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Avoid Asthma Medications Containing Ephedra?

I've been reading a lot lately about the safety of ephedra. I have asthma, and the drug is in my medication. Should I be worried?

Millions of people have used ephedrine, the active ingredient in ephedra (or ma huang), safely and properly as an asthma treatment for many years. Until your doctor says otherwise, I suggest you continue taking your current medication. The problem has been with weight loss and energy supplements containing ephedra. Recent reports about adverse effects -- including some deaths -- have spurred the Food and Drug Administration (FDA) to reconsider whether warning labels should be required on these products.

One of these reports came from a California scientist who found that an ephedra supplement could cause severe side effects, particularly when combined with caffeine. Other researchers at the University of Arkansas surveyed ephedra products on the market and found that about half of those they studied contained higher or lower dosages than stated on the labels. This could be serious. The danger of developing a side effect -- such as an irregular heartbeat, insomnia, and raised blood pressure -- increases when you take more ephedra than recommended.

I have always cautioned against high doses of ephedra and have warned against combining it with other stimulants, including caffeine, prescription medications, over-the-counter drugs, and some other dietary supplements.

A few years ago, the FDA said that taking more than 8 milligrams in a six-hour period, or a total daily intake of 24 mg, could lead to serious health problems. They proposed limiting the amount of ephedrine in products and requiring warning labels. However, that proposal was withdrawn -- the General Accounting Office questioned the reliability of reports cited by the FDA that indicate the adverse effects of ephedra.

A number of states have adopted the ephedra warning label issued in 1994 by the American Herbal Products Association, which reads: "Seek advice from a healthcare practitioner prior to use if you are pregnant or nursing, or if you have high blood pressure, heart or thyroid disease, diabetes, difficulty in urination due to prostate enlargement, or if taking a MAO inhibitor or any other prescription drug. Reduce or discontinue use if nervousness, tremor, sleeplessness, loss of appetite, or nausea occur. Not intended for use by persons under 18 years of age. Keep out of the reach of children."

If you have been using an asthma medication containing ephedra with no ill effects, I see no reason for you to stop now. Using products containing ephedra for weight loss or as a substitute for the street drug ecstasy is another story. My advice? Don't do it.


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