Side effects and dependence are less likely, though, if you take this herb for no longer than seven days at a time and wait at least three weeks before taking it again. You can safely take ephedra with a number of other herbs, including St. John's wort. Be sure to purchase preparations made from an effective ephedra species, such as E. sinica. If you are taking an MAO inhibitor for the treatment of depression or a prescription diuretic, check with your doctor before taking ephedra. Ephedra does not appear to interact negatively with other herbs.
Some people develop an increased heart rate when taking ephedra, even at recommended doses.
At higher than recommended doses, or if ephedra is taken for long periods, reactions such as nervousness, heart palpitations, paleness and insomnia may develop. Among the less common side effects are dizziness, loss of appetite, nausea and vomiting, muscle cramps, tingling, headache, kidney stones and difficult or painful urination. Dangerous reactions include high blood pressure, stroke and seizures. Very high doses can cause hallucinations and psychosis. Tolerance to ephedra-containing products can develop, meaning that over time, your body starts to require higher doses to produce the same effect.