Legal Status

Is Ephedra Legal in 2018? Supplements You Can STILL Buy Today

Is Ephedra Legal Is ephedra legal? It’s a question that’s often been asked since the banishment of ephedra alkaloids by the US FDA in 2004.

Confusion has reigned over ephedra and ephedrine legal status, not only in the United States, but the legalities and other countries.

Consumers wanting to know, once and for all, what’s legal and what isn’t should first understand ephedra and what it has to do with ephedrine. Laws differ by country and sometimes, even within states, provinces, or regions within a country.

Furthermore, some forms of this plant extract might be legal where you live while other forms might be banned and illegal to buy without a prescription.

In this article, we will discuss the legal status of the ephedrine alkaloid and the Ephedra Sinica herb from which it is derived. We will also compare its legality when used in certain over-the-counter asthma drugs versus weight loss supplements and diet pills.


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Is Ephedra Legal?

Since early 1990s, the legality of ephedra has been a contentious subject. Dosage standards, the concerns of individuals combining ephedra with other stimulants, and manufacturing quality and oversight were just a few of the issues that led the US FDA to take a closer look at this “wonder drug” deemed one of the best quick fixes for weight loss ever known.

Issues regarding not only quality control, but the ability of individuals to self-regulate and follow dosage recommendations (which differed widely depending on milligram strength, components, and manufacturer) were a huge concern.

At the height of its popularity, the FDA recommended the ephedrine was safe as an over-the-counter product in a dose of 25 mg per usage, not to exceed 150 mg a day.

The other alkaloid, pseudoephedrine, was approved by the FDA for a single 60 mg dosage, with no more than 240 mg per day.

Some (Council for Responsible Nutrition) deemed that 90 mg per day were safe for most, while a number of universities (Harvard and Columbia among them) deemed that individuals who were severely overweight or obese would be in the highest risk category for side effects because of the potential for contributing factors such as diabetes or high blood pressure.

Numerous sporting organizations including the International Olympic Committee deemed the ephedra was addictive, and its use frowned upon. [3]

In early February 2004, the FDA prohibited the sales of dietary supplements containing ephedra. By April 2004, over-the-counter products containing ephedrine were taken off the shelves. [4] The summary review that lists findings, efficacy, and safety can be found at the National Institutes of Health Office of Dietary Supplements. [5]

Ephedrine laws differ by country. Consumers interested in ordering any products banned in their country of origin or intending to ship through international marketplaces are responsible for determining legalities as well as the potential of their purchases being confiscated at international borders.

Where Can I Find Legal Ephedrine?

Finding legal ephedrine in the US since the ban is not especially difficult, as it is found in various milligram strengths in a number of cold and flu medications, asthma and bronchodilator products, and other sources.

However, it’s no longer available on the traditional “store shelf” – and in most cases, any product containing ephedrine must be obtained from the pharmacy counter.

While products containing ephedrine don’t necessarily require a prescription, it is common, at least in the United States, for a person to have to show identification to prove that they are over 18 years of age. They must also sign for the product, and are given a fact sheet regarding the product, its ingredients, and how those ingredients may affect the body.

Ephedrine Legal Status in the UK

What about the ephedrine legal status in the UK? For the latest information, potential consumers are recommended to visit gov.uk and visit their drug safety update pages.

As of 2015, ephedrine and pseudoephedrine are medications defined as nasal decongestants. They are available from pharmacies, but as of 2008, restrictions have been applicable due to the fact that active substances in such nasal decongestant products have the potential for use in the development of illegal manufacture of methylamphetamine, a Class A controlled drug in the UK. [6]

Also of note is that, as of 2015, it is deemed illegal to sell any product that contains more than 180 mg of ephedrine or 720 mg pseudoephedrine without a prescription. It is also deemed illegal to either supply or to sell combinations of ephedrine and pseudoephedrine that exceed those previous milligram dosages (720 mg pseudoephedrine or 180 mg of ephedrine).

Further, it is now deemed illegal in the UK to supply, sell, or provide a product that contains ephedrine and one that contain pseudoephedrine in a single transaction. Sales must be made by a pharmacist. [7]


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Ephedrine Legal Status in Canada

In Canada, ephedrine is listed as a Class A precursor, and under the Precursor Control Regulations (PCR) is defined as a regulated chemical. In order to import or export, package, sell, or produce, a license must first be obtained.

In 2007, Health Canada produced the National Health Products Compliance Guide that determined that, even with a prescription, ephedrine is still noted as a restricted substance that is not found under Food and Drug Regulations.

Dosages of ephedrine (and only for use as a nasal decongestant) are restricted to 8 mg per dose in regard to product sales, with recommendations not to exceed 32 mg ephedrine a day. [8]

Health Canada has warned that when ephedrine is taken with caffeine, even a low dose can trigger effects that exceed an approximation of 70 to 80 mg of ephedrine. The Association of Food and Drug Officials are still concerned that even at low doses in regard to milligram strength, cardiovascular events have, and continue to be, reported. [9]

Ephedrine Legal Status in Australia

Ephedrine legal status in Australia is also iffy in various circumstances. The Australian Government Department of Health: Therapeutic Goods Administration recently released an assessment report regarding ephedrine hydrochloride or ephedrine HCl.

In medical scenarios, the drug has a potential for use in surgical or emergency situations in the treatment of a low blood pressure. As of 2016, Specific guidelines for IV delivery of ephedrine hydrochloride is specified within the document. Currently, two ephedrine products are approved in Australia (Hospira ephedrine sulfate injection and DBL ephedrine sulfate) in medical scenarios.

In New Zealand, injection solutions of ephedrine hydrochloride are approved at up to 30 mg per milliliter. The same applies to UK specifications. In medical scenarios, a lowest effective dose maxes out at 30 mg.

In Australia, ephedrine, ephedra (Ma Huang), DHEA, and nor androstenedione have been defined and classified as anabolic steroids, or precursors, or prohibited imports unless special import permits have been obtained by the individual.

According to the Office of Drug Control, ephedrine is defined as a controlled substance, a precursor, and import or export requires permits, license, or license and permit. The same applies to pseudoephedrine, norephedrine, and norpseudoephedrine, all of which are alkaloids found in the more potent ephedrine species including Ma Huang or Chinese ephedra a.k.a. Ephedra sinica. [10]

Before considering purchase of ephedrine from any country, look to government resources for updated and reliable information. The reason for many of the restrictions is due to safety considerations and risk of side effects and adverse events for individuals misusing or abusing ephedrine.


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What is Ephedra, and Is Ephedra Legal or Not?

Ephedra is a species of plant. That plant is composed of parts that have long been associated as ingredients in formularies and dietary supplements. Most of the portions of the plant used in such purposes are the stems and leaves, both dried and pounded into powdered form. Dried as well as liquid extracts are also cultivated from the plant.

Ephedra sinica (Chinese Ma Huang) is just one of this species of plant – at least 100 different species grow around the world – noted for its use in the treatment of lung conditions and disorders.

Traditional Chinese medical practitioners have used portions of the ephedra (sinica species) plant to treat their patients for over 5,000 years. It’s also been used in traditional Ayurvedic Indian medical practices for much the same purposes.

Some historical references from other parts of the world are associated with the ephedra plant, most specifically from indigenous tribes of the Amazon forest and some references that date back to Egypt.

Since the plant has been used for thousands of years, why the issues regarding legalities? In a one word: misuse.

Ephedra was never intended to be used as a weight-loss drug, an energy booster, or physical performance enhancer. However, like many pharmaceutical, prescription- strength, and herbal remedies, it was discovered by Western populations as a beneficial component to purposes other than its primary usage in bronchodilator medications and treatments.

Consumers realized that the ephedrine had the potential to act as a stimulant, much like a super-dose of caffeine and triggered rumors of increased metabolism, heart rate, and energy. Ergo, consumers begin to use the product as a weight-loss drug.

By the late 1980s and into the 1990s, hundreds of ephedra and ephedrine products hit store shelves, all marketing themselves as weight-loss wonder drugs, energy promoters, and physical performance enhancers.

It didn’t take long for weight loss products containing ephedra and its potent alkaloids to become the most popular dietary supplements on the market, making manufacturers billions of dollars a year.

Ephedrine laws and ephedrine legal status changed as reports of serious side effects, adverse health events, and even potential deaths were linked to the use, misuse, and overuse of ephedra-containing its alkaloids.

In 2004, the US FDA deemed that while pure ephedra as used by Chinese medical practitioners was to be allowed, dietary products were no longer allowed to contain the ephedrine alkaloids nor the other alkaloids associated with many of the ephedra plant species. That implied:

  • Ephedrine
  • Pseudoephedrine
  • Norpseudoephedrine
  • Norephedrine
  • Methylephedrine
  • Methylpseudoephedrine

Each of these alkaloids can promote different behaviors in the body, increasing neurotransmitter activities that in turn stimulate certain receptors found in the brain, the heart muscle, and blood vessels throughout the body.

Ephedrine Drug Class and Mechanism of Action

Ephedrine is defined as a primary and stimulative alkaloid of the ephedra plant. The ephedrine drug class is defined as a vasopressor and decongestant.

Ephedrine is believed to stimulate thermogenesis or heat production in fat cells in some animal studies (in vitro). In others, the effects of ephedrine in regard to weight-loss have been conducted on small rodents and animals (monkeys), by “enhancing thermogenesis or anorexia.” [1]

Vasopressor drugs increase blood pressure by constricting or narrowing blood vessels. In medical scenarios, vasopressors are only used to treat drastically low blood pressure, more commonly in emergency or surgical situations for critically ill patients. Small amounts of vasopressin drugs are found in common medications today including but not limited to:

  • EpiPens
  • Neo-Synephrine
  • Primatene Mist (this form of Primatene has been discontinued in the US, but the tablets are still available)

The main function or activity of ephedrine is its ability to reduce swelling of nasal passages and sinuses, due to its functioning to either relax or dilate blood vessels that pass through the sinus cavity.

The same ability is effective in dilating or widening lung airways including the bronchial tubes, the bronchi, and the bronchioles, which caused them to relax and enable greater oxygenation; in short, a quite effective treatment for relieving asthma symptoms.

Ephedrine also has the potential to act as an appetite suppressant and has a function and behavior in the body that is similar to that of phenylpropanolamine (more commonly known as norephedrine which happens to be another alkaloid of the ephedra plant). Norephedrine is an appetite control component of ephedra; and in turn is also a drug compound that also happens to be banned in the US – in dietary supplements.

The primary components of the ephedra plant that provide medicinal and stimulative properties are its alkaloids. Two of the primary alkaloids – ephedrine and pseudoephedrine – behave like stimulants on the central nervous system.

Because of these mechanisms of action on certain body functions, they’re known as sympathomimetic amines because they specifically target the sympathetic nervous system.

The sympathetic nervous system involves a number of body functions over which we have no control, such as:

  • Respiratory rate
  • Blood pressure
  • Heart rate
  • The force with which the heart contracts
  • Constriction or dilation of blood vessels
  • Dilation or constriction of airways (bronchial tubes)
  • Metabolism
  • Digestion

Because of its stimulative behaviors and its ability to affect numerous body systems including that of the brain, ephedrine is likened to amphetamines, at least in regard to how the body responds to it.

Last but not least, is another component of ephedrine – an isomer known as pseudoephedrine.

Each of the alkaloid components of ephedra trigger different mechanisms of action that mainly have to do with changes in the chemical behaviors of brain function and activity. Because the brain controls every stimulus, response, and instruction for body movement, reaction, and function, its potency should not be underestimated.

One of the reasons why someone looking for weight loss or athletic performance enhancement would turn to products that contain ephedrine is for its very vasopressor and bronchial-dilating affects.

Opening the airways enables greater oxygen intake. Constricting blood vessels and increasing blood pressure requires energy, as the heart has to work harder, and triggers heat production or thermogenesis, otherwise known as fat burn.

The effects of ephedrine for these purposes is very short-term in nature, is non-sustainable, and causes much greater risks to health than any relevant or maintainable weight loss.

Does Ephedra Work for Weight Loss or Energy Boosts?

A number of studies have shown that while ephedra and its alkaloids can trigger a boost of energy due to the stimulative properties of the alkaloids, which include ephedrine and pseudoephedrine. Results for studies in regard to ephedra or ephedrine for weight loss are less remarkable.

Some studies regarding the efficacy of ephedra as well as ephedrine alkaloids for weight loss have been conducted. The National Institutes of Health identified and analyzed approximately 44 controlled trials involving ephedra, its alkaloids, and combination of other compounds for weight loss.

For example, combining ephedrine with caffeine, or ephedra with other herbal components that had caffeine like or stimulative effects. The results [2]?

  • Ephedrine used alone: individuals lost approximately 1.3 pounds per month more than the individual using the placebo. Length of study, four months.
  • Ephedrine plus caffeine: individuals lost approximately 2.2 pounds more per month than those using the placebo. Length of study, four months.
  • Ephedrine plus caffeine as opposed to ephedrine used alone: individuals lost approximately 0 .8 pounds per month more than a person who used ephedrine by itself.
  • Ephedrine as opposed to another weight-loss product: inconclusive. Ephedra in addition to other herbal components containing caffeine – individuals experienced 2.1 pounds weight loss more than those using a placebo. Length of study, four months.

Use of ephedra and its alkaloids with or without combinations of other stimulants does not tend to produce the dramatic weight loss that many consumers expect. For some, this leads to consuming larger amounts taken more frequently than recommended, which in turn increases the risk for side effects and adverse reactions.

Side Effects Linked to Ephedra

A number of side effects and adverse reactions have been associated with use of ephedra, with or without the alkaloids. This is because in countries where the ephedra alkaloids have been banned, manufacturers have substituted other ingredients to replace the stimulant effect previously offered by the alkaloids.

In some cases, these products can be as dangerous as ephedrine. One in particular is Bitter Orange, otherwise known as p-synephrine. Adding caffeine to ephedra or ephedrine products, regardless of form or milligram strength, can also contribute to a number of side effects and adverse reactions.

Among the more common side effects associated with stimulative products like ephedrine (even at low dosages) include:

  • Headache
  • Tremors
  • Anxiety or increased sense of nervousness
  • Complaints of jitters or a feeling of “jumping out of one’s skin”)
  • Changes in mood or behavior
  • Nausea, upset stomach, sometimes accompanied with vomiting
  • Increased heart rate

Some of the above-mentioned side effects are temporary in nature. The general half-life of ephedrine can last anywhere from one to six hours, depending on the person’s sensitivity to the stimulative properties of the product.

More serious side effects have also been linked to ephedra and ephedrine, especially in combination with other stimulants. Higher than recommended dosages or more frequency of use as well as length of use of ephedrine and ephedra can contribute to:

    • Heart palpitations
    • Tachycardia (racing heart rate)
    • Arrhythmias (irregular heart rate)
    • Seizures
    • Strokes
    • Myocardial infarction (heart attack)

Regardless of ephedrine laws or ephedrine legal status in any country, be aware of what ephedra and ephedrine are, how they affect the body, and whether benefits of use will outweigh risk.

Medical professionals warn that use of ephedra, ephedrine, and other stimulative components for weight loss, energy enhancement, or a boost in athletic performance, can become addictive – not just physically, but also psychologically.

Addiction treatment centers are seeing more of this type of addiction among younger users.

An ephedrine addiction may take time to present, as the component itself isn’t immediately addictive. Potential for addiction increases the longer it’s used; for example, more than four to six months.

Like other addictions, ephedrine may eventually be needed to prevent withdrawal symptoms and to facilitate a sensation or feeling of “normalcy” in the user.

Cutting ephedrine “cold turkey” can trigger very serious symptoms much like withdrawal of any substance like alcohol or drugs. Some of those symptoms include:

  • Agitation
  • Paranoia
  • Confusion
  • Lack of appetite
  • Nausea
  • Potential for seizures and/or tremors

According to drug rehab.org, some clients that have undergone ephedrine withdrawal and treatment claim it is almost as tough to overcome as an addiction to cocaine, and that the symptoms of withdrawal are similar to those of a heroin addiction.

Conclusion

When weighing the pros and cons of ephedra or ephedrine for weight loss or that energy boost, take the time to research benefits as opposed to the risk of side effects. A number of studies have been conducted on the adverse effects associated with ephedrine usage, with or without caffeine or other stimulative products. Individuals are typically young and healthy.

His ephedra legal? In some places, it is, but always research and ephedrine laws and ephedrine legal status in your country of origin before purchasing.


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