ma huang

Generic Name: ma huang (ephedra) (ma huang (ee FED ra))
Brand Name:

What is ma huang (ephedra)?

Because ma huang (ephedra) has been reported to cause serious, even fatal, side effects such as heart attack, stroke, irregular heartbeats, and sudden death, the FDA has recommended that consumers not take ma huang.

The use of ma huang in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous.

Ma huang is also known as sea ephedrine, ephedra, ephedra alkaloids, sea grape, yellow horse, yellow astringent, joint fir, squaw tea, Mormon tea, popotillo, and teamster's tea.

Ma huang has been used as a stimulant and for weight loss and appetite suppression.

Ma huang has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of ma huang may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Ma huang may also have uses other than those listed in this medication guide.

What is the most important information I should know about ma huang (ephedra)?

Because ma huang (ephedra) has been reported to cause serious, even fatal, side effects such as heart attack, stroke, irregular heartbeats, and sudden death, the FDA has recommended that consumers not take ma huang.

Ma huang is not recommended for use by people with heart disease; angina (chest pain); irregular heartbeats; high blood pressure; blood vessel disease; asthma or other lung disease; diabetes; insomnia; eating disorders (such as anorexia or bulimia); glaucoma; kidney disease; liver disease or hepatitis; mental health problems such as anxiety, depression, mania, bipolar disorder or psychosis; hyperthyroidism; prostate problems; urinary retention; or seizures.

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Ma huang has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of ma huang may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

What should I discuss with my healthcare provider before taking ma huang (ephedra)?

Ma huang is not recommended for use by people with

  • heart disease; angina (chest pain); irregular heartbeats; high blood pressure; or blood vessel disease;

  • asthma or other lung disease;

  • diabetes;

  • insomnia;

  • eating disorders (such as anorexia or bulimia);

  • glaucoma;

  • kidney disease;

  • liver disease or hepatitis;

  • hyperthyroidism;

  • mental health problems such as anxiety, depression, mania, bipolar disorder or psychosis;

  • prostate problems;

  • urinary retention; or

  • seizures.

The use of ma huang may be dangerous if you have any of the conditions listed above.

Before taking ma huang, talk to your doctor, pharmacist, or health care professional if you have allergies (especially to plants), have any medical condition, or if you take other medicines or other herbal/health supplements. Ma huang may not be recommended in some situations.

Do not take ma huang without first talking to your doctor if you are pregnant or could become pregnant. Ma huang may be harmful to an unborn baby.

Do not take ma huang without first talking to your doctor if you are breast-feeding a baby. Ma huang may be harmful to a nursing infant.

There is no information available regarding the use of ma huang by children. Do not give any herbal/health supplement to a child without first talking to the child's doctor.

How should I take ma huang (ephedra)?

The use of ma huang in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous.

Because ma huang (ephedra) has been reported to cause serious, even fatal, side effects such as heart attack, stroke, irregular heartbeats, and sudden death, the FDA has recommended that consumers not take ma huang.

If you choose to take ma huang, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider.

Standardized extracts, tinctures, and solid formulations of herbal/health supplements may provide a more reliable dose of the product.

Ma huang is usually taken by mouth. Take each dose with a full glass of water.

Taking ma huang with food may decrease stomach upset.

The recommended dose of ma huang is no more than 100 mg per day for no longer than 12 weeks. However, in some people, doses of 100 mg per day may not be safe. Consultation with a healthcare provider is recommended before taking ma huang.

Because ma huang has been reported to cause serious, even fatal, side effects such as heart attack, stroke, irregular heartbeats, and sudden death, the FDA has recommended that ephedra alkaloids (ma huang) be taken in doses no larger than 8 mg per serving, no more often than every 6 hours, and not to exceed 24 mg per day.

Do not use different formulations of ma huang or other products that contain ma huang or ephedra, caffeine, gotu kola, guarana, pseudoephedrine, phenylephrine, or other stimulants at the same time. Using different formulations together increases the risk of an overdose or serious side effects.

Store ma huang as directed on the package.

What happens if I miss a dose?

Missing a dose of ma huang is not harmful. Do not take a double dose to catch up, simply return to the regular schedule. Consult your doctor, pharmacist, or health care professional if you require further information.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of an ma huang overdose may include heart problems (heart attack, high blood pressure, irregular heartbeats), stroke, and/or death.

What should I avoid while taking ma huang (ephedra)?

Do not take other products that contain ma huang; ephedra; ephedra alkaloids; ephedrine; decongestants such as pseudoephedrine, phenylephrine, and others; weight loss medications; amphetamines; or other stimulants while taking ma huang.

Avoid products that contain caffeine while taking ma huang. Coffee, tea, cola, chocolate and herbal products that contain gotu kola, kola nut, guarana, and others are sources of caffeine.

Tell your doctor or dentist that you are taking this product before having surgery.

Ma huang (ephedra) side effects

Serious, even fatal, side effects have been reported with the use of ma huang. Stop taking the product and seek emergency medical attention if you experience:

  • a serious allergic reaction including difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives;

  • chest pain or irregular heartbeats;

  • increased blood pressure;

  • agitation, hostility, or personality changes;

  • thoughts of suicide;

  • pain or difficulty passing urine;

  • rapid or troubled breathing;

  • rash;

  • stomach pain;

  • vomiting; or

  • yellowing of the skin or eyes

Other less serious side effects have also been reported. Talk to your doctor or pharmacist if you experience

  • anxiety;

  • tremor or restlessness;

  • insomnia or difficulty sleeping;

  • dry mouth;

  • headache;

  • decreased appetite; or

  • nausea.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ma huang (ephedra)?

Do not take ma huang if you are taken or have recently taken (within the last 2 weeks):

  • a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl);

  • amphetamine-dextroamphetamine (Adderall);

  • pemoline (Cylert);

  • methylphenidate (Ritalin, Metadate, Methylin, Concerta);

  • dexmethylphenidate (Focalin);

  • amphetamine, dextroamphetamine (Dexadrine, Dextrostat), or methamphetamine (Desoxyn);

  • atomoxetine (Strattera);

  • a heart disease or blood pressure medicine;

  • ergot alkaloids such as ergotamine (Ergomar, Cafergot, Wigraine, Ercaf, others), or dihydroergotamine (D.H.E., Migranal);

  • thyroid hormones;

  • acetazolamide (Diamox), dichlorphenamide (Daranide), or methazolamide (Glauctabs, MZM, Neptazane);

  • atropine (Sal-Tropine);

  • a phenothiazine such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), promethazine (Phenergan), prochlorperazine (Compazine), perphenazine (Trilafon), trifluoperazine (Stelazine), and others;

  • a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor, Aventyl), trimipramine (Surmontil), or protriptyline (Vivactil);

  • an oral or injectable diabetes medicine (e.g., insulin);

  • haloperidol (Haldol);

  • cocaine;

  • a steroid medication such as cortisone (Cortone, others), prednisone (Deltasone, Orasone, others), methylprednisolone (Medrol), prednisolone (Prelone), and others;

  • creatine;

  • digoxin (Lanoxin);

  • linezolid (Zyvox);

  • procarbazine (Matulane);

  • an appetite suppressant or weight loss medication such as diethylpropion (Tenuate), benzphetamine (Didrex), phendimetrazine (Adipost, Bontril, Melfiat, Phendiet, Plegine, Prelu-2), phentermine (Adipex-P, Fastin, Ionamin, Obenix, Pro-Fast, Teramine, Zantryl), mazindol (Mazanor, Sanorex), sibutramine (Meridia), and others;

  • theophylline (Elixophyllin, Slo-Phyllin, Theo-Dur, Theochron, others) or aminophylline (Truphylline);

  • furazolindone (Furoxone);

  • general anesthetics (used during surgery); or

  • yohimbine.

You may not be able to take ma huang, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Do not take other products that contain ma huang; ephedra; ephedra alkaloids; ephedrine; decongestants such as pseudoephedrine, phenylephrine, and others; weight loss medications; amphetamines; or other stimulants while taking ma huang.

Avoid products that contain caffeine while taking ma huang. Coffee, tea, cola, chocolate and herbal products that contain gotu kola, kola nut, guarana, and others are sources of caffeine.

Drugs other than those listed here may also interact with ma huang. Talk to your doctor, pharmacist, or health care professional before taking any prescription or over-the-counter medicines or other herbal/health supplements.

Where can I get more information?

  • Your doctor, pharmacist, or health care provider may have more information about ma huang.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.04. Revision Date: 2010-12-15, 5:01:39 PM.

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