Ephedra side effects

Ephedra Side Effects. Ephedrine Hews. Available online at http //www. ephedrine-news.com. 

Figure 4.2 Steve Bechler, a former pitcher for the Baltimore Orioles, died after taking a weight loss supplement containing ephedra. Here he is being taken off the playing field during training camp, when he began to suffer from heat exhaustion, a side effect of ephedra-based drugs.

In February 2004, the FDA withdrew ephedra, one of the most popular dietary supplements, from the market because it finally had enough information to prove that ephedra presented an unreasonable risk of illness or injury under the conditions of use recommended on the product labeling. This withdrawal did not happen until many people suffered from the terrible potential side effects of this supplement (see Chapter 4). 

Normal doses range from 15 to 30 mg of actual alkaloid (ephedrine), and the lethal dose is in the 1-2 g range. Side effects from ephedra use include headache, irritability, restlessness, anxiety, insomnia, tachycardia, urinary disorders, and vomiting. 

There are a number of physiological effects related to ephedra consumption, and it is these side effects and reports of adverse events that are causing both the FDA and several state regulatory bodies to consider regulating it. 

According to the researchers, nearly half of the adverse events definitely, probably, or possibly caused by ephedra were cardiovascular side effects. The most common cardiovascular side effect was hypertension, or high blood pressure. Other reported cardiovascular events were palpitations, tachycardia (an abnormally fast heartbeat), stroke, and seizures. The researchers stated that 10 of the adverse events definitely, probably, or possibly caused by ephedra resulted in death, and 13 of the events caused permanent disability. In one-fifth of the cases, there was not enough evidence or information about the incident, and the remaining complications were not related to ephedra. 

Manufacturers of dietary supplements take a different stance when it comes to adverse events reporting. They claim that adverse events are anecdotal records and do not prove that ephedra caused the side effect or... 

Potential harmful side effects associated with ephedra include nervousness, irritability, headaches, insomnia, palpitations, depression, and paranoia. Other possible side effects are hypertension and rapid heartbeat. Ephedra users also face an increased risk of seizures, heart attack, and stroke. A heart attack or stroke caused by ephedra can result in death. 

Although the FDA, some medical authorities, and some states recognize that ephedra and its relative, phenylpropanolamine (PPA), may cause adverse health events or serious side effects, ephedra is not considered an addictive, habit-forming drug. Drug treatment and rehabilitation programs, therefore, do not address ephedra or PPA use. 

Anise 2. Asian ginseng 3. Cereus 4. Ephedra 5. Ginseng 6. Parsley 7. Shepherds purse 8. Verbena (vervain) 9. Capsicum 1. Phenelzine 2. Tranylcypromine 3. Modobemide May cause T blood pressure with anise and ephedra. T risk of side-effects such as psychosis and hallucinations with Asian ginseng. Headache, tremulousness and manic episodes have been reported with ginseng and phenelzine Unknown mechanism (anise, Asian ginseng) Inhibits metabolism of ephedra (MAOIs inhibit the metabolism of ephedra) Avoid concomitant use... 

Unlike the situation with ephedra, in many cases we simply have no idea what the components do. The constituents of some herbal drugs seem to work synergistically and cannot be separated without loss of activity of the preparation. Herbal preparations are most often used as crude mixtures and are not standardized or analyzed for the content of the active principlc(s). Hence, the chemistry of medicinal herbs cannot be treated in the same way as that of. say. a pure antibiotic or a calcium channel blocker. The medicinal chemistry of the actions, interactions, and side effects of herbal products is complex and difficult to assess clinically and chemically. Frequently, some of the compounds present... 

Shekelle, P., Hardy, M., Morton, S., Maglione, M., Suttorp, M., Roth, E., Jungvig, L., Mojica, W., Gagne, J., Rhodes, S., and McKinnon, E. 2003b. Ephedra and ephedrine for weight loss and athletic performance enhancement Clinical efficacy and side effects. Evidence Rep. Technol. Assessment (Summary) 76, 111-114. 

Herbal substitutes for dru [s of abuse A variety of herbal mixtures are offered for sale in magazines, on the internet and in so-called smart , eco or head shops. Many are marketed as herbal Ecstasy and the plants included in the formulations include Yohimbe bark, Kava-Kava (Piper methysticum),Y-3 e.emi, Hops, Jaborandi and Alisma. One product contains Kava-Kava, Guarana, Uva Ursi and Cascara bark. Many of the products sold as herbal Ecstasy contain either Ephedra sinica (Ma huang) or the Indian plant Sida cordifolia which both contain the alkaloid ephedrine (see R03c, Chapter VI). Other alkaloids may also occur, such as pseudoephedrine, norephedrine and norpseudoephedrine. The side-effects of ephedrine include tachycardia, anxiety, insomnia and arrythmias and a hypotensive crisis may develop if monamine oxidase inhibitors are also taken. Many adverse reactions and more than 20 deaths have been attributed to ephedrine and Ephedra consumption. Research conducted in the US shows that the daily intake of some Ephedra products would give ephedrine levels well above the recommended therapeutic doses. 

Ephedrine, isolated from Ephedra sinica, is the major active constituent of this plant species. It is used in the treatment of asthma, nasal congestion, and as a prophylactic to avoid hypotension associated with spinal anesthesia for cesarean section [55]. Herbal products containing Ephedra are used as antiobesity agents and energy boosters despite reports on serious side-effects, such as hypertension, seizures, myocardial infarction [56]. The 15,2/ -(- -)-enantiomer of ephedrine is not present in the plant. 

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