Ephedrine in the UK: – Do you Need a Prescription to Buy? [Legal Status]
Is ephedrine in the UK legal to use for non-medical purposes? It’s a question asked by athletes, bodybuilders, and dieters around the world; not just in regards to using it in the UK, but buying or selling it.
Before you sell or buy ephedrine in the UK, know the laws.
The same applies to use of the ephedra sinica herb in the United Kingdom.
When asking the question online, you’re going to find numerous responses, many of them from bodybuilding and muscle building forum board discussion threads. Can you rely on this information? Is it up to date and reliable? Some of it is and some of it isn’t.
Before you consider use of ephedrine for weight loss, to develop your own ECA stacks, or for energy enhancement or physical stamina, turn to government resources for the most recent updates on legal information.
Ephedra and Ephedrine Basics and Mechanism of Action
Visit any gym around the world and you’re likely to have heard about two components commonly used by those seeking accelerated weight loss or physical performance enhancement or stamina: ephedra and/or ephedrine.
Men and women seeking weight loss may also turn to ingredients and compounds in dietary weight loss supplements to accelerate and enhance goals in that arena.
For this reason, products containing ephedra and ephedrine are among the most commonly sought after around the world. In the US, Australia, New Zealand, Canada, and the UK, as well as other countries around the world, use of ephedrine and ephedra may be restricted, considered illegal, or carefully monitored.
Ephedra is a family of plants known as Ephedraceae. The plant has numerous species numbering into the dozens, growing in different locations around the world. The ephedra plant prefers semi-arid, dry, and more desert-like growing conditions so is found in the Mediterranean, portions of Africa, the Western United States, and throughout Asia.
Historical references have been found not only in ancient Egyptian documents, but use of ephedra for medical treatments has been reported in China for over 5,000 years. Its use is also commonly reported in old Ayurvedic medical practices from India.
The Native Americans used portions of the ephedra plant to brew teas (as did ancient Chinese medical practitioners) to treat a number of ailments. Among those ailments include breathing problems such as those caused by the common cold, swollen nasal passages, sinus issues, and lung conditions such as asthma or bronchitis
As a wound treatment, Native Americans and other cultures would use portions of the ephedra plant, pounded down into a powder form, to sprinkle into poultices placed over open wounds.
The most common application of the ephedra plant however, was in the treatment of breathing and lung conditions. This use is common among most of the cultures who adopted it.
Today, ephedra is used for other reasons entirely, primarily weight loss and energy enhancement.
The reason for this is the presence of ephedrine, an alkaloid component found in many species of the ephedra plant. Ephedra and other alkaloids include pseudoephedrine and norephedrine and are known as stimulants. More specifically, they’re defined as sympathomimetic amines.
Sympathomimetic amines stimulate the central nervous system: more precisely the sympathetic nervous system. This portion of the nervous system controls functions of the body but we can’t, such as:
- Breathing or respiratory rate
- Heart rate and certain cardiovascular functions including force (contractility) and rate
Before considering use of ephedrine in the UK, or using ephedra or ephedrine in an ECA stack in the UK (or anywhere else), it is recommended that the individual know specifically how such components can affect these autonomic behaviors in the body.
Ephedrine and pseudoephedrine influence the production of other stimulants and/or neurotransmitters in the brain. The ephedrine and pseudoephedrine have an effect on alpha and beta-adrenergic receptors.
An adrenergic receptor is something that responds to a stimulus and then triggers a specific action. For example, alpha and beta-adrenergic receptors stimulate cells to increase energy production. They also are a major component to the body’s “fright” response, triggering the commonly known “fight or flight response” caused by a surge of adrenaline.
A number of adrenergic receptors (a.k.a. sympathetic receptors) are found in the body’s arterial blood vessels. Among them include alpha-1, and beta-1 and beta-2 receptors.
When alpha receptors are stimulated, constriction of arteries throughout the body occurs. This constriction increases blood pressure and also increases the amount of blood returning back to the lungs and then the heart.
The heart muscle itself contains beta-1 receptors. When stimulated, the receptors in the heart accelerate heart rate and increase the force with which the heart contracts.
Both of these functions produce increase energy, which in turn promotes thermogenesis, which is simply defined as heat production. It’s a normal process in the body.
Ephedrine enhances these effects, but not always to a beneficial degree.
Finally, when components like ephedrine stimulate beta-2 receptors found in long airways, it triggers them to relax or dilate. This facilitates easier breathing and intake of oxygen. It is for this primary reason that ephedrine and pseudoephedrine were once, and still are, found in a number of asthma products including bronchodilators.
Unfortunately, ephedrine has been banned from weight loss products and other dietary supplements in the US and other countries around the world since 2004. The regulations passed by the US Food and Drug Administration were prompted due to the increasing number (numbering in the tens of thousands) of individuals experiencing severe and sometimes life-threatening side effects through the misuse, overuse, and abuse of ephedrine and pseudoephedrine found in such products.
Before considering use of ephedrine in the UK, know the law. The same applies to anyone interested or who wants to buy ephedrine in the UK. Do the laws between ephedrine and ephedra in the UK differ?
Government Regulations regarding Ephedrine in the UK
While it may be time-consuming and frustrating to try and find information regarding regulations for use of ephedrine in the UK, such research pays off.
According to government resources in the UK, reduction of non-medical usage of ephedrine and pseudoephedrine have been prevalent in the past decade. In addition to the concerns that ephedrine in the UK is once again becoming popular for weight loss or energy enhancement.
Growing concerns have also been noted in government reports regarding the use of ephedrine and pseudoephedrine commonly found in nasal decongestants and asthma medications for the manufacture of crystal meth (methyl-amphetamine), which in the UK is classified as a Class A controlled drug.
Because of these concerns, in 2007 the Medicines and Healthcare Products Regulatory Agency (MHRA) in the UK explored the possibility of reclassification of over-the-counter medications that contain ephedrine or pseudoephedrine to prescription-only medicines. 
What ultimately occurred was that the Commission on Human Medicines advised that over-the-counter products that contain ephedrine and pseudoephedrine should be restricted based on package size and that the number of packages available for sale at one time also be limited.
By 2009, any product containing ephedrine or pseudoephedrine would be reclassified from a pharmacy product to a prescription-only medicine.
Pseudoephedrine and ephedrine alkaloids are commonly found in a number of cough and cold medicines as well as nasal decongestants sold over the counter in pharmacies throughout the UK. A number of limitations and restrictions on the sales of such products were implemented in the past decade.
Restrictions and Limitations of Sales of Products Containing Ephedrine or Pseudoephedrine
As of 2008, ephedrine in the UK, and ability to buy ephedrine in the UK was limited. For example, in the UK it was deemed illegal (without a prescription) to :
- Sell any product that contain the ephedrine or pseudoephedrine that exceeded 720 mg of pseudoephedrine or 180 mg of ephedrine
- Sell or supply combinations of products that contained more than 180 mg ephedrine and 720 mg pseudoephedrine without a prescription
- Supply or sell any product combination that contain pseudoephedrine in one product, and ephedrine and another product within one transaction
Of course, such limitations have also reduced demand, and as of July 2009, pharmacies reported fewer pseudoephedrine capsules or tablets sold.
So while it is still legal to sell ephedrine in the UK, and buy ephedrine in the UK, it is highly recommended that the limitations and restrictions of such purchases or sales be observed.
In addition to the limitations and restrictions regarding the volume of ephedrine and pseudoephedrine sold in products within a single transaction, was the legislation proposed by the Royal Pharmaceutical Society of Great Britain to recommend that such products only be supplied in person by a licensed pharmacist or a trained staff member who is under the direct supervision of a pharmacist.
In addition, modifications to tills by a number of pharmacy chains have undergone modification so staff members can’t sell more than one package of any over-the-counter medicine that contains ephedrine or pseudoephedrine. 
A number of audits have also been implemented in the UK, similar to those in the United States, for sales. Products containing ephedrine in the UK are tracked and monitored. Because of the increased use of ephedrine and pseudoephedrine as precursors in the manufacture of methamphetamine, a number of programs and learning courses for pharmacists and retail distributors and staff have increased. So too has awareness regarding sales of such products.
As of 2009, training developed by the MethGuard UK Awareness Programme had been conducted in approximately 12,000 pharmacies. 
It should be noted by potential users of ephedrine in the UK, or those interested enough to buy ephedrine in the UK, that the status regarding use has continued. In the UK, a number of manufacturers have reformulated products to remove pseudoephedrine as an ingredient, but a number of products can still be found that contain it, as of 2010.
Among them, also common in other countries but under different brand names :
- Day Nurse
As of 2017, the Royal Pharmaceutical Society and other governmental agencies continue to advise and remind not only providers, but potential buyers, that restrictions on the sale of any products containing ephedrine and pseudoephedrine are still relevant.
A report published by the Medicines and Healthcare Products Regulatory Agency in the UK released a public assessment report in June 2017, updating and reinforcing the sales restrictions that were applicable in the UK regarding sales of ephedrine and pseudoephedrine as of April 2008. 
Legalities regarding Use of Ephedra in the UK
Review of regulations are readily available regarding use of ephedrine in the UK, as well as limitations for a person who wants to buy ephedrine in the UK. But what about ephedra in the UK?
The UK government, under the Medicines and Healthcare Products Regulatory Agency, also provides guidance on restricted as well as banned herbal ingredients, among which ephedra would apply. One of the most recent reports from this agency is dated December 2014.
The report lists a number of herbal ingredients that may be subject to restrictions in the UK. However, the opening paragraph of the document emphasizes the importance as well as responsibility of dealers, importers, and manufacturers to comply with UK laws in this regard.
Ephedra is the common name found within this list, with botanical source names that include:
Interested researchers can find these ephedra species under the legal category of SI 2130-Parts II and III. Maximum dosage (where permitted for internal use only) and maximum daily dosages are provided.
For ephedra as listed above, that means limitations of 600 mg per dose and 1800 mg per daily dose. According to the guidelines, the “product can only be sold in premises which are registered pharmacies and by or under the supervision of a pharmacist.” 
Fines and punishment regarding misuse or purchase of products containing ephedrine, pseudoephedrine, or pure ephedra can depend on the amount, past history, and whether the ephedrine in the UK is being sold or purchased illegally for illicit purposes.
The same applies to a number of drugs found under Class C, including anabolic steroids (not being used for personal use).
While it’s rare for an individual to be jailed or fined for personal use of ephedrine in the UK, or use of ephedra in the UK, a number of factors can apply such as where and how the compounds were purchased, their quantity, and personal history including previous drug offenses. 
Purchases or sales of ephedrine from the UK, or supply over borders of ephedra in the UK can attract the attention of border control agents as well as general and specialized mail services. These organizations may also have the option of filing charges, again depending on the amount and history of the individual caught doing so.
Individuals interested in traveling to or from the UK with ephedrine should be aware of UK border agency guidelines.
This also applies to any number of ways to create an ECA stack in the UK.
Creating an ECA stack in the UK
Creating an ECA stack in the UK is not that much different than creating an ECA stack anywhere else. Athletes, bodybuilders, and dieters purchasing cold and flu products, cough medicines, and asthma medications from a pharmacy often combine these products with caffeine and other herbal ingredients or stimulants to provide the effect they’re looking for.
Users looking to create an ECA stack in the UK should be aware of other herbal substances that may be found on the banned and restricted list of herbal ingredients published by the MHRA.
A number of recommendations for creating an ECA stack in the UK (or anywhere else) can be found on bodybuilding websites as well as through their forum boards and discussion threads. The dosages of each component of the ECA stack (originally defining ephedrine, caffeine, and aspirin) can differ widely among users.
Today, aspirin components have often been replaced with White willow bark, a natural analgesic and fever reducer that is designed to balance out at the acceleration of heat production or thermogenesis stimulated by the combination of ephedrine and caffeine.
Those learning or wanting to learn how to make an ECA stack in the UK merely need to log on to any number of websites and even global images to find samples.
Fairly common are dosages that hover around:
- 20 to 27 mg ephedrine
- 150 to 200 mg caffeine
- 24 to 27 mg of aspirin
The above ingredients are intended for one dose. A number of individuals creating their own ECA stacks take two to three dosages a day. This can exponentially increase the risk of negative side effects and adverse reactions.
Side Effects Associated with Ephedra/Ephedrine
A number of side effects and adverse reactions have been associated with ephedra and ephedrine usage. Any product, even a natural herb like ephedra, can trigger a number of unexpected reactions in a person’s body depending on their sensitivity to stimulants.
When combined, caffeine, ephedra and ephedrine in the UK, has been reported to cause a number of serious side effects. Among the most common include:
- Headaches, sometimes triggering a migraine
- Nausea, which may be accompanied by vomiting
- Heart palpitations
- Racing heart
- A sense of increased anxiety or nervousness
- Hand tremors or overall “jitteriness”
Ephedrine can affect numerous body systems and body functions, including balances of insulin, metabolic processes, and of course, cardiovascular and brain function.
A number of studies have been conducted on the efficacy of ephedrine to actually produce significant weight loss among users. It has been noted in numerous reports (those interested can access resources like PubMed for more specific information) that the effects of ephedrine on weight loss are minimal. The production of increased energy however, is more notable, especially when ephedrine is combined with various forms of caffeine.
A 2013 study explored a combination of caffeine, ephedrine, and leptin A-200 on visceral fat mass as well as weight loss over a six-month period on obese individuals. These individuals were given a combination of the three ingredients and then measured for outcomes in weight change, visceral fat mass, and lean mass.
The study determined that caffeine and ephedrine proved “modestly” effective as a weight-loss agent and did provide “significant” reductions in fat mass and approximately 4.3 kg in body weight. The leptin-A 200 alone was not particularly effective in promoting that weight-loss in the study. 
It should be noted that a number of the participants in the clinical trial dropped due to unpleasant side effects that included:
- Chest pain
A 2017 study also reported that the ephedra plant, containing a number of pharmacologically active alkaloids including ephedrine and pseudoephedrine, can potentially contribute to development of acute hepatitis. The exact process of this mechanism at a cellular level is as yet unknown, but the study did determine that ephedrine had an influence and stimulated mitochondrial oxidative stress and swelling. 
Over 700 references are noted in the US National Library of Medicine, National Institutes of Health regarding the effects of ephedrine on the cardiovascular system. Those interested in use of ephedrine in the UK or any country should be prepared for a number of side effects in addition to any perceived benefits of use.
Reports of myocardial infarction, arrhythmia, tachycardia, and brain seizures and strokes have been reported. A number of these individuals have been otherwise healthy and relatively young. The effects of ephedrine and ephedra on the body can differ greatly between individuals depending tolerance and sensitivity.
Ephedra in the UK and use of ephedrine in the UK goes beyond legal ramifications. The same applies to creating and using an ECA stack in the UK or other countries.
Some of the guidelines for creating an ECA stack in the UK, or in the US, or Australia, etc., can be extremely high, especially for beginners.
Purchasing adequate amounts of ephedrine in the UK to create stacks can be problematic for some. Those who want to buy ephedra in the UK often resort to underground resources for their product, which can increase the risk not only of legal ramifications, but receiving low-quality, low grade, or contaminated product.
- Gov.UK. Pseudoephedrine and ephedrine: Update on Managing Risk of Misuse
- MHRA Public Assessment Report. Controlling the risk of misuse of medicines containing pseudoephedrine and ephedrine. July 2009.
- Wing Tang. Deal with over-the-counter requests for pseudoephedrine with confidence. The Pharmaceutical Journal. PJ November 2010
- MHRA. Pseudoephedrine and ephedrine: managing the risk of medicines misuse. MHRA UK Public Assessment Report. June 2017.
- Gov.UK. Medicines & Healthcare Products Regulatory Agency. Banned and restricted herbal ingredients. Published 18 December 2014
- Gov.UK. Drug penalties
- Ann G. Liu, Steven R. Smith, Ken Fujioka, Frank L. Greenway. The Effect of leptin, caffeine/ephedrine, and their combination upon visceral fat mass and weight loss. DOI: 10.1002/oby.20416
- Lee Ay, Jang Y, Hong SH, Chang SH, Park S, Kim S, Kang KS, Kim JE, Cho MH. Ephedrine-induced mitophagy via oxidative stress in human hepatic stellate cells. J Toxicol Sci. 2017;42(4):461-473. doi: 10.2131/jts.42.461.