Ephedrine HCl (hydrochloride) is a synthetic drug used to treat asthma, bronchitis, hay fever allergies and nasal congestion.
Previously, Ephedrine HCl was promoted for weight loss and bodybuilding programs. It was commonly taken in an ECA stack with caffeine and aspirin.
Multiple clinical studies demonstrated that ephedrine could be used to reduce body fat composition and increase metabolic rate. However, this drug was also found to cause serious adverse reactions in some cases.
Use of this product in dietary supplements and fat burners is now banned around the world. While this drug continues to be sold for relief of breathing conditions, manufacturers cannot make claims about energy, fat loss or athletic performance.
Bodybuilders, dieters and athletes often buy over-the-counter ephedrine HCL pills intended to be used for the relief of nasal congestion and take them off-label for fat loss. However, this compound is usually combined with other active ingredients in these formulations and is not recommended to be used as a weight loss aid. Click here to buy ephedra supplements online legally without a prescription.
Ephedrine is an alkaloid that was initially derived from the Ephedra sinica plant. It was originally prescribed to asthmatics to help relief wheezing, chest tightness and to open airways.
It was not until 1972 that a general practitioner in Denmark noticed that patients who used this drug with caffeine to relieve asthma also experienced unexpected weight loss.
The product was quickly re-developed as a weight management drug and given the name the “Elsinore pill”. Within 5 years, over 70,000 patients had been given ephedrine HCL tablets to promote weight control.
Ephedrine can support weight reduction because it functions as a stimulant and a sympathomimetic drug. It is a phenethylamine molecule with a similar chemical structure to epinephrine (adrenaline) and amphetamine.
It activates alpha and beta-adrenergic receptors and stimulates the release of norepinephrine. This neurotransmitter belongs to the catecholamine family and is primarily classified as a nonselective adrenergic agonist.
Ephedrine promotes some of the same responses in the body as a surge of adrenaline does in times of stress. It causes a sympathetic nervous system response, increasing energy levels, vigilance, alertness, motivation and more.
Note the difference between norepinephrine or epinephrine and ephedrine. They are three different compounds, but with similar mechanisms of action in the body.
This drug can influence a number of different functions in the body including:
- Heart rate
- Respiratory rate
Mechanism of Action
Ephedrine HCL increases activation of alpha and beta adrenoreceptors through the body. Depending on where in the body these receptors are activated, they have different effects.
By stimulating alpha receptors, it contributes to relief of nasal congestion and increased blood pressure. Through its effects on beta receptors, it increases the force of cardiac contractions and promotes bronchodilation (widening of blood vessels).
When alpha receptors on arteries get activated, they constrict or become narrower. This increases blood pressure and enhances the flow of blood returning to the heart for oxygenation.
Individuals using products that have an influence on adrenergic receptors should know that skeletal muscle blood vessels lack alpha receptors because they must remain open to receive the blood flow that comes from the heart. This increases delivery of oxygen and nutrients for muscle strength, energy, stamina, and physical function.
Beta-1 receptors are found in the heart muscle. When triggered, these receptors speed up heart rate and also increase the force of heart contractions, resulting in a stronger pulse.
Beta-2 receptors are found in the airways of the lungs as well as skeletal muscle arteries. When stimulated, the bronchioles and the blood vessels dilate to enhance oxygenation in the lungs as well as circulation through the skeletal muscles.
These effects are purported to directly promote athletic performance enhancement, greater metabolic activity and easier breathing. Indirectly Ephedrine HCL can also affect mood, alertness, appetite suppression, the breakdown of fatty acids and utilization.
How Is Ephedrine HCl Used?
Ephedrine HCL is found in a number of oral decongestant medications. It is intended for treatment of patients diagnosed with severe allergies, asthma, and other lung or breathing disorders such as sinusitis or bronchitis.
It has also been used for the relief of symptoms of emphysema or chronic obstructive pulmonary disease (COPD). An injectable form of this drug is also used to treat low blood pressure in surgical scenarios.
The related alkaloid Pseudoephedrine is also sold as a nasal decongestant and is the primary active ingredient in the medication Sudafed.
Pure ephedrine HCL is highly regulated in many parts of the world. While previously sold without restriction as an over-the-counter drug, it now requires a prescription to buy in some countries.
In the United States, you can buy ephedrine pills over the counter in some states without a prescription. There is a limit on how much you can buy, and it must be sold in a maximum 25 mg tablet with 400 mg of guaifenesin.
Purchasers are required to be at least 18 years of age and to show ID before buying. You may be required to sign a log book verifying your name and address and your purchase details will be recorded in a central database.
Some states in the US also have additional requirements for sale and stricter regulations. These regulations are put in place to prevent anyone from buying too much of this drug at one time due to its use in in synthesizing methamphetamine.
In Canada, you can still buy ephedrine HCL tablets over-the-counter, but they can only be advertised for relief of nasal congestion. The maximum dose is 8mg per serving or 32mg per day.
Ephedrine is also found in major brands of asthma medicines and decongestant products that include:
- Primatene (oral form)
Recommendations For Use
The recommended usage and dosage of ephedrine for medical purposes will depend on age, weight and reasons for taking the product.
As a nasal decongestant, it is typically recommended to take between 8-50 mg per dose, up to 3-4 times per day. According to one site, it is recommended not to exceed 100 mg per day, although other sources mention 150 mg as the maximum dosage.
This product should be taken with meals and lots of water. To avoid sleep disruption, use it early in the day as it can cause insomnia if taken before bedtime.
When used off-label for weight loss, dosages are typically combined with caffeine in an EC Stack. Bodybuilders recommend using a pyramid-dose cycle which involved starting at a low dose and gradually increasing to gauge tolerance.
Long-term use of this product is potentially dangerous. Do not take for longer than four weeks without first consulting with a doctor. This product is not appropriate for everyone and you should check with a doctor first before using it.
Ephedrine is contraindicated in people who have high blood pressure, are at risk of cardiovascular disease, or who have had a previous cardiac event such as a stroke or heart attack. It should not be used by pregnant or nursing women.
Do not use this drug if you have been diagnosed with hyperthyroidism glaucoma, diabetes, anxiety disorder, depression, bipolar disorder, a history of seizures or benign prostatic hyperplasia.
Is Ephedrine HCl Effective for Weight Loss?
Ephedrine alkaloids are no longer legal in dietary supplements promoted to enhance weight loss results. The ephedra plant alkaloids were banned in 2004 by the US Food and Drug Administration.
Nevertheless, consumers today continue to buy ephedrine HCl and use it off-label to boost energy and fat loss. It remains highly sought-after as a diet pill because it is widely recognized as effective for increasing metabolism.
Several studies have been conducted on the benefits of ephedrine for weight loss. It has been shown to increase energy, calorie expenditure and to promote modest short-term weight loss compared to a placebo.
The National Institutes of Health Office of Dietary Supplements reviewed a number of studies examining its effects as a thermogenic agent. Studies of individuals using ephedrine showed anywhere between a 0.8 pound per month and up to a 2.2 pound per month loss in weight over those taking a placebo. 
In one study, participants taking ephedra with other herbs lost approximately 2 pounds per month more weight than individuals using a placebo for three months.
More significant results could be achieved when combining this supplement with a healthy diet, reduced caloric intake, and appropriate levels of exercise.
Few double-blind, placebo-controlled studies have been conducted on the effectiveness of taking ephedrine HCL for athletic performance. It is commonly used as a pre-workout supplement among bodybuilders and amateur athletes.
Prior to the FDA ban on this ingredient, sources claim that a large number of professional athletes took the drug, including dozens of NFL and MLB athletes. It has been shown to increase exercise output and boost energy levels over short periods of time.
However, this product has also been misused and abused at high doses as a performance-enhancing drug. This can dramatically increase the risk for side effects and adverse reactions.
Possible Side Effects and Dangers
Ephedrine HCl affects the sympathetic nervous system and can increase the risk of cardiovascular side effects. Like other stimulants it may increase heart rate and blood pressure.
Some of the common side effects that have been reported with use include:
- Changes in mood
- Increased perspiration or “cold sweats”
- Increased body temperature
- Dry mouth
- Jitters or restlessness
- Accelerated heart rate
- Irregular heartbeat
- Heart palpitations
- Difficulty sleeping
At high dosages or when used for long periods of time, it may contribute to dangerous outcomes like heart attack, stroke, seizure or death.
Other serious side effects and adverse reactions are also possible. This is especially true when the ephedrine is combined with other forms of caffeine or stimulants.
In an alarming study published in 2017, high concentrations of caffeine in postmortem blood has been associated in over 50 poisoning deaths.
While other drugs or concentration of drugs were also identified in the blood samples including ephedrine, antidepressants, benzodiazepines, and antipsychotics, it was deemed that the “predominantly psychoactive substance” was caffeine. The caffeine came from tablets or powders, not overconsumption of beverages containing caffeine. 
Individuals diagnosed with any medical issues including cardiovascular or metabolic conditions, high blood pressure, arrhythmias, diabetes, and more should, consult with their physician prior to using ephedrine HCL.
Prescription as well as over-the-counter drugs and supplements may interact with ephedra or ephedrine and produce side effects.
Before using products like ephedrine HCl for weight loss or energy enhancement, be aware of the potential for unexpected side effects and negative reactions.
- National Institutes of Health Office of Dietary Supplements. Ephedra and Ephedrine Alkaloids for Weight Loss and Athletic Performance
- Jones AW. Review of Caffeine-Related Fatalities along with Postmortem Blood Concentrations in 51 Poisoning Deaths. J Anal Toxicol. 2017 Apr 1;41(3):167-172. doi: 10.1093/jat/bkx011.