Possible Interaction: Caffeine and Ma Huang

“Of note, fatalities (though rare) have occurred with concomitant ephedra and caffeine use.”

“The direct cardiotoxity of ephedra, synergistic effect of caffeine and ephedra , and hypokalemia may cause refractory ventricular arrhythmia.”

“ Ephedra , when combined with caffeine (a common combination in many weight loss products), has been shown to raise blood pressure in healthy volunteers (by an average of 11.5 mm Hg systolic and 7.3 mm Hg diastolic in one study).”

“ Ephedra has been shown to be effective in promoting weight loss, especially when combined with caffeine , but it has a high adverse effect risk profile.”

“Use of ephedra or ephedrine and caffeine is associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations.”

“ Ephedra alkaloids may cause psychosis and their effects can be exaggerated by interaction with caffeine and ethanol.”

“The herbal medicine Ma Huang ephedra ) in combination with caffeine caused rapid clinical signs of toxicity including salivation, hyperactivity, ataxia, and eventually lethargy, and failure to respond to stimuli.”

“ Caffeine has been shown to potentiate the toxicity of the EA alkaloids.”

“Anecdotal, uncontrolled observations suggest that herbal stimulants containing ephedrine ephedra or ma huang) and caffeine (cocoa, coffee, tea, maté, guarana, cola or kola) can exacerbate seizures in people with epilepsy, especially when taken in combination.”

“ Ephedra , and its constituent ephedrine, are used in both stimulant and weight loss preparations, sometimes with caffeine ; safety concerns have arisen with this practice.”