|
- Ephedrine and
Pseudoephedrine
|
|
Ephedrine and pseudoephedrine are closely related
drugs with actions and side effects similar to the hormone epinephrine (adrenaline).
Ephedrine, available in prescription and nonprescription strengths, is sometimes used to
dilate bronchi (breathing tubes), making it easier for people with asthma to breathe.
Drugs with better activity and fewer side effects are more commonly used. Nonprescription
ephedrine nose drops (Vick Vatronol®) or spray (Pretz-D®) are used to relieve nasal
congestion due to the flu or hay fever. Pseudoephedrine (Afrin® tablets, Sudafed®, and
others) is a nonprescription drug taken by mouth to relieve nasal congestion due to the
flu or hay fever.
 | Interactions with Herbs
––– |
Ephedra sinica
(Ma huang)
Ephedra is the plant from which ephedrine was originally isolated. Ephedra, also called ma
huang, is used in many herbal products including supplements promoted for weight loss.
To prevent potentially serious interactions, people taking ephedrine or pseudoephedrine
should avoid using ephedra-containing drug products and should read product labels
carefully for ma huang or ephedra content. Native North American ephedra, sometimes called
Mormon tea, contains no ephedrine.
|
|
Product Recommendations |
|
- Contains:
Ephedrine 25mg & Guaifenesin 200mg
|
|
Tannin-containing
herbs
Tannins are a group of unrelated chemicals that give plants an astringent
taste. Herbs containing high amounts of tannins may interfere with the absorption of
ephedrine or pseudoephedrine taken by mouth.1 Herbs containing high levels of
tannins include green tea, black tea, uva ursi (Arctostaphylos uva-ursi), black walnut (Juglans
nigra), red raspberry (Rubus idaeus), oak (Quercus spp.),
and witch hazel (Hamamelis virginiana).
| Interactions with Foods and
Other Compounds ––– |
Food
Foods that acidify the urine may increase the
elimination of ephedrine from the body, potentially reducing the action of the drug.2
Urine-acidifying foods include eggs, peanuts, meat, chicken, vitamin
C (greater than 5 grams per day), wheat-containing foods, and others. Foods that
alkalinize the urine may slow the elimination of ephedrine from the body, potentially
increasing the actions and side effects of the drug.3 Urine-alkalinizing foods
include dairy products, nuts, vegetables (except corn and lentils), most fruits, and
others.
Caffeine
Caffeine, which is found in coffee, tea, chocolate, guaranį (Paullinia cupana), and some
nonprescription and supplement products, can amplify the side effects of ephedrine and
pseudoephedrine. People should avoid combination products containing
ephedrine/pseudoephedrine/ephedra and caffeine.
Summary of
Interactions for Ephedrine and Pseudoephedrine
| Depletion or interference |
None known |
| Adverse interaction |
- Caffeine
- Ephedra
|
| Side effect reduction/prevention |
None known |
| Supportive interaction |
None known |
| Reduced drug absorption/bioavailability
|
Tannin-containing herbs* such as green tea, black tea, uva ursi, black walnut, red raspberry, oak, and witch hazel |
| Other (see text) |
Vitamin C |
| For the convenience of the reader, the information in the
summary is categorized as follows: “Depletion or interference” indicates the
drug may deplete or interfere with the absorption or function of the supplement or herb.
“Adverse interaction” indicates that the supplement or herb used together with
the drug may result in undesirable effects. “Side effect reduction/prevention”
indicates the supplement or herb may reduce the likelihood and/or severity of a potential
side effect caused by the drug. “Supportive interaction” indicates the
supplement or herb may support or aid the function of the drug. “Reduced drug
absorption/bioavailability” indicates that the supplement or herb may decrease the
absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the
summary indicates that the interaction is supported only by weak, fragmentary, and/or
contradictory scientific evidence. |
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References:
1. Brinker F. Interactions of pharmaceutical and botanical medicines. J
Naturopathic Med 1997;7(2):14–20.
2. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 105.
3. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998,
105–6.
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