Ephedrine

Ephedrine is a sympathomimetic stimulant and bronchodilator derived from Ephedra plants (ma huang) and also made synthetically. Medically it has been used as a decongestant, to treat low blood pressure during anesthesia, and for asthma. It became widely known in weight-loss and 'energy' supplements before those were banned in the US, and it is chemically related to amphetamine and to pseudoephedrine.

Ephedrine stimulates the sympathetic nervous system, both by triggering release of norepinephrine and by directly activating adrenergic receptors. This raises heart rate and blood pressure, opens the airways (bronchodilation), and constricts blood vessels. Its stimulant and appetite-suppressing effects, and its cardiovascular strain, all flow from this broad adrenergic activity.

Effects include increased alertness and energy, appetite suppression, decongestion, and opened airways, alongside raised heart rate, higher blood pressure, jitteriness, anxiety, insomnia, and palpitations. At higher doses the cardiovascular and neurological stimulation becomes pronounced. Tolerance to the stimulant effects can develop with repeated use.

Ephedrine's central danger is cardiovascular: it raises heart rate and blood pressure and has been linked to heart attack, stroke, dangerous arrhythmias, and death, particularly at high doses, with heavy use, in people with underlying heart conditions, or when combined with other stimulants such as caffeine — the combination common in the banned weight-loss supplements. The FDA banned ephedra (ephedrine-alkaloid) dietary supplements in the US because the risks outweighed benefits. Combining ephedrine with certain antidepressants (MAO inhibitors) can cause a dangerous spike in blood pressure. Overheating and agitation can occur with heavy use. Because pure ephedrine is a methamphetamine precursor, it is legally restricted (see the legal section), and products bought outside regulated channels may be mislabeled or contaminated. Anyone with chest pain, severe headache, signs of stroke, a very high heart rate, or a dangerously high blood pressure needs emergency care — call 911, and Poison Control at 1-800-222-1222 can advise. This page has not yet been medically reviewed.