Ephedrine

Last Updated: December 19 2022

Ephedrine is one of the four active components of the herb Ephedra. It is able to induce fat loss via increasing the amount of fat available for fuel as well as by increasing heat expenditure. It has been implicated in increasing the metabolic rate by up to 5% in humans. It has also been noted to cause serious side-effects in some instances, and its legal status varies by region.

Ephedrine is most often used for

What is ephedrine?

Ephedrine is a stimulant that activates the sympathetic nervous system. It is chemically synthesized for use as a drug in clinical practice, but ephedrine is also one of the ephedrine-type alkaloids that are extracted from plants in the Ephedra genus and have effects on the heart, vascular system, and other organs.[79] Supplements derived from Ephedra plants (e.g., the Chinese botanical Ma Huang) are often referred to as “ephedra” and are marketed for many uses, including weight loss.[80] Due to ephedra’s serious side effects, the Food and Drug Administration (FDA) has banned the sale of dietary supplements containing ephedra and ephedrine-type alkaloids in the United States.[81]

What are ephedrine’s main benefits?

Ephedrine and supplements derived from Ephedra plants can cause weight loss[80][82] and improve blood lipid profiles (increased HDL cholesterol and decreased LDL cholesterol and triglycerides).[82] Some studies show that ephedrine and ephedra supplements can improve exercise performance,[80][83][84][85] but these effects are not consistent and are often found only when ephedrine is taken in combination with caffeine.[80][83][86][87]

What are ephedrine’s main drawbacks?

Ephedrine and supplements derived from Ephedra plants can cause autonomic hyperactivity (e.g., heart palpitations, tremors, twitching, insomnia, and sweating), gastrointestinal problems (e.g., nausea, vomiting, reflux, and heartburn), and psychiatric symptoms (e.g., agitation, lowered mood, irritability, and anxiety).[82][80] Ephedra supplements have also been implicated in adverse cardiovascular and cerebrovascular outcomes including stroke, heart attack, and death.[88][80]

Furthermore, ephedrine and its derivatives (pseudoephedrine, methylephedrine, etc.) are currently included on the prohibited list of substances issued by the World Anti-Doping Agency (WADA). Therefore, athletes who use ephedra supplements or over-the-counter drugs containing ephedrine (e.g., decongestants) must ensure that they are following the rules of their sport and holding the necessary therapeutic use exemptions (TUE).

How does ephedrine work?

The exact mechanisms are not fully understood but both ephedrine[89][90] (the drug) and ephedrine-type alkaloids[79][91] (from Ephedra plants) activate various adrenergic receptors in multiple tissues (heart, lungs, blood vessels, adipose tissue, muscles, etc.). This increases sympathetic nervous system activity, causing heart rate and blood pressure to rise and bronchioles in the lungs to dilate. The role of ephedrine and ephedra supplements in weight loss is likely related to increased fatty acid release from fat stores (adipose) and increased whole-body fat oxidation and energy expenditure.[92][93][94] Because a rise in energy expenditure would increase heat production (thermogenesis), this likely explains the increased sweating caused by ephedrine and ephedra supplements.

What else is Ephedrine known as?
Note that Ephedrine is also known as:
  • Ephedra Vulgaris
  • Ephedraceae
  • ma huang
Ephedrine should not be confused with:
  • Ephedrone
  • Epinephrine
Dosage information

All Doses Standardized to Ephedrine HCl

In an ECA stack, ephedrine is dosed at 20-24mg for three doses taken throughout the day.

Human studies have found success with ephedrine in isolation on fat metabolism with doses of 20-50mg thrice a day. The higher range (150mg) may be too stimulatory for some, and can induce headaches or light hand tremors.

Ephedrine tends to be consumed with xanthine compounds like caffeine and sometimes with Aspirin. The combination of Ephedrine and caffeine is shown repeatedly to be highly synergistic.

Join our supplement information course

Examine Database: Ephedrine
What works and what doesn't?

Unlock the full potential of Examine

Get started

Don't miss out on the latest research

References
1.^Caveney S, Charlet DA, Freitag H, Maier-Stolte M, Starratt ANNew observations on the secondary chemistry of world Ephedra (Ephedraceae)Am J Bot.(2001 Jul)
7.^Van Eenoo P, Lootens L, Spaerkeer A, Van Thuyne W, Deventer K, Delbeke FTResults of stability studies with doping agents in urineJ Anal Toxicol.(2007 Nov-Dec)
8.^Jiménez C, de la Torre R, Ventura M, Segura J, Ventura RStability studies of amphetamine and ephedrine derivatives in urineJ Chromatogr B Analyt Technol Biomed Life Sci.(2006 Oct 20)
10.^Kucio C, Jonderko K, Adamczak DEffect of ephedrine on gastric emptying in obese patientsPol Arch Med Wewn.(1991 Jul)
11.^Astrup A, Toubro S, Christensen NJ, Quaade FPharmacology of thermogenic drugsAm J Clin Nutr.(1992 Jan)
16.^Haller CA, Jacob P 3rd, Benowitz NLEnhanced stimulant and metabolic effects of combined ephedrine and caffeineClin Pharmacol Ther.(2004 Apr)
18.^Ma G, Bavadekar SA, Davis YM, Lalchandani SG, Nagmani R, Schaneberg BT, Khan IA, Feller DRPharmacological effects of ephedrine alkaloids on human alpha(1)- and alpha(2)-adrenergic receptor subtypesJ Pharmacol Exp Ther.(2007 Jul)
19.^Vansal SS, Feller DRDirect effects of ephedrine isomers on human beta-adrenergic receptor subtypesBiochem Pharmacol.(1999 Sep 1)
20.^Shannon JR, Gottesdiener K, Jordan J, Chen K, Flattery S, Larson PJ, Candelore MR, Gertz B, Robertson D, Sun MAcute effect of ephedrine on 24-h energy balanceClin Sci {Lond}.(1999 May)
21.^Cheng JT, Liu IM, Yen ST, Juang SW, Liu TP, Chan PStimulatory effect of D-ephedrine on beta3-adrenoceptors in adipose tissue of ratsAuton Neurosci.(2001 Apr 12)
22.^Astrup A, Lundsgaard C, Madsen J, Christensen NJEnhanced thermogenic responsiveness during chronic ephedrine treatment in manAm J Clin Nutr.(1985 Jul)
23.^Nielsen B, Astrup A, Samuelsen P, Wengholt H, Christensen NJEffect of physical training on thermogenic responses to cold and ephedrine in obesityInt J Obes Relat Metab Disord.(1993 Jul)
26.^Vukovich MD, Schoorman R, Heilman C, Jacob P 3rd, Benowitz NLCaffeine-herbal ephedra combination increases resting energy expenditure, heart rate and blood pressureClin Exp Pharmacol Physiol.(2005 Jan-Feb)
28.^Astrup A, Buemann B, Christensen NJ, Toubro S, Thorbek G, Victor OJ, Quaade FThe effect of ephedrine/caffeine mixture on energy expenditure and body composition in obese womenMetabolism.(1992 Jul)
29.^Greenway FL, Bray GATreatment of hypothalamic obesity with caffeine and ephedrineEndocr Pract.(2008 Sep)
31.^Daly PA, Krieger DR, Dulloo AG, Young JB, Landsberg LEphedrine, caffeine and aspirin: safety and efficacy for treatment of human obesityInt J Obes Relat Metab Disord.(1993 Feb)
34.^Pasquali R, Casimirri F, Melchionda N, Grossi G, Bortoluzzi L, Morselli Labate AM, Stefanini C, Raitano AEffects of chronic administration of ephedrine during very-low-calorie diets on energy expenditure, protein metabolism and hormone levels in obese subjectsClin Sci (Lond).(1992 Jan)
35.^Astrup A, Bülow J, Madsen J, Christensen NJContribution of BAT and skeletal muscle to thermogenesis induced by ephedrine in manAm J Physiol.(1985 May)
36.^Williams AD, Cribb PJ, Cooke MB, Hayes AThe effect of ephedra and caffeine on maximal strength and power in resistance-trained athletesJ Strength Cond Res.(2008 Mar)
37.^Jacobs I, Pasternak H, Bell DGEffects of ephedrine, caffeine, and their combination on muscular enduranceMed Sci Sports Exerc.(2003 Jun)
39.^Bell DG, Jacobs I, Ellerington KEffect of caffeine and ephedrine ingestion on anaerobic exercise performanceMed Sci Sports Exerc.(2001 Aug)
41.^Bell DG, Jacobs I, Zamecnik JEffects of caffeine, ephedrine and their combination on time to exhaustion during high-intensity exerciseEur J Appl Physiol Occup Physiol.(1998 Apr)
42.^Bell DG, Jacobs I, McLellan TM, Zamecnik JReducing the dose of combined caffeine and ephedrine preserves the ergogenic effectAviat Space Environ Med.(2000 Apr)
43.^Bell DG, McLellan TM, Sabiston CMEffect of ingesting caffeine and ephedrine on 10-km run performanceMed Sci Sports Exerc.(2002 Feb)
45.^Ingerslev J, Svendsen TL, Mørk AIs an ephedrine caffeine treatment contraindicated in hypertensionInt J Obes Relat Metab Disord.(1997 Aug)
47.^Hackman RM, Havel PJ, Schwartz HJ, Rutledge JC, Watnik MR, Noceti EM, Stohs SJ, Stern JS, Keen CLMultinutrient supplement containing ephedra and caffeine causes weight loss and improves metabolic risk factors in obese women: a randomized controlled trialInt J Obes (Lond).(2006 Oct)
48.^Boozer CN, Daly PA, Homel P, Solomon JL, Blanchard D, Nasser JA, Strauss R, Meredith THerbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trialInt J Obes Relat Metab Disord.(2002 May)
50.^Dunnick JK, Kissling G, Gerken DK, Vallant MA, Nyska ACardiotoxicity of Ma Huang/caffeine or ephedrine/caffeine in a rodent model systemToxicol Pathol.(2007 Aug)
51.^Nyska A, Murphy E, Foley JF, Collins BJ, Petranka J, Howden R, Hanlon P, Dunnick JKAcute hemorrhagic myocardial necrosis and sudden death of rats exposed to a combination of ephedrine and caffeineToxicol Sci.(2005 Feb)
52.^Howden R, Hanlon PR, Petranka JG, Kleeberger S, Bucher J, Dunnick J, Nyska A, Murphy EEphedrine plus caffeine causes age-dependent cardiovascular responses in Fischer 344 ratsAm J Physiol Heart Circ Physiol.(2005 May)
53.^Buemann B, Marckmann P, Christensen NJ, Astrup AThe effect of ephedrine plus caffeine on plasma lipids and lipoproteins during a 4.2 MJ/day dietInt J Obes Relat Metab Disord.(1994 May)
55.^Krieger DR, Daly PA, Dulloo AG, Ransil BJ, Young JB, Landsberg LEphedrine, caffeine and aspirin promote weight loss in obese subjectsTrans Assoc Am Physicians.(1990)
64.^Nørregaard J, Jørgensen S, Mikkelsen KL, Tønnesen P, Iversen E, Sørensen T, Søeberg B, Jakobsen HBThe effect of ephedrine plus caffeine on smoking cessation and postcessation weight gainClin Pharmacol Ther.(1996 Dec)
66.^Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, Rhodes SL, Jungvig L, Gagné JEfficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysisJAMA.(2003 Mar 26)
67.^Toubro S, Astrup A, Breum L, Quaade FThe acute and chronic effects of ephedrine/caffeine mixtures on energy expenditure and glucose metabolism in humansInt J Obes Relat Metab Disord.(1993 Dec)
68.^Toubro S, Astrup AV, Breum L, Quaade FSafety and efficacy of long-term treatment with ephedrine, caffeine and an ephedrine/caffeine mixtureInt J Obes Relat Metab Disord.(1993 Feb)
71.^Bruno A, Nolte KB, Chapin JStroke associated with ephedrine useNeurology.(1993 Jul)
72.^Martínez-Quintana E, Rodríguez-González F, Cuba-Herrera JMyocardial necrosis and severe biventricular dysfunction in the context of chronic ephedrine abuseAdicciones.(2010)
73.^Flanagan CM, Kaesberg JL, Mitchell ES, Ferguson MA, Haigney MCCoronary artery aneurysm and thrombosis following chronic ephedra useInt J Cardiol.(2010 Feb 18)
75.^Sachdeva R, Sivasankaran S, Fishman RF, Zarich SW, McPherson CACoronary thrombosis related to use of Xenadrine RFATex Heart Inst J.(2005)
76.^Backer R, Tautman D, Lowry S, Harvey CM, Poklis AFatal ephedrine intoxicationJ Forensic Sci.(1997 Jan)