EPHEDRA, MA HUANG is a dietary supplement (herbal remedy). Ephedra is usually promoted for weight loss and boosting energy. However, there is no FDA-approved medical use for this herb at this time. Most products that contain Ephedra, Ma Huang (ephedrine) also contain other herbal products. Many products also contain caffeine or herbal sources of caffeine (like guarana or kola nut). The safety and effectiveness of these combination products have not been established. NOTE: The FDA has alerted the public in December 2003 that dietary supplements containing ephedra present an unreasonable health risk of illness or injury. Consumers are urged to stop buying and using these products immediately. The FDA intends to ban the sale of Ephedra products by March 2004. Ephedra, Ma huang is available from many different manufacturers of dietary supplements.
It is important for you to tell your prescriber or other health care professional that you are using ephedra, Ma huang. Some herbs exert potent effects and may interact with other drugs you are taking.
You should discuss ephedra, Ma huang with your health care professional BEFORE taking it if you have any of these conditions:
angina or chest pain
asthma or other lung disease
blood vessel disease
eating disorder like anorexia or bulimia
high blood pressure
irregular heart rhythm
mental health problems like anxiety, depression or psychosis
overweight and taking prescription medications for weight loss
seizures or convulsions
trouble with urination
an unusual or allergic reaction to ephedra, Ma huang, ephedrine, pseudoephedrine, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
Talk to your health care professional prior to taking ephedra or products that contain ephedra or Ma huang. Ephedra, Ma huang is usually taken by mouth (swallowed). If ephedra, Ma huang upsets your stomach, you may want to take each dose with food. Take each dose with a large glass of water.
Ephedra, Ma huang is not for long-term use without the advice of a health care professional. The dosing suggested by manufacturers of ephedra, Ma huang may not be safe in some patients. Get advice from a health care professional regarding the dosing of Ephedra, Ma huang.
Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
Missing a dose is probably not harmful. If you miss a dose, simply resume taking it on your previous schedule; however, do not take extra or double doses to catch up.
Do not take ephedra, Ma huang with any of the following medications:
medicines called MAO inhibitors-phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), selegiline (Eldepryl®)
Ephedra, Ma huang may also interact with the following medications:
corticosteroids, such as prednisone or methylprednisolone
ergot alkaloids, such as ergotamine
guarana or kola nut
medicines for colds and breathing difficulties, such as pseudoephedrine
medicines for mental depression
medicines for heart disease or high blood pressure
prescription stimulants or medicines for weight loss, like dextroamphetamine, diethylpropion, fenfluramine, phendimetrazine and sibutramine
thyroid hormones, such as levothyroxine
For many herbs, interactions with other medications are unknown. That is why you should always be careful when mixing herbal remedies with traditional medications. If you take any other medications or herbs, consult with your health care professional prior to taking ephedra, Ma huang.
Tell your prescriber or health care professional about all other medicines you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check before starting or stopping any of your medicines.
Although you can buy ephedra, Ma Huang without a prescription, check with your health care professional prior to taking ephedra. You may have a condition that might make it dangerous for you to take ephedra, Ma huang in any amounts.
Allergic reactions are possible with ephedra, Ma huang since it comes from a plant. Stop using this herb if you develop a rash or other unusual effects and contact your health care professional.
If ephedra, Ma huang makes it difficult for you to sleep at night, take your last dose a few hours before bedtime, or talk to your health care professional. You may need to stop taking ephedra, Ma huang.
Avoid consumption of caffeine-containing products, such as colas, coffee, tea and chocolate while taking ephedra, Ma huang. Many ephedra herbal products for weight loss also contain caffeine or herbal sources of caffeine (examples: guarana and kola nut). Excessive intake of caffeine may cause nervousness, nausea, fast heartbeat, irritability or other side effects. You should avoid strenuous exercise if you have been taking ephedra, Ma huang.
It is recommended that you avoid excessive consumption of alcoholic beverages while taking ephedra, Ma huang. Alcohol may increase the risk of serious side effects.
The long-term effectiveness of ephedra supplements in weight loss is not well established. Additionally, serious adverse effects have occurred even with short-term use of ephedra, even in otherwise healthy persons. There is no way to predict who may have a serious reaction to ephedra. Risks of side effects may be greater if you have a chronic health condition. Talk to your health care provider about your risk for adverse effects from ephedra, Ma huang.
Different brands of ephedra, Ma huang might contain different amounts of active ingredient. Use a brand from a reliable manufacturer and a product in which the ephedra content has been standardized. The package should list the milligram amount of ephedrine per capsule, tablet, or serving size. A standardized product is more likely to contain the same amount of herb from dose to dose. Your health care professional or pharmacist can assist you in finding a product.
If you are scheduled to have surgery, an outpatient procedure or dental work, let your surgeon or dentist know you are taking ephedra, Ma huang prior to your appointment. You may need to stop taking ephedra, Ma huang several days or weeks before your procedure or surgery.
Side effects that you should report to your prescriber or health care professional as soon as possible:
Rare or Uncommon:
dizziness, or fainting spells
numbness or tingling in the hands or feet
rapid or troubled breathing
severe, persistent, or worsening headache
yellowing of your eyes or skin
anxiety, hostility, or suicidal thoughts
excessive sweating or inability to cool down after strenuous exercise
fast or irregular heartbeat, palpitations
increased blood pressure
pain or difficulty passing urine
skin rash (persistent)
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
agitation or nervousness
loss of appetite
nausea, stomach upset
Keep out of the reach of children in a container that small children cannot open. Many herbal products are not supplied in child-proof packaging.
Store at room temperature below 30 degrees C (86 degrees F). Throw away any unused herb after the expiration date.
GENERAL INFORMATION REGARDING DIETARY SUPPLEMENTS:
Dietary supplements include amino acids, vitamins, minerals, herbs, botanicals, and other plant-derived substances, and extracts of these substances. These products are easy to identify as they must state "Dietary Supplement" on the label. A "Supplement Facts" panel is provided on the label for most products. Supplements are not drugs and are not regulated like drugs. You should note that rigid quality control standards are not required for dietary supplements. Differences in the potency and purity of these products can occur. Scientific data to support the use of a dietary supplement for a certain disease or ailment may not be available. This product is not intended to diagnose, treat, cure or prevent any disease.
The Food and Drug Administration suggests the following to help consumers protect themselves:
Always read product labels and follow directions.
"Natural" doesn't mean a product is safe for humans to take.
Look for products containing ingredients with the "USP" notation. This indicates the manufacturer followed the standards of the US Pharmacopoeia.
Supplements produced or distributed by a nationally known food or drug company are more likely to be made under tight controls as these companies have standards in place for their other products. You can write to the company for more information about how the product was made.