Ma-Huang in Normotensive Adults
Many of our patients are ingesting pharmacologically active substances obtained by mail order or in health food stores. Known by such names as Herbal Ecstacy and Escalation, patients believe that these products can produce euphoria, increased sexual sensations, and heightened awareness.
Ma-huang comes from the dried stem of ephedra species native to northwest India, Pakistan, and China. Used to treat hay fever and asthma for thousands of years, the plant has been determined to contain ephedrine and pseudoephedrine.
Such products may be marketed as nutritional supplements and may not fall under the same FDA scrutiny as traditional pharmaceutical products. White et al intended to determine if use of the manufacturer-recommended amounts of the substances could lead to changes in blood pressure (BP) or heart rate (HR) in normotensive individuals.
Twelve young men and women underwent ambulatory BP monitoring prior and subsequent to ingesting four capsules of powdered ma-huang 375 mg, repeated once nine hours later.
No adverse effects were reported by the subjects. Half of tham experienced a statistically significant 10 bpm increase in mean 12-hour HR (3 increased, but to a non-significant level; 3 were unchanged). Two subjects had a statistically significant increase in systolic BP.
The authors note that the changes produced were of no toxicity to the normotensive subjects but that, coupled with other stimulants or with excessive dosing, especially in hypertensive or heart disease patients, toxicity could occur. Hence, clinicians and patients need to be informed of this potential.
White L, et al. J Clin Pharmacol 1997;37:116-122.
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