Dietary Supplements: Ephedra Page: 4 of 20
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Dietary Supplements: Ephedra
Background
Ephedrine is the pharmaceutically active compound found in both natural form
in herbal ephedra and the synthetic ingredient present in certain over-the-counter
(OTC) drug products.1 Recent attention to the dietary supplements containing
ephedra and their regulatory status has been of concern to Congress, the supplement
industry and consumers. This report will attempt to clarify the current regulatory
status of dietary supplement products containing ephedra.
Ephedra is a botanical, whose herbal properties have been known for centuries
by the name of Ma Huang in China, where it was first used as a remedy for the
treatment of bronchial asthma. Although some 40 species are known worldwide, its
herbal and pharmaceutical effects are attributable to the contents of ephedrine and
related alkaloids found primarily in the species of Chinese origin. Historically,
practitioners of traditional medicine in China have been trained in the art and skills
of compounding small amounts of a variety of botanical ingredients, including
ephedra, to treat specific conditions. Ma Huang has generally been consumed in the
form of an invigorating tea or infusion with beneficial effects on respiration. Most
recently, ephedra in pill form has been promoted for weight reduction and as a
performance enhancer in body building and other sports.
In western cultures, ephedrine has been used for years in various drug products.
Ephedrine is mainly used as an ingredient in bronchodilator and decongestants, for
treating asthma and hayfever, and to combat circulatory collapse in reaction to
anesthesia, poisoning, shock and allergic reactions.
The pharmaceutical effects of ephedra are due to the ephedrine alkaloids, but the
herbal product may not have the same physiological effect as the pure compound,
which can be produced synthetically. The ephedra herb has been used for similar
medical purposes, although dietary supplement advocates claim that its action is
more gentle and less likely to cause adverse effects. However, a report that
investigated the pharmacokinetics of ephedrine from three commercially available
herbal Ma Huang products, compared to 25 milligrams (mg) ephedrine hydrochloride
capsules showed that the products had similar effect.2 The authors reported that
Note: Since ephedrine is the active chemical present in both dietary supplements and OTC
drug products, the term ephedra will be used to refer to the dietary supplement (natural)
form and ephedrine will refer to the drug (synthetic) form for purposes of this report.
2 Gurley, B., et al. Ephedrine pharmacokinetics after ingestion of nutritional supplements
containing Ephedra sinica (Ma Huang). Therapeutic Drug Monitoring. 1998. v. 20, pp. 439-
445.
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Porter, Donna V. Dietary Supplements: Ephedra, report, February 4, 2004; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc806435/m1/4/: accessed April 18, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.