. A., Thomas, J. S., and Steen, S. N. Theophylline and ephedrine in asthma. Curr Ther Res Clin Exp 1975;18(4):573-577. View abstract.
- Martinet A, Hostettmann K, and Schutz Y. Thermogenic effects of commercially available phytotherapy compounds aimed at treating human obesity. Phytomedicine 1999;6(4):S174.
- Martinez-Quintana, E., Rodriguez-Gonzalez, F., and Cuba-Herrera, J. [Myocardial necrosis and severe biventricular dysfunction in the context of chronic ephedrine abuse]. Adicciones. 2010;22(1):25-28. View abstract.
- May, C. S., Pickup, M. E., and Paterson, J. W. The acute and chronic bronchodilator effects of ephedrine in asthmatic patients. Br J Clin Pharmacol 1975;2(6):533-537. View abstract.
- McLaughlin, E. T., Bethea, L. H., and Wittig, H. J. Comparison of the bronchodilator effect of oral fenoterol and ephedrine in asthmatic children. Ann Allergy 1982;49(4):191-195. View abstract.
- Meston, C. M. and Heiman, J. R. Ephedrine-activated physiological sexual arousal in women. Arch Gen.Psychiatry 1998;55(7):652-656. View abstract.
- Minamizawa, K., Goto, H., Shimada, Y., Terasawa, K., and Haji, A. Effects of eppikahangeto, a Kampo formula, and Ephedrae herba against citric acid-induced laryngeal cough in guinea pigs. J Pharmacol Sci 2006;101(2):118-125. View abstract.
- Moawad, F. J., Hartzell, J. D., Biega, T. J., and Lettieri, C. J. Transient blindness due to posterior reversible encephalopathy syndrome following ephedra overdose. South Med J 2006;99(5):511-514. View abstract.
- Molnar, D., Torok, K., Erhardt, E., and Jeges, S. Safety and efficacy of treatment with an ephedrine/caffeine mixture. The first double-blind placebo-controlled pilot study in adolescents. Int J Obes.Relat Metab Disord. 2000;24(12):1573-1578. View abstract.
- Moran, D. H., Perillo, M., LaPorta, R. F., Bader, A. M., and Datta, S. Phenylephrine in the prevention of hypotension following spinal anesthesia for cesarean delivery. J.Clin.Anesth. 1991;3(4):301-305. View abstract.
- Munns G and Aldrich C. Ephedrine in the treatment of bronchial asthma in children. JAMA 1927;88:1233.
- Ngan Kee, W. D., Khaw, K. S., Lee, B. B., Lau, T. K., and Gin, T. A dose-response study of prophylactic intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Anesth.Analg. 2000;90(6):1390-1395. View abstract.
- Ngan Kee, W. D., Lau, T. K., Khaw, K. S., and Lee, B. B. Comparison of metaraminol and ephedrine infusions for maintaining arterial pressure during spinal anesthesia for elective cesarean section. Anesthesiology 2001;95(2):307-313. View abstract.
- Pasquali, R., Baraldi, G., Cesari, M. P., Melchionda, N., Zamboni, M., Stefanini, C., and Raitano, A. A controlled trial using ephedrine in the treatment of obesity. Int J Obes. 1985;9(2):93-98. View abstract.
- Pasquali, R., Casimirri, F., Melchionda, N., Grossi, G., Bortoluzzi, L., Morselli Labate, A. M., Stefanini, C., and Raitano, A. Effects of chronic administration of ephedrine during very-low-calorie diets on energy expenditure, protein metabolism and hormone levels in obese subjects. Clin Sci (Colch.) 1992;82(1):85-92. View abstract.
- Pasquali, R., Cesari, M. P., Melchionda, N., Stefanini, C., Raitano, A., and Labo, G. Does ephedrine promote weight loss in low-energy-adapted obese women? Int J Obes. 1987;11(2):163-168. View abstract.
- Perrotta DM. From the Centers for Disease Control and Prevention. Adverse events associated with ephedrine-containing products--Texas, December 1993- September 1995. JAMA 12-4-1996;276(21):1711-1712. View abstract.
- Pierce, E. T., Carr, D. B., and Datta, S. Effects of ephedrine and phenylephrine on maternal and fetal atrial natriuretic peptide levels during elective cesarean section. Acta Anaesthesiol.Scand. 1994;38(1):48-51. View abstract.
- Pinnas, J. L., Schachtel, B. P., Chen, T. M., Roseberry, H. R., and Thoden, W. R. Inhaled epinephrine and oral theophylline-ephedrine in the treatment of asthma. J Clin Pharmacol 1991;31(3):243-247. View abstract.
- Rejent T, Michalek R, and Krajewski M. Caffeine fatality with coincident ephedrine. Bull Int Assoc Forensic Toxicol 1981;16:18-19.
- Ryall JE. Caffeine and ephedrine fatality. Bull Int Assoc Forensic Toxicol 1984;17:13.
- Saito, H. [Mechanism of reversal of the blood pressure by ephedrine. (2)]. Nippon Yakurigaku Zasshi 1977;73(1):83-92. View abstract.
- Saito, H. [Mechanisms of reversal of the blood pressure by ephedrine. (1)]. Nippon Yakurigaku Zasshi 1977;73(1):73-82. View abstract.
- Schweinfurth, J. and Pribitkin, E. Sudden hearing loss associated with ephedra use. Am J Health Syst Pharm 2-15-2003;60(4):375-377. View abstract.
- Shaikh, W. A. Ephedrine-saline nasal wash in allergic rhinitis. J Allergy Clin Immunol. 1995;96(5 Pt 1):597-600. View abstract.
- Shufman, N. E., Witztum, E., and Vass, A. [Ephedrine psychosis]. Harefuah 1994;127(5-6):166-8, 215. View abstract.
- Singh, A., Rajeev, A. G., and Dohrmann, M. L. Cardiomyopathy associated with ephedra-containing nutritional supplements. Congest.Heart Fail. 2008;14(2):89-90. View abstract.
- Song, H. J., Shim, K. N., Ryu, K. H., Kim, T. H., Jung, S. A., and Yoo, K. A case of ischemic colitis associated with the herbal food supplement ma huang. Yonsei Med.J. 6-30-2008;49(3):496-499. View abstract.
- Tashkin, D. P., Meth, R., Simmons, D. H., and Lee, Y. E. Double-blind comparison of acute bronchial and cardiovascular effects of oral terbutaline and ephedrine. Chest 1975;68(2):155-161. View abstract.
- Taylor, W. F., Heimlich, E. M., Strick, L., and Busser, R. Ephedrine and theophylline in asthmatic children: quantitive observations on the combination and ephedrine tachyphylaxis. Ann Allergy 1965;23(9):437-440. View abstract.
- Thomas, D. G., Robson, S. C., Redfern, N., Hughes, D., and Boys, R. J. Randomized trial of bolus phenylephrine or ephedrine for maintenance of arterial pressure during spinal anaesthesia for Caesarean section. Br.J.Anaesth. 1996;76(1):61-65. View abstract.
- Tinkelman, D. G. and Avner, S. E. Ephedrine therapy in asthmatic children. Clinical tolerance and absence of side effects. JAMA 2-7-1977;237(6):553-557. View abstract.
- Tormey, W. P. and Bruzzi, A. Acute psychosis due to the interaction of legal compounds--ephedra alkaloids in 'vigueur fit' tablets, caffeine in 'red bull' and alcohol. Med Sci Law 2001;41(4):331-336. View abstract.
- Traboulsi, A. S., Viswanathan, R., and Coplan, J. Suicide attempt after use of herbal diet pill. Am J Psychiatry 2002;159(2):318-319. View abstract.
- Ueda, W., Kataoka, Y., Takimoto, E., Tomoda, M. K., Aono, J., Sagara, Y., and Manabe, M. Ephedrine-induced increases in arterial blood pressure accelerate regression of epidural block. Anesth.Analg. 1995;81(4):703-705. View abstract.
- Unger, D. L. Blood pressure and pulse rate changes in hypertensive asthmatic patients: effects of an ephedrine compound. Ann Allergy 1968;26(12):637-638. View abstract.
- Wang, G. Z. and Hikokichi, O. [Experimental study in treating chronic renal failure with dry extract and tannins of herba ephedra]. Chinsese Journal of Integrated Traditional and Western Medicine 1994;14(8):485-488. View abstract.
- Weinberger, M. M. and Bronsky, E. A. Evaluation of oral bronchodilator therapy in asthmatic children. Bronchodilators in asthmatic children. J Pediatr 1974;84(3):421-427. View abstract.
- Weinberger, M. M. Use of ephedrine in bronchodilator therapy. Pediatr Clin North Am 1975;22(1):121-127. View abstract.
- Williams, A. D., Cribb, P. J., Cooke, M. B., and Hayes, A. The effect of ephedra and caffeine on maximal strength and power in resistance-trained athletes. J Strength.Cond.Res 2008;22(2):464-470. View abstract.
- Wright, R. G., Shnider, S. M., Levinson, G., Rolbin, S. H., and Parer, J. T. The effect of maternal administration of ephedrine on fetal heart rate and variability. Obstet Gynecol 1981;57(6):734-738. View abstract.
- Zhang, Y., Chang, J., Zhang, R. M., Liu, L. L., Li, F. S., Jiang, X. Y., Wang, L., Mao, B., and Li, T. Q. [Mahuang Zhisou Capsule in treatment of acute upper respiratory tract infection of external wind-cold syndrome: a multi-center, randomized controlled, and double-blind trial]. Zhong.Xi.Yi.Jie.He.Xue.Bao. 2008;6(6):581-585. View abstract.
- Anon. Ephedra and ephedrine for weight loss and athletic performance enhancement: clinical efficacy and side effects. Evid Rep Technol Assess (Summ) 2003;76:1-4.
- Anon. High-dose ephedra pills still illegal, FDA says. Reuters, April 15, 2005.
- Atkinson RL. The herbal ephedra and caffeine debate continues. Int J Obes Relat Metab Disord 2002;26:589.
- Baker J, Zhang X, Boucher T, Keyler D. Investigation of quality in ephedrine-containing dietary supplements. Journal of Herbal Pharmacotherapy 2003;3:5-17.
- Bell DG, Jacobs I, Ellerington K. Effect of caffeine and ephedrine ingestion on anaerobic exercise performance. Med Sci Sports Exerc 2001;33:1399-403. View abstract.
- Bent S, Tiedt TN, Odden MC, Shilpak MG. The relative safety of ephedra compared with other herbal products. Ann Intern Med 2003;138:468-71. View abstract.
- Boozer CN, Daly PA, Homel P, et al. Herbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial. Int J Obes Relat Metab Disord 2002;26:593-604. View abstract.
- Boozer CN, Nasser JA, Heymsfield SB, et al. An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Int J Obes Relat Metab Disord 2001;25:316-24. View abstract.
- Breum L, Pedersen JK, Ahlstrom F, et al. Comparison of an ephedrine/caffeine combination and dexfenfluramine in the treatment of obesity. A double-blind multi-centre trial in general practice. Int J Obes Relat Metab Disord 1994;18:99-103. View abstract.
- Brooks SM, Sholiton LJ, Werk EE Jr, Altenau P. The effects of ephedrine and theophylline on dexamethasone metabolism in bronchial asthma. J Clin Pharmacol 1977;17:308-18. View abstract.
- Caron MF, Hotsko AL, Robertson S, et al. Electrocardiographic and hemodynamic effects of Panax ginseng. Ann Pharmacother 2002;36:758-63.. View abstract.
- Coffey CS, Steiner D, Baker BA, Allison DB. A randomized double-blind placebo-controlled clinical trial of a product containing ephedrine, caffeine, and other ingredients from herbal sources for treatment of overweight and obesity in the absence of lifestyle treatment. Int J Obes Relat Metab Disord 2004;28:1411-9. View abstract.
- Dawson, J. K., Earnshaw, S. M., and Graham, C. S. Dangerous monoamine oxidase inhibitor interactions are still occurring in the 1990s. J Accid.Emerg.Med 1995;12(1):49-51. View abstract.
- Doyle H, Kargin M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996;313:756. View abstract.
- Dulloo AG, Miller DS. Ephedrine, caffeine and aspirin: "over-the-counter" drugs that interact to stimulate thermogenesis in the obese. Nutrition 1989;5:7-9.
- Dulloo AG, Miller DS. Aspirin as a promoter of ephedrine-induced thermogenesis: potential use in the treatment of obesity. Am J Clin Nutr 1987;45:564-9. View abstract.
- Dulloo AG. Herbal simulation of ephedrine and caffeine in treatment of obesity. Int J Obes Relat Metab Disord 2002;26:590-2.
- FDA announces the availability of new Ephedrine and street drug alternative docs. Available at: www.fda.gov (Accessed 6 April 2000).
- FDA Statement on Tenth Circuit's Ruling to Uphold FDA Decision Banning Dietary Supplements Containing Ephedrine Alkaloids. FDA Statement, August 21, 2006. Available at: http://www.fda.gov/bbs/topics/NEWS/2006/NEW01434.html.
- FDA Takes Aim at Ephedra. The Washington Post. Available at: http://www.washingtonpost.com/archive/politics/2000/03/19/fda-takes-aim-at-ephedra/4ce534a7-d291-44ec-88a8-38e97ff27e3b/ (Accessed 19 March 2000).
- FDA. Proposed rule: dietary supplements containing ephedrine alkaloids. Available at: www.verity.fda.gov (Accessed 25 January 2000).
- Food and Drug Administration, HHS. Final rule declaring dietary supplements containing ephedrine alkaloids adulterated because they present an unreasonable risk; Final rule. Fed Regist 2004;69:6787-6854. View abstract.
- Gardner SF, Franks AM, Gurley BJ, et al. Effect of a multicomponent, ephedra-containing dietary supplement (Metabolife 356) on Holter monitoring and hemostatic parameters in healthy volunteers. Am J Cardiol 2003;91:1510-3, A9.
- Greenway FL, Raum WJ, DeLany JP. The effect of an herbal dietary supplement containing ephedrine and caffeine on oxygen consumption in humans. J Altern Complement Med 2000;6:553-5. View abstract.
- Gurley B. Extract versus herb: Effect of formulation on the absorption rate of botanical ephedrine from dietary supplements containing ephedra (ma huang). Ther Drug Monit 2000;22:497.
- Gurley BJ, Gardner SF, Hubbard MA. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000;57:963-9. View abstract.
- Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8. View abstract.
- Haller CA, Jacob P 3rd, Benowitz NL. Enhanced stimulant and metabolic effects of combined ephedrine and caffeine. Clin Pharmacol Ther 2004;75:259-73. View abstract.
- Haller CA, Jacob P 3rd, Benowitz NL. Pharmacology of ephedra alkaloids and caffeine after single-dose dietary supplement use. Clin Pharmacol Ther 2002;71:421-32. View abstract.
- Haller CA, Meier KH, Olson KR. Seizures reported in association with use of dietary supplements. Clin Toxicol (Phila) 2005;43:23-30. View abstract.
- Horton TJ, Geissler CA. Aspirin potentiates the effect of ephedrine on the thermogenic response to a meal in obese but not lean women. Int J Obes 1991;15:359-66. View abstract.
- Jacobs KM, Hirsch KA. Psychiatric complications of Ma-huang. Psychosomatics 2000;41:58-62. View abstract.
- Jenkins DJ, Wesson V, Wolever TM, et al. Wholemeal versus wholegrain breads: proportion of whole or cracked grain and the glycaemic response. BMJ 1988;297:958-60. View abstract.
- Jubiz, W. and Meikle, A. W. Alterations of glucocorticoid actions by other drugs and disease states. Drugs 1979;18(2):113-121. View abstract.
- Kalman D, Incledon T, Gaunaurd I, et al. An acute clinical trial evaluating the cardiovascular effects of an herbal ephedra-caffeine weight loss product in healthy overweight adults. Int J Obes 2002;26:1363-66.. View abstract.
- Kernan, W. N., Viscoli, C. M., Brass, L. M., Broderick, J. P., Brott, T., Feldmann, E., Morgenstern, L. B., Wilterdink, J. L., and Horwitz, R. I. Phenylpropanolamine and the risk of hemorrhagic stroke. N.Engl.J Med 12-21-2000;343(25):1826-1832. View abstract.
- Kim BS, Song MY, Kim H. The anti-obesity effect of Ephedra sinica through modulation of gut microbiota in obese Korean women. J Ethnopharmacol. 2014;152(3):532-9. View abstract.
- Kockler DR, McCarthy MW, Lawson CL. Seizure activity and unresponsiveness after hydroxycut ingestion. Pharmacotherapy 2001;21:647-51.. View abstract.
- Leikin JB, Klein L. Ephedra causes myocarditis. Clin Toxicol 2000;38:353-4.
- Levisky JA, Karch SB, Bowerman DL, et al. False-positive RIA for methamphetamine following ingestion of an Ephedra-derived herbal product. J Anal Toxicol 2003;27:123-4.
- Lindsay BD. Are serious adverse cardiovascular events an unintended consequence of the Dietary Supplement Health and Education Act of 1994? Mayo Clin Proc 2002;77:7-9. View abstract.
- Louis E. Tremor disorders: identification and treatment. Medical Update for Psychiatrists 1997;2:172-6.
- McBride BF, Karapanos AK, Krudysz A, et al. Electrocardiographic and hemodynamic effects of a multicomponent dietary supplement containing ephedra and caffeine: a randomized controlled trial. JAMA 2004;291:216-21. View abstract.
- Morgenstern LB, Viscoli CM, Kernan WN, et al. Use of Ephedra-containing products and risk for hemorrhagic stroke. Neurology 2003;60:132-5. . View abstract.
- Nadir A, Agrawal S, King PD, Marshall JB. Acute hepatitis associated with the use of a Chinese herbal product, ma-huang. Am J Gastroenterol 1996;91:1436-8. View abstract.
- Okada S, Rohan PJ, Miller FW, et al. Myopathies following ingestion of special nutritional products. Arthritis Rheum 1996;39:349.
- Powell T, Hsu FF, Turk J, Hruska K. Ma-huang strikes again: ephedrine nephrolithiasis. Am J Kidney Dis 1998;32:153-9. View abstract.
- Ros JJ, Pelders MG, De Smet PA. A case of positive doping associated with a botanical food supplement. Pharm World Sci 1999;21:44-6. View abstract.
- Samenuk D, Link MS, Homoud MK, et al. Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine. Mayo Clin Proc 2002;77:12-6. View abstract.
- Schweinfurth J, Pribitkin E. Sudden hearing loss associated with ephedra use. Am J Health Syst Pharm 2003;60:375-7.
- Shekelle PG, Hardy ML, Morton SC, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003;289:1537-45.. View abstract.
- Soni MG, Carabin IG, Griffiths JC, Burdock GA. Safety of ephedra: lessons learned. Toxicol Lett 2004;150:97-110. View abstract.
- Tang J, Zhou X, Ji H, Zhu D, Wu L. Effects of ephedra water decoction and cough tablets containing ephedra and liquorice on CYP1A2 and the pharmacokinetics of theophylline in rats. Phytother Res. 2012;26(3):470-4. View abstract.
- Theoharides TC. Sudden death of a healthy college student related to ephedrine toxicity from a ma-huang containing drink. J Clin Psychopharmacol 1997;17:437-9.
- Toubro S, Astrup AV, Breum L, Quaade F. fety and efficacy of long-term treatment with ephedrine, caffeine and an ephedrine/caffeine mixture. Int J Obes Relat Metab Disord 1993;17:S69-72. View abstract.
- Ujino H, Morimoto O, Yukioka H, Fujimori M. [Acute angle-closure glaucoma after total hip replacement surgery]. Masui 1997;46:823-6. View abstract.
- Vahedi K, Domingo V, Amarenco P, Bousser MG. Ischemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for bodybuilding. J Neurol Neurosurg Psychiatr 2000;68:112-3. View abstract.
- Vierck JL, Icenoggle DL, Bucci L, Dodson MV. The effects of ergogenic compounds on myogenic satellite cells. Med Sci Sports Exerc 2003;35:769-76. View abstract.
- Vukovich MD, Schoorman R, Heilman C, et al. Caffeine-herbal ephedra combination increases resting energy expenditure, heart rate and blood pressure. Clin Exp Pharmacol Physiol 2005;32:47-53. View abstract.
- Walton R, Manos GH. Psychosis related to ephedra-containing herbal supplement use. South Med J 2003;96:718-20.. View abstract.
- Weinberger M and Bronsky E. Interaction of ephedrine and theophylline. Clin Pharmacol Ther 1974;15(2):223.
- White LM, Gardner SF, Gurley BJ, et al. Pharmacokinetics and Cardiovascular Effects of Ma-Huang (Ephedra sinica) in Normotensive Adults. J Clin Pharmacol 1997;37:116-22. View abstract.
- Wilde-Mathews A, Schaefer-Munoz S. Judge overturns ban on ephedra, roils FDA policy. Wall Street Journal, April 15, 2005. Available at: http://www.wsj.com/articles/SB111350487573807266.
- Wilson BE, Hobbs WN. Case report: pseudoephedrine-associated thyroid storm: thyroid hormone-catecholamine interactions. Am J Med Sci 1993;306:317-9. View abstract.
- Yates KM, O'Connor A, Horsley CA. "Herbal Ecstasy": a case series of adverse reactions. N Z Med J 2000;113:315-7.. View abstract.
- Zaacks SM, Klein L, Tan CD, et al. Hypersensitivity myocarditis associated with ephedra use. J Toxicol Clin Toxicol 1999;37:485-9. View abstract.
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