Ephedra

© Steven Foster

This fact sheet provides basic information about ephedra—common 

names, what the science says, potential side effects and cautions, and 

resources for more information.

Common Names—ephedra, Chinese ephedra, ma huang

Latin Name—Ephedra sinica

Ephedra is an evergreen shrub-like plant native to Central Asia and 

Mongolia. The principal active ingredient, ephedrine, is a compound 

that can powerfully stimulate the nervous system and heart. Ephedra 

has been used for more than 5,000 years in China and India to treat 

conditions such as colds, fever, flu, headaches, asthma, wheezing, and 

nasal congestion. More recently, ephedra was used as an ingredient in 

dietary supplements for weight loss, increased energy, and enhanced 

athletic performance.

The dried stems and leaves of the ephedra plant have been used to 

create capsules, tablets, tinctures, and teas.

What the Science Says 

• An NCCAM-funded study that analyzed phone calls to poison 

control centers found a higher rate of side effects from ephedra, 

compared with other herbal products.

• Other studies and systematic reviews have found an increased risk 

of heart, psychiatric, and gastrointestinal problems, as well as high 

blood pressure and stroke, with ephedra use.

• According to the U.S. Food and Drug Administration (FDA), there is 

little evidence of ephedra’s effectiveness, except for short-term 

weight loss. However, the increased risk of heart problems and 

stroke outweighs any benefits.

Side Effects and Cautions 

• In 2004, the FDA banned the U.S. sale of dietary supplements 

containing ephedra. The FDA found that these supplements had an 

unreasonable risk of injury or illness—particularly cardiovascular 

complications—and a risk of death. The ban does not apply to 

traditional Chinese herbal remedies or to products like herbal teas 

regulated as conventional foods.1

 

1 Products regulated as drugs that contain chemically synthesized ephedrine are not 

dietary supplements and are not covered by this rule. These include drugs used for the 

short-term treatment of asthma, bronchitis, and allergic reactions.
• Between 1995 and 1997, the FDA received more than 900 reports of possible ephedra toxicity. 

Serious adverse events such as stroke, heart attack, and sudden death were reported in 37 cases.

• Using ephedra may worsen many health conditions such as cardiovascular disease, kidney 

disease, and diabetes.

• Ephedra may cause seizures in otherwise healthy people as well as in people with seizure disorders.

• Taking ephedra can also result in anxiety, difficulty urinating, dry mouth, headache, heart 

damage, high blood pressure, irregular heart rhythms, irritation of the stomach, kidney stones,

nausea, psychosis, restlessness, sleep problems, and tremors.

• Women who are pregnant or breastfeeding and children should avoid taking ephedra.

• Ephedra use may lead to serious health problems when used with other dietary supplements 

or medicines.

• Combining ephedra with caffeine increases the risk of potentially serious side effects.

• Tell all your health care providers about any complementary health practices you use. Give them a 

full picture of what you do to manage your health. This will help ensure coordinated and safe care. 

For tips about talking with your health care providers about complementary and alternative 

medicine, see NCCAM’s Time to Talk campaign at nccam.nih.gov/timetotalk/. 

Sources

Ephedra. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. 

Newton, MA: Lippincott Williams & Wilkins; 2000:110-117.

Ephedra. Natural Medicines Comprehensive Database Web site. Accessed at www.naturaldatabase.com on May 8, 2009.

Ephedra (Ephedra sinica)/Ma huang. Natural Standard Database Web site. Accessed at www.naturalstandard.com on May 8, 2009.

Thurn AL. Ephedra (Ma Huang). In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. 

New York, NY: Marcel Dekker; 2005:189-195.

U.S. Food and Drug Administration. Final rule declaring dietary supplements containing ephedrine alkaloids adulterated 

because they present an unreasonable risk. Federal Register. 2004;69(28):6788-6854.

For More Information

Visit the NCCAM Web site at nccam.nih.gov and view Using Dietary Supplements Wisely

(nccam.nih.gov/health/supplements/wiseuse.htm).

NCCAM Clearinghouse

Toll-free in the U.S.: 1-888-644-6226

TTY (for deaf and hard-of-hearing callers): 1-866-464-3615

E-mail: info@nccam.nih.gov

PubMed®

Web site: www.ncbi.nlm.nih.gov/sites/entrez

NIH Office of Dietary Supplements

Web site: www.ods.od.nih.gov

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of 

your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care 

provider. The mention of any product, service, or therapy is not an endorsement by NCCAM.

National Institutes of Health

♦♦♦

U.S. Department of Health and Human Services

D336

Created December 2006

Updated April 2012