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What is Ephedra (Ma Huang)
Ephedra is the genus name for no less than 40 species of herbs also known as Ma huang, which has been used in Chinese medicine for more than 5000 years. Ephedra species are erect evergreen shrubs.
The stems and twigs contain the highest amounts of alkaloids and the fruits are alkaloid-free. Ephedra is grown in China, India, Pakistan, Europe and North and Central America. Common Ephedra spp. include Ephedra sinica, Ephedra equisetine and Ephedra gerardiana.
The major active agent found in most Ephedra spp. is (-)ephedrine, which constitutes 80—90% of the total alkaloid fraction; (+)pseudoephedrine is usually present in lesser quantities.
Other trace alkaloids include: (-)norephedrine, (+/-)norpseudoephedrine, (-)N-methylephedrine, (+)N-methylpseudoephedrine, (-)pseudoephedrine and (+)norephedrine (also known as phenylpropanolamine or PPA). Total alkaloid content is dependent upon the Ephedra species cultivated, but averages 2%.
However, the North and Central American species contain no sympathomimetic alkaloids. Ephedra spp. have been used in traditional herbal medicine for treatment of mild asthma, bronchitis, enuresis and headache.
Germany’s Commission E has approved Ephedra for short-term use in diseases of the respiratory tract with mild bronchospasms in adults and children > 6 years of age.
In the US, ephedra has no established or recognized role in the management of respiratory disorders.
Indications
- enuresis
- nasal congestion
- obesity
- urinary incontinence
NOTE: Ephedra is not intended to diagnose, treat, cure, or prevent any disease. Consumers should also be informed that rigid quality control standards are not required for nutraceuticals and substantial variability can occur in both the potency and the purity of these products.
Side Effects
- agitation
- angina
- anorexia
- anxiety
- arrhythmia exacerbation
- blurred vision
- cardiac arrest
- chest pain (unspecified)
- dizziness
- elevated hepatic enzymes
- euphoria
- headache
- hepatitis
- hyperbilirubinemia
- hyperglycemia
- hypertension
- insomnia
- irritability
- jaundice
- libido increase
- mania
- myocardial infarction
- myocarditis
- nausea
- palpitations
- physiological dependence
- premature ventricular contractions (PVCs)
- psychological dependence
- psychosis
- rash
- seizures
- sinus tachycardia
- stroke
- suicidal ideation
- supraventricular tachycardia (SVT)
- tolerance
- tremor
- urinary retention
- vasculitis
- ventricular fibrillation
- vomiting
- weakness
- xerostomia
Monitoring Parameters
- (drug no longer available)
- laboratory monitoring not necessary
Contraindications
- acute myocardial infarction
- angina
- anorexia nervosa
- anxiety
- asthma
- breast-feeding
- bulimia nervosa
- cardiac arrhythmias
- cardiac disease
- cardiomyopathy
- children
- coronary artery disease
- depression
- diabetes mellitus
- geriatric
- glaucoma
- heart failure
- hepatic disease
- hepatitis
- hypertension
- hyperthyroidism
- infants
- insomnia
- jaundice
- labor
- MAOI therapy
- neonates
- obesity
- obstetric delivery
- phenylketonuria
- pheochromocytoma
- pregnancy
- prostatic hypertrophy
- psychosis
- pulmonary disease
- renal failure
- renal impairment
- seizure disorder
- seizures
- strenuous exercise
- stroke
- substance abuse
- suicidal ideation
- surgery
- tachycardia
- thyroid disease
- thyrotoxicosis
- urinary retention
- ventricular arrhythmias
- ventricular fibrillation
- ventricular tachycardia
Interactions
No information is available regarding drug interactions associated with Ephedra Ma Huang
