Ephedrine

Last Updated: July 22, 2023

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.

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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.[1] 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.[2] 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.[3]

What are ephedrine’s main benefits?

Ephedrine and supplements derived from Ephedra plants can cause weight loss[2][4] and improve blood lipid profiles (increased HDL cholesterol and decreased LDL cholesterol and triglycerides).[4] Some studies show that ephedrine and ephedra supplements can improve exercise performance,[2][5][6][7] but these effects are not consistent and are often found only when ephedrine is taken in combination with caffeine.[2][5][8][9]

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).[4][2] Ephedra supplements have also been implicated in adverse cardiovascular and cerebrovascular outcomes including stroke, heart attack, and death.[10][2]

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[11][12] (the drug) and ephedrine-type alkaloids[1][13] (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.[14][15][16] 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.

Examine Database: Ephedrine
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References
  1. ^González-Juárez DE, Escobedo-Moratilla A, Flores J, Hidalgo-Figueroa S, Martínez-Tagüeña N, Morales-Jiménez J, Muñiz-Ramírez A, Pastor-Palacios G, Pérez-Miranda S, Ramírez-Hernández A, Trujillo J, Bautista EA Review of the genus: Distribution, Ecology, Ethnobotany, Phytochemistry and Pharmacological Properties.Molecules.(2020-Jul-20)
  2. ^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)
  3. ^Food and Drug Administration, HHSFinal rule declaring dietary supplements containing ephedrine alkaloids adulterated because they present an unreasonable risk. Final ruleFed Regist.(2004 Feb 11)
  4. ^Yoo HJ, Yoon HY, Yee J, Gwak HSEffects of Ephedrine-Containing Products on Weight Loss and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Pharmaceuticals (Basel).(2021-Nov-22)
  5. ^Magkos F, Kavouras SACaffeine and ephedrine: physiological, metabolic and performance-enhancing effects.Sports Med.(2004)
  6. ^Bell DG, McLellan TM, Sabiston CMEffect of ingesting caffeine and ephedrine on 10-km run performance.Med Sci Sports Exerc.(2002-Feb)
  7. ^Jacobs I, Pasternak H, Bell DGEffects of ephedrine, caffeine, and their combination on muscular endurance.Med Sci Sports Exerc.(2003-Jun)
  8. ^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)
  9. ^Bell DG, Jacobs I, Ellerington KEffect of caffeine and ephedrine ingestion on anaerobic exercise performance.Med Sci Sports Exerc.(2001-Aug)
  10. ^Richard Andraws, Preety Chawla, David L BrownCardiovascular effects of ephedra alkaloids: a comprehensive reviewProg Cardiovasc Dis.(2005 Jan-Feb)
  11. ^Stohs SJ, Shara M, Ray SDp-Synephrine, ephedrine, p-octopamine and m-synephrine: Comparative mechanistic, physiological and pharmacological properties.Phytother Res.(2020-Aug)
  12. ^Vansal SS, Feller DRDirect effects of ephedrine isomers on human beta-adrenergic receptor subtypes.Biochem Pharmacol.(1999-Sep-01)
  13. ^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 subtypes.J Pharmacol Exp Ther.(2007-Jul)
  14. ^Astrup A, Breum L, Toubro SPharmacological and clinical studies of ephedrine and other thermogenic agonists.Obes Res.(1995-Nov)
  15. ^Napolitano A, Murgatroyd PR, Finer N, Hussey EK, Dobbins R, O'Rahilly S, Nunez DJAssessment of acute and chronic pharmacological effects on energy expenditure and macronutrient oxidation in humans: responses to ephedrine.J Obes.(2011)
  16. ^A Astrup, J Bülow, J Madsen, N J ChristensenContribution of BAT and skeletal muscle to thermogenesis induced by ephedrine in manAm J Physiol.(1985 May)
Examine Database References
  1. Appetite - Toubro S, Astrup ARandomised comparison of diets for maintaining obese subjects' weight after major weight loss: ad lib, low fat, high carbohydrate diet v fixed energy intakeBMJ.(1997 Jan 4)
  2. Weight - 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)
  3. Weight - Coffey CS, Steiner D, Baker BA, Allison DBA randomized double-blind placebo-controlled clinical trial of a product containing ephedrine, caffeine, and other ingredients from herbal sources for treatment of overweight and obesity in the absence of lifestyle treatmentInt J Obes Relat Metab Disord.(2004 Nov)
  4. Weight - Pasquali R, Cesari MP, Melchionda N, Stefanini C, Raitano A, Labo GDoes ephedrine promote weight loss in low-energy-adapted obese womenInt J Obes.(1987)
  5. Weight - Ingerslev J, Svendsen TL, Mørk AIs an ephedrine caffeine treatment contraindicated in hypertensionInt J Obes Relat Metab Disord.(1997 Aug)
  6. Weight - Kim HJ, Park JM, Kim JA, Ko BPEffect of herbal Ephedra sinica and Evodia rutaecarpa on body composition and resting metabolic rate: a randomized, double-blind clinical trial in Korean premenopausal womenJ Acupunct Meridian Stud.(2008 Dec)
  7. Metabolic Rate - Molnár DEffects of ephedrine and aminophylline on resting energy expenditure in obese adolescentsInt J Obes Relat Metab Disord.(1993 Feb)
  8. Metabolic Rate - 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)
  9. Metabolic Rate - B Nielsen, A Astrup, P Samuelsen, H Wengholt, N J ChristensenEffect of physical training on thermogenic responses to cold and ephedrine in obesityInt J Obes Relat Metab Disord.(1993 Jul)
  10. Heart Rate - Eccles R, Jawad MS, Jawad SS, Angello JT, Druce HMEfficacy and safety of single and multiple doses of pseudoephedrine in the treatment of nasal congestion associated with common coldAm J Rhinol.(2005 Jan-Feb)
  11. Nasal Congestion - Taverner D, Danz C, Economos DThe effects of oral pseudoephedrine on nasal patency in the common cold: a double-blind single-dose placebo-controlled trialClin Otolaryngol Allied Sci.(1999 Feb)
  12. Weight - 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)
  13. Weight - Astrup A, Lundsgaard C, Madsen J, Christensen NJEnhanced thermogenic responsiveness during chronic ephedrine treatment in manAm J Clin Nutr.(1985 Jul)
  14. Weight - Bogacka I, Gettys TW, de Jonge L, Nguyen T, Smith JM, Xie H, Greenway F, Smith SRThe effect of beta-adrenergic and peroxisome proliferator-activated receptor-gamma stimulation on target genes related to lipid metabolism in human subcutaneous adipose tissueDiabetes Care.(2007 May)
  15. Metabolic Rate - Dulloo AG, Miller DSThe thermogenic properties of ephedrine/methylxanthine mixtures: human studiesInt J Obes.(1986)
  16. Body Fat - 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)
  17. Body Fat - Boozer CN, Nasser JA, Heymsfield SB, Wang V, Chen G, Solomon JLAn herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trialInt J Obes Relat Metab Disord.(2001 Mar)
  18. Subjective Well-Being - 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)
  19. Metabolic Rate - A Astrup, J Bülow, J Madsen, N J ChristensenContribution of BAT and skeletal muscle to thermogenesis induced by ephedrine in manAm J Physiol.(1985 May)
  20. Nausea Symptoms - Wuhrman E, Clark MUse of ephedrine for the short-term treatment of postoperative nausea and vomiting: a case reportJ Perianesth Nurs.(2011 Oct)