0
Sign In  | Subscribe
18 March 2003, Vol 138, No. 6>
Summaries for Patients | 18 March 2003

Ephedra Is Associated with More Adverse Effects than Other Herbs FREE

[+] Article and Author Information

The summary below is from the full report titled “The Relative Safety of Ephedra Compared with Other Herbal Products.” It is in the 18 March 2003 issue of Annals of Internal Medicine (volume 138, pages 468-471). The authors are S Bent, TN Tiedt, MC Odden, and MG Shlipak.


Ann Intern Med. 2003;138(6):I-56. doi:10.7326/0003-4819-138-6-200303180-00004
Text Size: A A A

What is the problem and what is known about it so far?

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.

Why did the researchers do this particular study?

To find out whether ephedra is associated with more adverse effects than other herbs.

What was studied?

Number of adverse effects reported to poison control centers in the United States in 2001.

How was the study done?

The researchers looked at adverse effects from herbal products that were reported to U.S. poison control centers. A poison control specialist determined whether the adverse effect could be attributed to “normal” or “recommended” use of the product. Reports of overdose or clear abuse of “recommended” use were not examined. The researchers also compared the numbers of different herbal products that were sold in the United States in 2001 with the numbers of reported adverse effects.

What did the researchers find?

Products containing ephedra accounted for 64% of all reported adverse effects from herbs even though they represented less than 1% of total herbal product sales. The risk for an adverse effect from ephedra compared with other commonly used herbal products was very high. For example, relative risks for adverse effects from ephedra were 100 times greater than from kava and as much as 700 times greater than from Ginkgo biloba. Types and severity of adverse effects were not described.

What were the limitations of the study?

The researchers studied adverse effects that were reported to poison control centers. However, many people don't report adverse effects to these centers. More people taking ephedra might have reported effects to the centers, and more people taking other products might have failed to report effects. The actual number of people who took ephedra was not known. Thus, the study does not show the actual frequency of adverse effects in patients taking ephedra.

What are the implications of the study?

Ephedra is associated with greatly increased risk for adverse effects compared with other commonly used herbal products.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Advertisement

Related Content

Customize your page view by dragging & repositioning the boxes below.

Topic Collections
PubMed Articles
Determination of Ephedrine and Pseudoephedrine by Field-Amplified Sample Injection Capillary Electrophoresis.
Journal of chromatographic science Issue date: 2013 Apr 25
Mechanisms of Herb-Induced Nephrotoxicity.
Current medicinal chemistry Issue date: 2013 Apr 12

Annals of Internal Medicine

Other Resources

Copyright © 2013 The American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)