Ephedra

Botanical

What is it

Ephedra refers to plants of the genus Ephedra, most importantly Ephedra sinica (ma huang), which contain the stimulant alkaloids ephedrine and pseudoephedrine. Ephedra alkaloid supplements have been banned in the United States since 2004.

Evidence for 1 use

AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.

Asthma and decongestion (medical pseudoephedrine/ephedrine)

Strong Evidence

Purified ephedrine and pseudoephedrine are effective for asthma and nasal congestion in regulated medical settings, separate from supplement use.

How it works

Ephedrine and related alkaloids stimulate alpha and beta adrenergic receptors, raising heart rate, blood pressure, and metabolic rate. They also dilate bronchi, which is why ephedrine was historically used in asthma medications. The alkaloid content of the raw plant varies widely, making dosing unpredictable. Clinical trials before the ban showed modest weight loss, but at the cost of significant cardiovascular adverse events. Ephedrine remains a regulated medication in some countries.

Dosage

Ephedra alkaloid-containing supplements are banned for sale in the US. Where legally available (for example, in some traditional Chinese medicine contexts), doses are set by clinicians. Medical ephedrine is dosed per drug labeling, not as a supplement.

When and how to take it

Not applicable as a self-administered supplement in the US.

2 commercial forms

Compare the main delivery options and what they’re best suited for.

Ephedra sinica herb extract

Banned in the US as a dietary supplement.

Variable alkaloid content; safety concerns

Ephedra-derived medical ephedrine

Regulated as a medication, not a supplement.

Standardized prescription form

Safety

Ephedra has been linked to heart attacks, strokes, seizures, severe hypertension, and deaths, especially when combined with caffeine or in people with cardiovascular risk factors. The FDA banned dietary supplements containing ephedrine alkaloids based on this risk.

Who should be cautious

Avoid in everyone using over-the-counter supplements. Specifically avoid in cardiovascular disease, hypertension, hyperthyroidism, anxiety disorders, pregnancy, breastfeeding, and in children and the elderly. Banned by most sports organizations.

Interactions

Severe interactions with MAO inhibitors, other stimulants, caffeine, decongestants, antihypertensives, theophylline, and many psychiatric medications. Risk of hypertensive crisis and serotonin-syndrome-like reactions.

Documented interactions

Evidence-graded pair pages with sources, dosing notes, and timing guidance — a complement to the narrative section above.

Warnings (1)

+ caffeine

critical

Combining caffeine with ephedra adds two stimulants together and can drive dangerous increases in heart rate and blood pressure.

See all 1 Ephedra interaction →

Frequently asked questions

Is ephedra still legal?⌄

Ephedrine alkaloid dietary supplements have been banned in the US since 2004. Medical use of ephedrine is regulated separately.

Are "ephedra-free" stimulant supplements safer?⌄

Not necessarily. Many use other stimulants such as synephrine, caffeine, or DMHA, which carry their own risks.

References

Ephedra on Wikidata — Wikidata link

Ephedra on NIH DSLD (US supplement label database) — NIH Dietary Supplement Label Database link

Research on Ephedra (PubMed search) — PubMed link

Track Ephedra with Pilora

Set up dose reminders, check interactions, and join the community in the Pilora iPhone app.

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Evidence-based·How we grade evidence

Disclaimer: These statements have not been evaluated by the FDA. This page is educational, not a substitute for personalized medical advice. Evidence grades are AI-assisted assessments — talk to your doctor before starting any new supplement, especially if you’re pregnant, breastfeeding, on medications, or managing a chronic condition.