Ephedrine

Last Updated: October 13, 2024

Ephedrine is one of the four active components of the herb Ephedra. It is able to induce fat loss via increasing the amount of fat available for fuel as well as by increasing heat expenditure. It has been implicated in increasing the metabolic rate by up to 5% in humans. It has also been noted to cause serious side-effects in some instances, and its legal status varies by region.

dosageDosage
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Ephedrine is most often used for

What is ephedrine?

Ephedrine is a stimulant that activates the sympathetic nervous system and is used clinically; it is derived from plants in the Ephedra genus. Due to serious side effects, the FDA has banned the sale of dietary supplements containing ephedra and ephedrine-type alkaloids in the United States.

What are ephedrine’s main benefits?

Ephedrine and supplements from Ephedra plants can aid in weight loss and improve blood lipid profiles by increasing HDL cholesterol and decreasing LDL cholesterol and triglycerides. Additionally, they may enhance exercise performance, particularly when combined with caffeine, although these effects are not consistently observed.

What are ephedrine’s main drawbacks?

Ephedrine and its derivatives can lead to various side effects, including autonomic hyperactivity, gastrointestinal issues, psychiatric symptoms, and serious cardiovascular risks such as stroke and heart attack. Additionally, ephedrine is on the World Anti-Doping Agency's prohibited list, which athletes must consider when using related supplements or medications.

How does ephedrine work?

Ephedrine activates various adrenergic receptors in multiple tissues; this leads to increased sympathetic nervous system activity, which raises heart rate and blood pressure and dilates the bronchioles. Its role in weight loss may stem from enhanced fatty acid release, increased fat oxidation, and elevated energy expenditure, which contribute to thermogenesis and increased sweating.

What are other names for Ephedrine?
Note that Ephedrine is also known as:
  • Ephedra Vulgaris
  • Ephedraceae
  • ma huang
Ephedrine should not be confused with:
  • Ephedrone
  • Epinephrine
Dosage information

All Doses Standardized to Ephedrine HCl

In an ECA stack, ephedrine is dosed at 20-24mg for three doses taken throughout the day.

Human studies have found success with ephedrine in isolation on fat metabolism with doses of 20-50mg thrice a day. The higher range (150mg) may be too stimulatory for some, and can induce headaches or light hand tremors.

Ephedrine tends to be consumed with xanthine compounds like caffeine and sometimes with Aspirin. The combination of Ephedrine and caffeine is shown repeatedly to be highly synergistic.

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References
  1. ^González-Juárez DE, Escobedo-Moratilla A, Flores J, Hidalgo-Figueroa S, Martínez-Tagüeña N, Morales-Jiménez J, Muñiz-Ramírez A, Pastor-Palacios G, Pérez-Miranda S, Ramírez-Hernández A, Trujillo J, Bautista EA Review of the genus: Distribution, Ecology, Ethnobotany, Phytochemistry and Pharmacological Properties.Molecules.(2020-Jul-20)
  2. ^Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, Rhodes SL, Jungvig L, Gagné JEfficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysisJAMA.(2003 Mar 26)
  3. ^Food and Drug Administration, HHSFinal rule declaring dietary supplements containing ephedrine alkaloids adulterated because they present an unreasonable risk. Final ruleFed Regist.(2004 Feb 11)
  4. ^Yoo HJ, Yoon HY, Yee J, Gwak HSEffects of Ephedrine-Containing Products on Weight Loss and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Pharmaceuticals (Basel).(2021-Nov-22)
  5. ^Magkos F, Kavouras SACaffeine and ephedrine: physiological, metabolic and performance-enhancing effects.Sports Med.(2004)
  6. ^Bell DG, McLellan TM, Sabiston CMEffect of ingesting caffeine and ephedrine on 10-km run performance.Med Sci Sports Exerc.(2002-Feb)
  7. ^Jacobs I, Pasternak H, Bell DGEffects of ephedrine, caffeine, and their combination on muscular endurance.Med Sci Sports Exerc.(2003-Jun)
  8. ^Williams AD, Cribb PJ, Cooke MB, Hayes AThe effect of ephedra and caffeine on maximal strength and power in resistance-trained athletesJ Strength Cond Res.(2008 Mar)
  9. ^Bell DG, Jacobs I, Ellerington KEffect of caffeine and ephedrine ingestion on anaerobic exercise performance.Med Sci Sports Exerc.(2001-Aug)
  10. ^Richard Andraws, Preety Chawla, David L BrownCardiovascular effects of ephedra alkaloids: a comprehensive reviewProg Cardiovasc Dis.(2005 Jan-Feb)
  11. ^Stohs SJ, Shara M, Ray SDp-Synephrine, ephedrine, p-octopamine and m-synephrine: Comparative mechanistic, physiological and pharmacological properties.Phytother Res.(2020-Aug)
  12. ^Vansal SS, Feller DRDirect effects of ephedrine isomers on human beta-adrenergic receptor subtypes.Biochem Pharmacol.(1999-Sep-01)
  13. ^Ma G, Bavadekar SA, Davis YM, Lalchandani SG, Nagmani R, Schaneberg BT, Khan IA, Feller DRPharmacological effects of ephedrine alkaloids on human alpha(1)- and alpha(2)-adrenergic receptor subtypes.J Pharmacol Exp Ther.(2007-Jul)
  14. ^Astrup A, Breum L, Toubro SPharmacological and clinical studies of ephedrine and other thermogenic agonists.Obes Res.(1995-Nov)
  15. ^Napolitano A, Murgatroyd PR, Finer N, Hussey EK, Dobbins R, O'Rahilly S, Nunez DJAssessment of acute and chronic pharmacological effects on energy expenditure and macronutrient oxidation in humans: responses to ephedrine.J Obes.(2011)
  16. ^A Astrup, J Bülow, J Madsen, N J ChristensenContribution of BAT and skeletal muscle to thermogenesis induced by ephedrine in manAm J Physiol.(1985 May)
  17. ^Lipka AF, Vrinten C, van Zwet EW, Schimmel KJ, Cornel MC, Kuijpers MR, Hekster YA, Weinreich SS, Verschuuren JJEphedrine treatment for autoimmune myasthenia gravis.Neuromuscul Disord.(2017 Mar)
  18. ^Haller CA, Benowitz NLAdverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids.N Engl J Med.(2000 Dec 21)
  19. ^Schier JG, Traub SJ, Hoffman RS, Nelson LSEphedrine-induced cardiac ischemia: exposure confirmed with a serum level.J Toxicol Clin Toxicol.(2003)
  20. ^Vahedi K, Domigo V, Amarenco P, Bousser MGIschaemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for body building.J Neurol Neurosurg Psychiatry.(2000 Jan)
  21. ^Samenuk D, Link MS, Homoud MK, Contreras R, Theoharides TC, Wang PJ, Estes NA 3rdAdverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine.Mayo Clin Proc.(2002 Jan)
  22. ^Hallas J, Bjerrum L, Støvring H, Andersen MUse of a prescribed ephedrine/caffeine combination and the risk of serious cardiovascular events: a registry-based case-crossover study.Am J Epidemiol.(2008 Oct 15)
  23. ^Persky AM, Berry NS, Pollack GM, Brouwer KLModelling the cardiovascular effects of ephedrine.Br J Clin Pharmacol.(2004 May)
  24. ^Vukovich MD, Schoorman R, Heilman C, Jacob P 3rd, Benowitz NLCaffeine-herbal ephedra combination increases resting energy expenditure, heart rate and blood pressureClin Exp Pharmacol Physiol.(2005 Jan-Feb)
  25. ^Boozer CN, Nasser JA, Heymsfield SB, Wang V, Chen G, Solomon JLAn herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trialInt J Obes Relat Metab Disord.(2001 Mar)
  26. ^Maglione M, Miotto K, Iguchi M, Jungvig L, Morton SC, Shekelle PGPsychiatric effects of ephedra use: an analysis of Food and Drug Administration reports of adverse events.Am J Psychiatry.(2005 Jan)
  27. ^Capwell RREphedrine-induced mania from an herbal diet supplement.Am J Psychiatry.(1995 Apr)
  28. ^Herridge CF, a'Brook MFEphedrine psychosis.Br Med J.(1968 Apr 20)
  29. ^Haller CA, Jacob P 3rd, Benowitz NLEnhanced stimulant and metabolic effects of combined ephedrine and caffeine.Clin Pharmacol Ther.(2004 Apr)
  30. ^Haller CA, Jacob P, Benowitz NLShort-term metabolic and hemodynamic effects of ephedra and guarana combinations.Clin Pharmacol Ther.(2005 Jun)
  31. ^Thomas J. Kim, H W LeBourgeois 3rdBanned, but Not Forgotten: A Case of Ephedrine-Induced PsychosisPrim Care Companion J Clin Psychiatry.(2004)
  32. ^Fleming RMSafety of ephedra and related anorexic medications.Expert Opin Drug Saf.(2008 Nov)
  33. ^Astrup A, Buemann B, Christensen NJ, Toubro S, Thorbek G, Victor OJ, Quaade FThe effect of ephedrine/caffeine mixture on energy expenditure and body composition in obese womenMetabolism.(1992 Jul)
  34. ^Dingemanse J, Guentert T, Gieschke R, Stabl MModification of the cardiovascular effects of ephedrine by the reversible monoamine oxidase A-inhibitor moclobemide.J Cardiovasc Pharmacol.(1996 Dec)
  35. ^Casella M, Dello Russo A, Izzo G, Pieroni M, Andreini D, Russo E, Colombo D, Bologna F, Bolognese L, Zeppilli P, Tondo CVentricular arrhythmias induced by long-term use of ephedrine in two competitive athletes.Heart Vessels.(2015 Mar)
  36. ^Morgenstern LB, Viscoli CM, Kernan WN, Brass LM, Broderick JP, Feldmann E, Wilterdink JL, Brott T, Horwitz RIUse of Ephedra-containing products and risk for hemorrhagic stroke.Neurology.(2003 Jan 14)
  37. ^Chen C, Biller J, Willing SJ, Lopez AMIschemic stroke after using over the counter products containing ephedra.J Neurol Sci.(2004 Jan 15)
  38. ^To LB, Sangster JF, Rampling D, Cammens IEphedrine-induced cardiomyopathy.Med J Aust.(1980 Jul 12)
  39. ^Snipelisky DF, Kurklinsky AK, Chirila RTransient Cardiomyopathy and Quadriplegia Induced by Ephedrine Decongestant.Tex Heart Inst J.(2015 Dec)
  40. ^Banner AS, Sunderrajan EV, Agarwal MK, Addington WWArrhythmogenic effects of orally administered bronchodilators.Arch Intern Med.(1979 Apr)
  41. ^Lachkar Y, Bouassida WDrug-induced acute angle closure glaucoma.Curr Opin Ophthalmol.(2007 Mar)
  42. ^Ah-Kee EY, Egong E, Shafi A, Lim LT, Yim JLA review of drug-induced acute angle closure glaucoma for non-ophthalmologists.Qatar Med J.(2015)
  43. ^Yang MC, Lin KYDrug-induced Acute Angle-closure Glaucoma: A Review.J Curr Glaucoma Pract.(2019 Sep-Dec)
  44. ^R Young, M Gabryszuk, R A Glennon(-)Ephedrine and caffeine mutually potentiate one another's amphetamine-like stimulus effectsPharmacol Biochem Behav.(1998 Oct)
  45. ^Shekelle P, Hardy ML, Morton SC, Maglione M, Suttorp M, Roth E, Jungvig L, Mojica WA, Gagné J, Rhodes S, McKinnon EEphedra and ephedrine for weight loss and athletic performance enhancement: clinical efficacy and side effects.Evid Rep Technol Assess (Summ).(2003 Mar)
  46. ^Tang J, Zhou X, Ji H, Zhu D, Wu LEffects of ephedra water decoction and cough tablets containing ephedra and liquorice on CYP1A2 and the pharmacokinetics of theophylline in rats.Phytother Res.(2012 Mar)
  47. ^Zhi JG, Levy GEffect of ephedrine and hydrocortisone on theophylline-induced seizures in rats.J Pharm Sci.(1990 Jul)
  48. ^FDA-Approved Drugs\(May 2011)
  49. ^Weinberger M, Bronsky E, Bensch GW, Bock GN, Yecies JJInteraction of ephedrine and theophylline.Clin Pharmacol Ther.(1975 May)
  50. ^Ishiyama T, Kashimoto S, Oguchi T, Matsukawa T, Kumazawa TThe effects of clonidine premedication on the blood pressure and tachycardiac responses to ephedrine in elderly and young patients during propofol anesthesia.Anesth Analg.(2003 Jan)
  51. ^Tanaka M, Nishikawa TEnhancement of pressor response to ephedrine following clonidine medication.Anaesthesia.(1996 Feb)
  52. ^Goyagi T, Tanaka M, Nishikawa TOral clonidine premedication enhances the pressor response to ephedrine during spinal anesthesia.Anesth Analg.(1998 Dec)
  53. ^Nishikawa T, Kimura T, Taguchi N, Dohi SOral clonidine preanesthetic medication augments the pressor responses to intravenous ephedrine in awake or anesthetized patients.Anesthesiology.(1991 Apr)
  54. ^ Statler, A., Maani, C., Kohli, A“Ephedrine”, in StatPearls(Internet). USA: StatPearls Publishing(2023)
  55. ^Hirsch MS, Walter RM, Hasterlik RJSubarachnoid hemorrhage following ephedrine and MAO inhibitor.JAMA.(1965 Dec 13)
  56. ^Lefebvre H, Noblet C, Moore N, Wolf LMPseudo-phaeochromocytoma after multiple drug interactions involving the selective monoamine oxidase inhibitor selegiline.Clin Endocrinol (Oxf).(1995 Jan)
  57. ^Elis J, Laurence DR, Mattie H, Prichard BNModification by monoamine oxidase inhibitors of the effect of some sympathomimetics on blood pressure.Br Med J.(1967 Apr 8)
  58. ^Tang J, Ji H, Shi J, Wu LEphedra water decoction and cough tablets containing ephedra and liquorice induce CYP1A2 but not CYP2E1 hepatic enzymes in rats.Xenobiotica.(2016)
  59. ^Zhuang W, He T, Jia BB, Wang ZZ, Zhang L, Dong XZ, Xi SYInteraction between Chinese medicine and digoxin: Clinical and research update.Front Pharmacol.(2023)
  60. ^Gurley BJ, Gardner SF, Hubbard MAContent versus label claims in ephedra-containing dietary supplements.Am J Health Syst Pharm.(2000 May 15)
  61. ^Kuczkowski KMEphedrine-containing oral nutritional supplements in a pregnant athlete: is it worth the risk?Acta Obstet Gynecol Scand.(2006)
  62. ^Dusitkasem S, Herndon BH, Somjit M, Stahl DL, Bitticker E, Coffman JCComparison of Phenylephrine and Ephedrine in Treatment of Spinal-Induced Hypotension in High-Risk Pregnancies: A Narrative Review.Front Med (Lausanne).(2017)
  63. ^Bent S, Tiedt TN, Odden MC, Shlipak MGThe relative safety of ephedra compared with other herbal products.Ann Intern Med.(2003 Mar 18)
  64. ^Kockler DR, McCarthy MW, Lawson CLSeizure activity and unresponsiveness after hydroxycut ingestion.Pharmacotherapy.(2001 May)
  65. ^Powell T, Hsu FF, Turk J, Hruska KMa-huang strikes again: ephedrine nephrolithiasis.Am J Kidney Dis.(1998 Jul)
  66. ^Bennett S, Hoffman N, Monga MEphedrine- and guaifenesin-induced nephrolithiasis.J Altern Complement Med.(2004 Dec)
  67. ^Audicana M, Urrutia I, Echechipia S, Muñoz D, Fernández de Corres LSensitization to ephedrine in oral anticatarrhal drugs.Contact Dermatitis.(1991 Mar)
Examine Database References
  1. Appetite - Toubro S, Astrup ARandomised comparison of diets for maintaining obese subjects' weight after major weight loss: ad lib, low fat, high carbohydrate diet v fixed energy intakeBMJ.(1997 Jan 4)
  2. Weight - Hackman RM, Havel PJ, Schwartz HJ, Rutledge JC, Watnik MR, Noceti EM, Stohs SJ, Stern JS, Keen CLMultinutrient supplement containing ephedra and caffeine causes weight loss and improves metabolic risk factors in obese women: a randomized controlled trialInt J Obes (Lond).(2006 Oct)
  3. Weight - Coffey CS, Steiner D, Baker BA, Allison DBA 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 treatmentInt J Obes Relat Metab Disord.(2004 Nov)
  4. Weight - Pasquali R, Cesari MP, Melchionda N, Stefanini C, Raitano A, Labo GDoes ephedrine promote weight loss in low-energy-adapted obese womenInt J Obes.(1987)
  5. Weight - Ingerslev J, Svendsen TL, Mørk AIs an ephedrine caffeine treatment contraindicated in hypertensionInt J Obes Relat Metab Disord.(1997 Aug)
  6. Weight - Kim HJ, Park JM, Kim JA, Ko BPEffect of herbal Ephedra sinica and Evodia rutaecarpa on body composition and resting metabolic rate: a randomized, double-blind clinical trial in Korean premenopausal womenJ Acupunct Meridian Stud.(2008 Dec)
  7. Metabolic Rate - Molnár DEffects of ephedrine and aminophylline on resting energy expenditure in obese adolescentsInt J Obes Relat Metab Disord.(1993 Feb)
  8. Metabolic Rate - Pasquali R, Casimirri F, Melchionda N, Grossi G, Bortoluzzi L, Morselli Labate AM, Stefanini C, Raitano AEffects of chronic administration of ephedrine during very-low-calorie diets on energy expenditure, protein metabolism and hormone levels in obese subjectsClin Sci (Lond).(1992 Jan)
  9. Metabolic Rate - B Nielsen, A Astrup, P Samuelsen, H Wengholt, N J ChristensenEffect of physical training on thermogenic responses to cold and ephedrine in obesityInt J Obes Relat Metab Disord.(1993 Jul)
  10. Heart Rate - Eccles R, Jawad MS, Jawad SS, Angello JT, Druce HMEfficacy and safety of single and multiple doses of pseudoephedrine in the treatment of nasal congestion associated with common coldAm J Rhinol.(2005 Jan-Feb)
  11. Weight - Boozer CN, Daly PA, Homel P, Solomon JL, Blanchard D, Nasser JA, Strauss R, Meredith THerbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trialInt J Obes Relat Metab Disord.(2002 May)
  12. Weight - Astrup A, Lundsgaard C, Madsen J, Christensen NJEnhanced thermogenic responsiveness during chronic ephedrine treatment in manAm J Clin Nutr.(1985 Jul)
  13. Weight - Bogacka I, Gettys TW, de Jonge L, Nguyen T, Smith JM, Xie H, Greenway F, Smith SRThe effect of beta-adrenergic and peroxisome proliferator-activated receptor-gamma stimulation on target genes related to lipid metabolism in human subcutaneous adipose tissueDiabetes Care.(2007 May)
  14. Metabolic Rate - Dulloo AG, Miller DSThe thermogenic properties of ephedrine/methylxanthine mixtures: human studiesInt J Obes.(1986)
  15. Nasal Congestion - Taverner D, Danz C, Economos DThe effects of oral pseudoephedrine on nasal patency in the common cold: a double-blind single-dose placebo-controlled trialClin Otolaryngol Allied Sci.(1999 Feb)
  16. Weight - Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, Rhodes SL, Jungvig L, Gagné JEfficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysisJAMA.(2003 Mar 26)
  17. Body Fat - Boozer CN, Nasser JA, Heymsfield SB, Wang V, Chen G, Solomon JLAn herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trialInt J Obes Relat Metab Disord.(2001 Mar)
  18. Subjective Well-Being - Williams AD, Cribb PJ, Cooke MB, Hayes AThe effect of ephedra and caffeine on maximal strength and power in resistance-trained athletesJ Strength Cond Res.(2008 Mar)
  19. Metabolic Rate - A Astrup, J Bülow, J Madsen, N J ChristensenContribution of BAT and skeletal muscle to thermogenesis induced by ephedrine in manAm J Physiol.(1985 May)
  20. Nausea Symptoms - Wuhrman E, Clark MUse of ephedrine for the short-term treatment of postoperative nausea and vomiting: a case reportJ Perianesth Nurs.(2011 Oct)