IV 
108TH CONGRESS 
1ST SESSION 
H. RES. 435
Expressing the sense of the House of Representatives that the Secretary 
of Health and Human Services should take immediate action to remove 
dietary supplements containing ephedrine alkaloids from the market. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 6, 2003
Mrs. DAVIS of California (for herself, Mr. WAXMAN, Mr. GREENWOOD, Mr. 
WALDEN of Oregon, and Mr. SWEENEY) submitted the following resolu-
tion; which was referred to the Committee on Energy and Commerce 
RESOLUTION 
Expressing the sense of the House of Representatives that 
the Secretary of Health and Human Services should 
take immediate action to remove dietary supplements 
containing ephedrine alkaloids from the market.
Whereas, a RAND Corporation study commissioned by the 
Department of Health and Human Services found no evi-
dence for long-term efficacy of ephedrine alkaloids for 
weight loss and that there is no credible science showing 
that ephedrine or dietary supplements containing ephed-
rine alkaloids, as those products are used by the general 
population, improve athletic performance; 
Whereas ephedrine alkaloids can increase heart rate and 
blood pressure and stimulate the central nervous system, 
and can lead to serious adverse events such as strokes,
•HRES 435 IH 
seizures, psychosis, cardiac arrhythmia, heart attacks, 
and deaths; 
Whereas the Food and Drug Administration has received ap-
proximately 16,500 adverse event reports for consumers 
who have used dietary supplements containing ephedrine 
alkaloids, including approximately 155 reports of death; 
Whereas the Inspector General of the Department of Health 
and Human Services has noted with concern that about 
60 percent of persons suffering adverse events related to 
the use of dietary supplements containing ephedrine alka-
loids are under the age of 40; 
Whereas a study published in the Journal of Neurology found 
that there may be an association between the use of more 
than 32 milligrams per day of ephedra and an increased 
risk of hemorragic stroke, while the daily dose rec-
ommended by the dietary supplement industry is about 3 
times that much; 
Whereas a study published in Mayo Clinical Proceedings 
found that in 36 out of 37 serious cardiovascular events 
associated with ephedrine alkaloids examined, the patient 
had consumed doses of a dietary supplement containing 
ephedrine alkaloids at or below the dose recommended by 
the manufacturer; 
Whereas a study commissioned by the Food and Drug Ad-
ministration to review reports of ephedrine alkaloid-re-
lated adverse events (including serious adverse events 
such as seizures, strokes, and death), which resulted in 
publication in the New England Journal of Medicine of 
an article in 2000, found that 31 percent of the reports 
were definitely or probably related to ephedrine alkaloid
•HRES 435 IH 
Whereas major drug store chains representing 17,300 stores 
nationwide have pulled ephedrine alkaloid-containing die-
tary supplements from their shelves; and 
Whereas the largest specialty retailer of dietary supplements 
in the country, which has 5,300 stores nationwide, has 
pulled ephedrine alkaloids from its shelves: Now, there-
fore, be it
Resolved, That it is the sense of the House of Rep-
resentatives that—
(1) the Secretary of Health and Human Serv-
ices has authority under subsections (a) and (f) of 
section 402 of the Federal Food, Drug, and Cos-
metic Act (21 U.S.C. 343) to determine that dietary 
supplements containing ephedrine alkaloids—
(A) present a significant or unreasonable 
risk of illness or injury; 
(B) pose an imminent hazard to public 
health or safety; or 
(C) contain poisonous or deleterious sub-
stances that may render dietary supplements 
injurious to health; 
(2) there is sufficient evidence to make such a 
determination; and 
(3) the Secretary should take immediate action 
to remove dietary supplements containing ephedrine 
alkaloids from the marketplace.
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