Ephedra (ma huang) is an herb. It contains several substances called ephedra alkaloids, such as ephedrine and pseudoephedrine. Medicines that contain ephedra alkaloids were used to treat nasal congestion and asthma; however, use of the alkaloids for these purposes has declined because of frequent reported adverse effects and safer alternatives. More recently, ephedra has been an ingredient in dietary supplements to “promote weight loss and enhance energy.” Adverse effects, including nervousness, insomnia, heart attack, and stroke, have been reported in patients taking products that contain ephedra or ephedra alkaloids. The actual frequency of adverse effects due to ephedra is unclear. Furthermore, whether adverse effects are more common with ephedra than with other herbal products is unknown.