Hypertensive ephedra

Ephedra (sea grape, ma-huang, yellow horse) ephedra sinica Relieves colds, improves respiratory function, headaches, diuretic effects 3heart rate, psychosis l hedra should only be used after consulting with the physician. Many restrictions apply and the herb can cause serious reactions. Do not use with cardiac glycosides, monoamine oxidase inhibitor halothane, guanethidine, (MAOIs) or oxytocin. Do not use with 3. John s wort or in weight loss formulas. 

A) Ephedra has been associated with increased risk of hypertension and tachycardia but not stroke. 

N.A. Ephedra nevadensis Wats. Pseudoephedrine, 1-ephedrine, d-pseudoephedrine.100 A decongestant and asthma remedy, for hypertension, hay fever. 

At higher doses, ephedra may be toxic. An overdose of ephedra can cause nausea, vomiting, fever, palpitations, tachycardia, hypertension, psychosis, respiratory depression, convulsions, and coma. 

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. 

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. 

Ephedra was implicated in the deaths of eight patients, and although it was pointed out that several had pre-existing conditions such as chest pain and hypertension (30), the authors justifiably responded that these were contraindications to the use of Ephedra in the first place, and they cast doubt on the adequacy of the warnings provided (31). 

Ephedra has been closely linked to methamphetamine production. There are movements In many localities to outlaw the herb. There are many drug interactions with Ma huang. )9-BI(K kcrs may enhance the sympathetic effect and cause hypertentiion. MAOIs may interact with ephedra to cause hypertensive cri.si.s. Phcnothiaz.ines might block the or effects of ephedra, causing hypotension and tachycardia. Simultaneous use of theophylline may cau.se GI and CNS effects. In pregnancy, ephedra is absolutely contraindicated (uterine stimulation). Persons with heart disease, hypertension, and diabetes should not take ephedra. 

Many cases of serious adverse effects and even fatalities have been reported that were linked with ephedra or ephedrine administration over the last 10 years. Haller and Benowitz published a review of 140 reports of adverse events related to the use of ephedra alkaloids that were submitted to the FDA between June 1997 and March 1999. Using standardized rating system for assessing causation, 31% of the cases were considered to be definitely or probably related to the use of ephedra alkaloid-containing supplements, and another 31% were deemed to be possibly related. Among these adverse events, 47% involved in cardiovascular symptoms and 18% involved the CNS. Hypertension was the most frequent adverse effect, followed by palpitations, tachycardia, or both stroke and seizures. Ten events led to death and 13 cases produced permanent disability. 

Haller and Benowitz evaluated 140 reports of ephedra-related toxicity and concluded that 31% of the cases were definitely related to ephedra toxicity and a further 31% were possibly related 47% of reports of ephedra toxicity involved cardiovascular problems and 18% involved problems with the CNS. Hypertension was the single most frequent adverse reaction, followed by palpitation, tachycardia, stroke and seizure. Ten events resulted in death and 13 events caused permanent disability. The authors concluded that use of dietary supplements that contains ephedra may pose a health risk. ... 

In the only large study ever done to assess risk factors for stroke in young people (age 20-49) over a 1 -yr period (in Poland, a country where ephedra based products are widely used), nearly half the stroke cases were associated with preexisting hypertension, another 15% had hyperlipidemia, and 6% were diabetic (Jovanovic, 1996). None of the individuals were ephedrine users. 

Ma-huang, other ephedra preparations Sympathomimetics Ephedrine in Ma-huang is additive with other sympathomimetics hypertension, stroke... 

Ephedra (Ma-huang, sea grape, yellow horse) Bronchodilator, diet aid, CNS stimulant Hypertension, cardiac arrhythmias, stroke, seizures... 

Ma huang Ephedrine (various Ephedra spp.) Stimulant athletic performance enhancement appetite suppressant Insomnia hypertension, tachycardia psychosis, seizures (see Caffeine, p 142). 

Mormon tea Ephedra virldls 1 Ephedra tachycardia, hypertension (see p 320)... 

Haller CA, Benowitz NL Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000 343(25) 1833-1838. [PMID 11117974] (Review of 140 reports submitted to the FDA Included hypertension, stroke, and seizures. There were 10 deaths and 13 patients had permanent disability.)... 

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