Adverse effects

There is strong evidence that ephedra is associated with serious side effects, including death. The US Food and Drug Administration (FDA) advises that consumers immediately stop using dietary supplements containing ephedra or ephedrine alkaloids. More information on the FDA and ma huang/ephedrine is available on the FDA website.

Reported adverse effects include anxiety, insomnia, headache, increased heart rate, increased blood pressure, urinary retention, increased blood glucose, a "flushing" sensation, acute hepatitis, kidney stones, myocarditis, stroke and psychosis. Excessive doses have resulted in heart failure, hypertensive crisis, tachycardia, CNS excitation, arrhythmia, myocardial infarction, stroke and death.

As might be expected, other stimulants such as decongestants and caffeine should be avoided or used with caution by individuals taking ma huang. Alarmingly, supplements often contain ma huang in combination with other stimulants, including botanical sources of caffeine such as guarana and kola nut. Ma huang has the potential to interact with conventional drugs, including theophylline, MAO inhibitors, hypoglycemic drugs, antihypertensives and digoxin.

Individuals with hypertension, angina, heart failure, diabetes, a psychiatric condition, or a previous heart attack or stroke should be especially advised to avoid this herb.

More Information

• FDA Statement (04/12/2004)
• NCCAM Update on Government Actions to Reduce Risk of Ephedra (Updated 12/30/2003)