Herbal Alert Ephedra

Many members of the Ephedra family have been used medicinally (ie, E. sinica and E. intermedia). Ephedra preparations have traditionally been used to relieve cold symptoms, improve respiratory function, as an adjunct in weight loss, and to treat a variety of conditions from headaches to sexually transmitted disease. Large doses may cause a variety of adverse reactions, such as hypertension, irregular heart rate, tremors, epigastric pain, nausea, vomiting, sweating, weakness, and possible dependence. Ephedra is contraindicated in patients with hypertension, glaucoma, hypertrophy of the prostate, urinary tract problems, clotting disorders, anxiety, anorexia, colitis, thyroid disease, or diabetes. Ephedra should not be used with the cardiac glycosides, halothane, guanethi-dine, MAOIs, oxytocin, and in patients taking St. John's wort. Weight loss preparations containing ephedra should be avoided.

Before taking this herb the patient should consult the primary care provider. When taking a standardized extract, 12 to 25 mg total alkaloids (calculated as ephedrine) two to three times daily is the normal dosage. When taking the capsules or tablets, the normal dosage is 500 to 1000 mg two to three times daily.

The FDA warns the public not to take ephedrine-contain-ing dietary supplements with labels that portray the products as an alternative to illegal street drugs such as Ecstasy because these products may pose serious health risks to consumers.

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