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Salem Health: Addictions, Substance Abuse & Alcoholism, Second Edition

Ephedrine

by Lenela Glass-Godwin, MS

Category: Substances

Also known as: Ma huang

Definition: Ephedrine is an alkaloid drug derived from plants of the genus Ephedra (family Ephedraceae); it also is produced synthetically. Ephedrine is similar in chemical structure to amphetamine and methamphetamine drugs.

Status: Legal (certain formulations by prescription only in the United States and United Kingdom); illegal for use as a dietary supplement; sold over-the-counter in Canada as a nasal decongestant

Classification: Scheduled Listed Chemical Product (SLCP)

Source: Primary natural source of ephedrine is as an extract from plants of the genus Ephedra, specifically E. sinica and E. distachya; most commercial supplies are grown in China. Because of the expense of extracting ephedrine from natural sources, most pharmaceutical sources of the drug are L-ephedrine, which is produced synthetically.

Transmission route: Ephedrine occurs as fine white crystals or powder; the drug is readily soluble in water. In capsule form it is administered orally, and when dissolved in water can be administered in a nasal spray. It also can be given subcutaneously or intravenously.

History of Use

Ephedrine has been used as an herbal preparation (ma huang) for thousands of years in Chinese medicine as a treatment for asthma and bronchitis. A Japanese chemist, Nagayoshi Nagai, first isolated ephedrine from the plant E. distachya in 1885, and it has been used in Western medicine since that time.

Ephedrine acts to increase the activity of noradrenaline on adrenergic receptors in the brain. It indirectly stimulates the sympathetic nervous system and can cross the blood-brain barrier and affect the central nervous system directly by causing the release of noradrenaline and dopamine. Thus, its action is similar to that of the drugs amphetamine and methamphetamine. Ephedrine can also be used in the production of methamphetamine due to the drugs’ similar chemical structures.

Ephedrine has been misused by athletes, particularly by weightlifters and bodybuilders, because it is thought to act as an appetite suppressant and may promote fat utilization. Many athletes need to maintain a certain weight and body fat percentage before competition, leading to ephedrine’s use, often in combination with caffeine and aspirin. In 2004, the US Food and Drug Administration banned the use of ephedrine in dietary supplements aimed at weight loss.

Effects and Potential Risks

Ephedrine has many legitimate medical uses, primarily in the treatment of respiratory problems but also to treat hypotension, narcolepsy, certain types of depression, and myasthenia gravis (an autoimmune neuromuscular disorder). However, ephedrine has many potentially serious side effects, and persons with heart disease, angina pectoris, hyperthyroidism, diabetes, and enlarged prostate must be closely supervised by their physicians during use of the substance.

Side effects of ephedrine include nervousness, panic disorder, insomnia, vertigo, difficult breathing, headache, tachycardia (rapid and erratic heartbeat), nausea, anorexia, and painful urination. Ephedrine should not be used during pregnancy except under extremely close medical supervision. Negative drug interactions occur between ephedrine and certain antidepressants, namely serotonin-norepinephrine reuptake inhibitors, and monoamine oxidase inhibitors. Ephedrine should not be used with medications for cough and congestion.

For Further Information

1 

“Ephedra.” New York State Office of Alcoholism and Substance Abuse Services. New York State, n.d. Web. 29 Oct. 2015.

2 

Fontanarosa, Phil B., Drummond Rennie, and Catherine D. DeAngelis. “The Need for Regulation of Dietary Supplements: Lessons from Ephedra.” Journal of the American Medical Association 289 (2003): 1568–70. Print.

3 

Kuhar, Michael J., and Howard Liddle. Drugs of Abuse. New York: Marshall Cavendish Reference, 2012. Print.

4 

Martin, Elizabeth. An A to Z of Medicinal Drugs. New York: Oxford UP, 2010. Print.

5 

Maxwell, Jane Carlisle, and Beth A. Rutkowski. “The Prevalence of Amphetamine and Methamphetamine Abuse in North America: A Review of the Indicators, 1992–2007.” Drug and Alcohol Review 27.3 (2008): 229–35. Print.

See also:

Amphetamine misuse; Methamphetamine; Stimulant misuse

Citation Types

Type
Format
MLA 9th
Glass-Godwin, Lenela. "Ephedrine." Salem Health: Addictions, Substance Abuse & Alcoholism, Second Edition, edited by Paul Moglia, Salem Press, 2018. Salem Online, online.salempress.com/articleDetails.do?articleName=Addictions2e_0121.
APA 7th
Glass-Godwin, L. (2018). Ephedrine. In P. Moglia (Ed.), Salem Health: Addictions, Substance Abuse & Alcoholism, Second Edition. Salem Press. online.salempress.com.
CMOS 17th
Glass-Godwin, Lenela. "Ephedrine." Edited by Paul Moglia. Salem Health: Addictions, Substance Abuse & Alcoholism, Second Edition. Hackensack: Salem Press, 2018. Accessed September 13, 2025. online.salempress.com.