How is ephedrine taken

Ephedra Ephedra sinica is an herb with a long history of use in traditional Chinese medicine for asthma, bronchitis, allergies, and cold and flu symptoms. It is also known as Ma huang. During the s, ephedra became popular outside of traditional Chinese medicine for weight loss and to enhance sports performance.

Its popularity continued to grow, and it was found in many nutritional supplements marketed for weight loss and performance enhancement. However, the U. The primary active ingredients in ephedra are the alkaloids ephedrine and pseudoephedrine. Both increase heart rate, constrict blood vessels, dilate bronchial tubes, and have thermogenic properties to increase body heat and metabolic rate.

These alkaloids have been linked to stroke , seizures, psychosis, and death. Dietary supplements containing any amount of ephedrine or pseudoephedrine are banned in the United States, however, some supplement companies have removed these alkaloids from ephedra and reformulated their products.

In Canada, ephedra is authorized by Health Canada for use only as a nasal decongestant. Nutritional supplements with ephedra may not also contain stimulants, such as caffeine, which may heighten the effect of ephedra and increase its dangerous side effect. Canadian products containing ephedra also may not imply claims of weight loss, appetite suppression, body-building effects, or increased energy. The once popular stimulant was used for weight loss, sports performance, and asthma and other respiratory problems.

Ephedra is used in weight loss supplements. Proponents claim that it may help promote weight loss and suppress appetite. Prior to the ban on ephedra supplements, many dietary supplements marketed for weight loss also contained caffeine-containing herbs, such as green tea, yerba mate, and guarana.

Ephedra is similar in structure to amphetamine, so it has been used to increase athletic performance in strength and endurance sports, increase alertness and aggressiveness on the field, and reduce fatigue in sports such as ice hockey, baseball, football, and cycling.

There is no strong evidence, however, that it can improve sports performance, and is not recommended for this purpose given the potential side effects. Ephedra has a long history of use in traditional Chinese medicine and Western herbalism as a remedy for asthma , bronchitis, allergies, fever, chills and cold and flu symptoms, such as nasal congestion. Side effects of ephedra may include:. Use of ephedra has also been associated with stroke , seizures, psychosis, and death when used inappropriately.

A National Institutes of Health review of 16, adverse events linked to ephedra and identified two deaths, nine strokes, four heart attacks, one seizure and five psychiatric cases. The study concluded ephedra is associated with higher risks of heart palpitations, digestive effects, and symptoms of hyperactivity of the autonomic nervous system tremor, insomnia , especially when combined with caffeine or other stimulants such as kola nut, green tea, guarana or yerba mate.

Many adverse effects are attributed to overdose, abuse, and combining it with other stimulants that heighten its effect, such as caffeine. Side effects of ephedra, however, can vary and are not dose dependent. Products containing caffeine seemed to promote slightly more weight loss than those containing only ephedrine.

However, none of the studies lasted longer than six months, far less than the twelve months researchers consider the minimum necessary to establish the value of a weight loss product studies that lasted less than two months were excluded from our analysis because two months is simply too short a time to assess a meaningful change in weight. We found no studies that assessed the effects of ephedra-containing dietary supplements on athletic performance.

Thus we analyzed only studies of products containing ephedrine or ephedrine plus caffeine, seven studies in all. No two studies were judged similar enough in design to combine their results: Measures of athletic performance varied widely from one study to another. As a result, our conclusions regarding the effects of ephedrine on athletic performance are based on a nonquantitative synthesis of the research rather than on meta-analysis.

In addition, no study looked at long-term changes in performance. Our analysis found that one-time use of ephedrinecontaining products seems to enhance immediate physical performance, but only when taken in combination with caffeine. These results, too, must be interpreted with caution. The studies assessed performance immediately after a single dose; none of the studies examined the type of chronic, long-term use typical of consumers of these products.

What's more, the study participants,all young, fit males,may not be typical of the average consumer. To assess the safety of ephedra- and ephedrine-containing products, we reviewed four sources for reports of adverse events. First, we reviewed the clinical trials included in our analyses of weight loss and athletic performance, most of which reported adverse events for both treatment and placebo groups. The trials contained no reports of very serious adverse events such as death and cardiovascular events.

This is not surprising, considering that the occurrence of such events is likely to be quite rare less than one in a thousand users and the clinical trials included only a few thousand people. However, we found a two- to threefold increase in the occurrence of nausea, vomiting, anxiety, autonomic hyperactivity, and palpitations, and a trend toward an increase in headaches.

We also reviewed descriptions of medical cases published in peer-reviewed journals. This review identified 70 reports of adverse events, including heart attacks, strokes, and serious psychiatric problems.

We then obtained all adverse-event reports submitted to the FDA prior to September that were associated with the use of ephedraor ephedrine-containing products and for which records existed: more than 1, adverse-event reports on ephedra and on products containing ephedrine. Finally, we analyzed more than 18, adverse-event reports received by one of the largest U. These reports had been turned over to the FDA at the request of the U. Deptartment of Justice.

Based on the available evidence, these reports were classified as "sentinel events," "possible sentinel events," or lacking in sufficient evidence see Table 1. NOTE: The hour requirement was applied to reports of psychiatric events because these events are believed to result from prolonged use. The majority of the adverse-event reports lacked sufficient information to demonstrate a connection between the event and use of ephedra or ephedrine.

Of particular concern is that half the sentinel events occurred in apparently healthy people under the age of The studies we reviewed suggest that ephedra- and ephedrine-containing products may be modestly effective in promoting weight loss, but the evidence on enhancing athletic performance is not definitive.

However, the use of ephedra or ephedrine does cause an increase in jitteriness, mood changes, palpitations, nausea, and vomiting.

Moreover, the adverse-event reports raise serious concerns about the safety of ephedra and ephedrine products. In response to our report, the federal government quickly moved to propose stricter labeling of ephedra products and solicited public comment on whether the safety evidence thus far warrants further restrictions. By itself, the existing evidence is insufficient to link these products conclusively with death and other serious health problems.

However, our analysis of the existing studies and their shortcomings suggests that a more definitive answer to questions about ephedra's safety could be obtained by doing what is called a "case-control" study. Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article.

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