Potential Interactions
Based on known interactions between the active ingredients of ephedra, ephedrine and pseudoephedrine, the following medications could theoretically interact with ephedra:
- Aerolate, T-Phyl, and Uniphyl (theophylline) -- a medication used for asthma, emphysema and chronic bronchitis
- Amphetamines, such as those used for narcolepsy or attention deficit hyperactivity, such as Adderall (dextroamphetamine)
- Antidepressants, particularly monoamine oxidase inhibitors (MAOIs), such as Marplan (isocarboxazid), Nardil (phenelzine) and Parnate (tranylcypromine), due to an increased risk of high blood pressure and stroke; tricyclic antidepressants, such as Elavil (amitriptyline) and Pamelor (nortriptyline)
- Aspirin (acetylsalicylic acid)
- Blood pressure medication
- Diabetes medications, such as insulin, Glucophage (metformin), Diabeta, Glynase, Micronase (glyburide)
- Narcotics, such as codeine
- Pitosin (Oxytocin) or Secale Alkaloid Derivatives
- St. John's Wort
- Stimulants -- Ephedra should not be combined with other substances with a stimulant effect, such as caffeine and Sudafed (pseudoephedrine hydrochloride), as it may have an additive effect. Herbs known to contain caffeine include green tea, kola nut, guarana and yerba mate, while bitter orange is a stimulant.
Sources:
Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs . Boston: Integrative Medicine Communications; 2000:111-117.
Food and Drug Administration. FDA announces rule prohibiting sale of dietary supplements containing ephedrine alkaloids effective April 12. April 12, 2004. Accessed January 18, 2008 <http://www.fda.gov/bbs/topics/news/2004/NEW01050.html>.
Food and Drug Administration. The Tenth Circuit Court of Appeals Upholds FDA's Decision Banning Dietary Supplements Containing Ephedrine Alkaloids. August 23, 2006. Accessed January 18, 2008 <http://www.cfsan.fda.gov/~dms/cfsup145.html>.
Health Canada. Ephedra/ephedrine - Frequently Asked Questions. January 2002. Accessed January 18, 2008. <http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2002/2002_01bk2_e.html>.
National Institutes of Health Office of Dietary Supplements. Ephedra and Ephedrine Alkaloids for Weight Loss and Athletic Performance. July 1, 2004. Accessed January 18, 2008. <http://dietary-supplements.info.nih.gov/factsheets/ephedraandephedrine.asp>.
Shekelle P, Morton SC, Maglione M, Hardy M, Suttorp M, Roth E, Jungvig L, Mojica W, Gagné J, Rhodes S, McKinnon E, and Newberry S. Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects. Prepared for the Agency for Healthcare Research and Quality, 2003. Accessed January 18, 2008. <www.ahrq.gov/clinic/ephedinv.htm>.
