Ma Huang

This genus of about 40 species of shrubs and climbers occurs in S Europe, N Africa, Asia, and subtropical America. Joint firs have green branches and scale-like, much-reduced leaves. Scientists find the genus of great interest as an evolutionary link between flowering plants and conifers. A few species are cultivated, mainly as groundcover for dry situations. Male and female plants must be grown together for fruits to be produced. Ephedra species contain alkaloids, notably ephedrine, which was first isolated by Nagai and Hamanashi in 1885. Extracts are included in many patent medicines for excess mucus and asthma, and added to stimulant products aimed at young people and athletes, though the consumption of ephedrine in any form is banned in international sporting events. Various species are used medicinally, including Ephedra equisetina, E. intermedia, the Indian E. gerardiana, and E. sinica—the last usually having the highest alkaloid content. The pharmaceutical term Ephedrae herba and Chinese name ma huang are used for the drug sourced from any of these species. Research has shown anti-viral effects, notably against influenza. A similar stimulant to ephedrine, norpseudophedrine, or cathine is found in Catha edulis (See, khat). American species of Ephedra are low in alkaloids and not considered a viable source commercially. Several are known as Mormon Tea, being used as a substitute for tea and coffee, which are avoided by Mormons. Another common name is "whorehouse tea" as ir was once served in the waiting rooms of brothels in Nevada and California to cure syphilis.

This Chinese medicine, used for thousands of years, contains the alkaloid ephedrine, which has been extensively promoted as a way to aid weight loss, enhance sports performance, and increase energy. As of 2004, however, all dietary supplements containing ephedrine were banned in the United States, when it was determined that using this substance could cause serious side affects, including heart attack, seizure, stroke, and death.

Dwarf evergreen shrub with upright to sprawling stems, and minute leaves, reduced to scales at the nodes. Male inflorescence is cone-like; female is solitary, appearing in early summer, followed by fleshy, red fruits.

Common Name:
Ma Huang
Other Names:
Desert Herb, Ephedra, Ephedrine, Herbal Ecstasy, Joint fir, Sea Grape, Shrubby Horsetail, Yellow Horse
Botanical Name:
Ephedra distachya, Ephedra sinica
Native Location:
S and E Europe
Sharply drained to dry soil in sun. Tolerates poor soil.
By seed sown in autumn; by division in autumn or spring.
Stems are collected at any time and dried for use in powders, decoctions, tinctures, or liquid extracts.
1m (3ft)
1m (3ft)
Parts Used:
Stems, Branch, Root, Rhizomes, Whole Plant
A pungent, bitter, warm, diuretic herb that dilates the bronchial vessels, stimulates the heart and central nervous system, and increases perspiration.
Medicinal Uses:
Internally for asthma, hay fever, and allergic complaints. Often combined with Hyssopus officinalis (See, hyssop), Primula veris (See, cowslip), or Thymus vulgaris (See, thyme) for asthma or serios bronchial complaints, and with Chamaemelum nobile (See, Roman chamomile) or Urtica dioica (See, stinging nettle) for allergic reactions. In traditional Chinese medicine, often combined with Rehmannia glutinosa (See, Chinese foxglove) for kidney weakness, Prunus dulcis (See, almond) for asthma, Cinnamomum cassia (see, cassia bark) for colds, or Mentha arvensis (See, corn mint) for allergies. Used in Ayurvedic medicine for arthritis and edema. For use by qualified practioners only. Not given to patients taking monoamine oxidase (MAO) inhibitors or suffering from high blood pressure, angina, glaucoma, prostate disease, or hyperthyroidism.
To treat asthma, cough, bronchitis, nasal congestion, joint ailments, pains in the bones; as a heart and central nervous system stimulant. Germany's Commission E has approved the use of ma-huang to treat cough and bronchitis.
Typical Dose:
A typical dose of ma-huang may range from 12 to 30 mg total ephedra alkaloids, calculated as ephedrine, up to a maximum of 120mg per day.
Possible Side Effects:
Ma-Huang's side effects include dizziness, anxiety, irritability, insomnia, headache, anorexia, and nausea. It may also be associated with irregular heartbeat, heart attack, and sudden death.
Drug Interactions:
Taking Ma-Huang with these drugs may increase the risk of hypertension (high blood pressure):
Acebutolol, (Novo-Acebutolol, Sectral)
Albuterol, (Proventil, Ventolin)
Amlodipine, (Norvasc)
Atenolol, (Apo-Atenol, Tenormin)
Benazapril, (Lotensin)
Betaxolol, (Betoptic S, Kerlone)
Bisoprolol, (Monocor, Zebeta)
Brimonidine, (Alphagan P, PMS-Brimonidine Tartrate)
Bumetanide, (Bumex, Burinex)
Candesartan, (Atacand)
Captopril, (Capoten, Novo-Captopril)
Carteolol, (Cartrol, Ocupress)
Carvedilol, (Coreg)
Chlorthiazide, (Diuril)
Chlorthalidone, (Apo-Chlorthalidone, Thalitone)
Clonidine, (Catapres, Duraclon)
Diazoxide, (Hyperstat, Proglycem)
Diltiazem, (Cardizem, Tiazac)
Dobutamine, (Dobutrex)
Dopamine, (Intropin)
Dopexamine, (Dopacard)
Doxazosin, (Alti-Doxazosin, Cardura)
Enalapril, (Vasotec)
Ephedrine, (PretzD)
Eplerenone, (Inspra)
Eprosartan, (Teveten)
Esmolol, (Brevibloc)
Felodipine, (Plendil, Renedil)
Fenoldopam, (Corlopam)
Fosinopril, (Monopril)
Furosemide, (Apo-Furosemide, Lasix)
Guanabenz, (Wytensin)
Guanadrel, (Hylorel)
Guanfacine, (Tenex)
Hydralazine, (Apresoline, Novo-Hyalazin)
Hydrochlorothiazide, (Apo-Hydro, Microzide)
Hydrocholorothiazide and Triamterene, (Dyazide, Maxzide)
Indapamide, (Lozol, Nu-Indapamide)
Irbesartan, (Avapro)
Isoetharine, (Beta2, Bronkosol)
Isoproterenol, (Isuprel)
Isradipine, (DynaCirc)
Labetalol, (Normodyne, Trandate)
Lisinopril, (Prinivil, Zestril)
Losartan, (Cozaar)
Mecamylamine, (Inversine)
Mefruside, (Baycaron)
Metaproterenol, (Alupent)
Metaraminol, (Aramine)
Methyclothiazide, (Aquatensen, Enduron)
Methyldopa, (Apo-Methyldopa, Nu-Medopa)
Metolazone, (Mykrox, Zaroxolyn)
Metoprolol, (Betaloc, Lopressor)
Midodrine, (Amatine, ProAmatine)
Minoxidil, (Loniten, Rogaine)
Moexipril, (Univasc)
Nadolol, (Apo-Nadol, Corgard)
Nicardipine, (Cardene)
Nifedipine, (Adalat CC, Procardia)
Nisoldipine, (Sular)
Nitroglycerin, (Minitran, Nitro-Dur)
Nitroprusside, (Nipride, Nitropress)
Norepinephrine, (Levophed)
Olmesartan, (Benicar)
Oxprenolol, (Slow-Trasicor, Trasicor)
Oxytocin, (Pitocin, Syntocinon)
Perindopril Erbumine, (Aceon, Coversyl)
Phenoxybenzamine, (Dibenzyline)
Phentolamine, (Regitine, Rogitine)
Phenylephrine, (Neo-Synephrine, Vicks Sinex Nasal Spray)
Pindolol, (Apo-Pindol, Novo-Pindol)
Polythiazide, (Renese)
Prazosin, (Minipress, Nu-Prazo)
Propanolol, (Inderal, InnoPran XL)
Pseudoephedrine, (Dimetapp Decongestant, Sudafed 12 Hour)
Pseudoephedrine, (Dimetapp Decongestant, Sudafed)
Quinapril, (Accupril)
Ramipril, (Altace)
Reserpine, (Reserpine)
Spironolactone, (Aldactone, Novo-Spiriton)
Telmisartan, (Micardis)
Terazosin, (Alti-Terazosin, Hytrin)
Terbutaline, (Brethine)
Timolol, (Betimol, Timoptic)
Torsemide, (Demadex)
Trandolapril, (Mavik)
Triamterene, (Dyrenium)
Trichlormethiazide, (Metatensin, Naqua)
Valsartan, (Diovan)
Verapamil, (Calan, Isoptin DR)
Taking Ma-Huang with these drugs may increase the risk of agitation, excessive sweating, hypertensive crisis, and hyperthermia:
Albuterol, (Proventil, Ventolin)
Amitriptyline, (Elavil, Levate)
Amitriptyline and Chlordiazepoxide, (Limbitrol)
Amitriptyline and Perphenazine, (Etrafon, Triavil)
Amoxapine, (Asendin)
Brimonidine, (Alphagan P, PMS-Brimonidine Tartrate)
Clomipramine, (Anafranil, Novo-Clopramine)
Desipramine, (Alti-Desipramine, Norpramin)
Dobutamine, (Dobutrex)
Dopamine, (Intropin)
Dopexamine, (Dopacard)
Doxepin, (Sinequan, Zonalon)
Ephedrine, (PretzD)
Imiprimine, (Apo-Imipramine, Tofranil)
Iproniazid, (Marsilid)
Isoetharine, (Beta2, Bronkosol)
Isoproterenol, (Isuprel)
Lofepramine, (Feprapax, Gamanil)
Melitracen, (Dixeran)
Metaproterenol, (Alupent)
Metaraminol, (Aramine)
Moclobemide, (Alti-Moclobemide, Nu-Moclobemide)
Norepinephrine, (Levophed)
Nortriptyline, (Aventyl HCl, Pamelor)
Phenelzine, (Nardil)
Phenylephrine, (Neo-Synephrine, Vicks Sinex Nasal Spray)
Protriptyline, (Vivactil)
Pseudoephedrine, (Dimetapp Decongestant, Sudafed)
Selegiline, (Eldepryl)
Terbutaline, (Brethine)
Tranylcypromine, (Parnate)
Trimipramine, (Apo-Trimip, Surmontil)
Taking ma-huang with these drugs may reduce blood levels of the drugs:
Beclamethasone, (Beconase, Vanceril)
Betamethasone, (Celestone, Diprolene)
Budesonide, (Entocort, Rhinocort)
Budesonide and Formoterol, (Symbicort)
Cortisone, (Cortone)
Deflazacort, (Calcort, Dezacor)
Dexamethasone, (Decadron, Dexasone)
Flunisolide, (AeroBid, Nasarel)
Fluorometholone, (Eflone, Flarex)
Fluticasone, (Cutivate, Flonase)
Hydrocortisone, (Anusol-HC, Locoid)
Methylprednisolone, (DepoMedrol, Medrol)
Prednisolone, (Inflamase Forte, Pred Forte)
Prednisone, (Apo-Prednisone, Deltasone)
Triamcinolone, (Aristocort, Trinasal)
Taking ma-huang with these drugs may increase the effects of the drug:
Albuterol, (Proventil, Ventolin)
Brimonidine, (Alphagan P, PMS-Brimonidine Tartrate)
Dobutamine, (Dobutrex)
Dopamine, (Intropin)
Dopexamine, (Dopacard)
Ephedrine, (PretzD)
Isoetharine, (Beta2, Bronkosol)
Isoproterenol, (Isuprel)
Metaproterenol, (Alupent)
Metaraminol, (Aramine)
Norepinephrine, (Levophed)
Phenylephrine, (Neo-Synephrine, Vicks Sinex Nasal Spray)
Pseudoephedrine, (Dimetapp Decongestant, Sudafed, Sudafed 12-Hour)
Terbutaline, (Brethine)
Taking ma-huang with these drugs may increase the risk of herb toxicity:
Acetazolamide, (Apo-Acetazolamide, Diamox Sequels)
Aluminum Hydroxide, (AlternaGel, AluCap)
Aluminum Hydroxide and Magnesium Carbonate, (Gaviscon Extra Strength, Gaviscon Liquid)
Aluminum Hydroxide and Magnesium Hydroxide, (Maalox, Rulox)
Aluminum Hydroxide and Magnesium Trisilicate, (Gaviscon Tablet)
Aluminum Hydroxide, Magnesium Hydroxide, and Simethicone, (Maalox, Mylanta Liquid)
Calcium Carbonate, (Rolaids Extra Strength, Tums)
Calcium Carbonate and Magnesium Hydroxide, (Mylanta Gelcaps, Rolaids Extra Strength)
Dichlorphenamide, (Daranide)
Famotidine, Calcium Carbonate, and Magnesium Hydroxide, (Pepcid Complete)
Magaldrate and Simethicone, (Riopan Plus, Riopan Plus Double Strength)
Magnesium Hydroxide, (Ducolax Milk of Magnesia, Phillips' Milk of Magnesia)
Magnesium Oxide, (Mag-Ox 400, Uro-Mag)
Magnesium Sulfate, (Epsom Salts)
Sodium Bicarbonate, (Brioschi, Neut)
Taking ma-huang with these drugs may increase the risk of tachycardia (rapid heart rate):
Chlorpromazine, (Thorazine, Largactil)
Fluphenazine, (Modecate, Prolixin)
Mesoridazine, (Serentil)
Perphenazine, (Apo-Perphenazine, Trilafon)
Prochlorperazine, (Compazine, Compro)
Promethazine, (Phenergan)
Thiethylperazine, (Torecan)
Thioridazine, (Mellaril)
Thiothixene, (Navane)
Trifluoperazine, (Novo-Trifluzine, Stelazine)
Taking ma-huang with these drugs may increase the risk of hyperglycemia (high blood sugar):
Acarbose, (Prandase, Precose)
Acetohexamide, (Acetohexamide)
Chlorpropamide, (Diabinese, Novo-Propamide)
Gliclazide, (Diamicron, Novo-Gliclazide)
Glimepiride, (Amaryl)
Glipizide, (Glucotrol)
Glipizide and Metformin, (Metaglip)
Gliquidone, (Beglynor, Glurenorm)
Glyburide, (DiaBeta, Micronase)
Glyburide and Metformin, (Glucovance)
Insulin, (Humulin, Novolin R)
Metformin, (Glucophage, Riomet)
Miglitol, (Glyset)
Nateglinide, (Starlix)
Pioglitazone, (Actos)
Repaglinide, (GlucoNorm, Prandin)
Rosiglitazone, (Avandia)
Rosiglitazone and Metformin, (Avandamet)
Tolazamide, (Tolinase)
Tolbutamide, (Apo-Tolbutamide, Tol-Tab)
Taking ma-huang with these drugs may be harmful:
Digitalis, (Digitek, Lanoxin)—May increase the risk of arrhythmia (irregular heartbeat).
Reserpine, (Reserpine)—May increase the effects of the herb.
Lab Test Alterations:
  • May cause false positive results in urine amphetamine/methamphetamine tests.
  • May increase plasma catecholamine levels.
  • May increase blood glucose levels.
  • May increase blood lactate levels.
  • May cause false positive results in urine ephedrine tests.
  • May increase values on liver function tests, including aspartic acid transaminase (AST), alanine aminotransferase (ALT), total bilirubin, and urine bilirubin.
Disease Effects:
  • May worsen anxiety.
  • May worsen anorexia because it contains ephedra, which can reduce the appetite.
  • May worsen diabetes by interfering with blood sugar control.
  • May worsen heart disease by triggering rapid or irregular heartbeat.
  • May encourage the formation of kidney stones.
Food Interactions:
Increased stimulatory and adverse effects of both ma-huang and caffeine when the two are taken together.
Supplement Interactions:
  • Increased risk of insomnia, nervousness, dizziness, elevated blood pressure (hypertension), and adverse cardiovascular effects when used with herbs and supplements that have stimulant properties, such as caffeine, Coffee, Cola Nut, and others.
  • May cause increased vasoconstriction (constriction of blood vessels) and hypertension (elevated blood pressure) when combined with Ergot alkaloid derivatives.
  • When used with Panax Ginseng, may increase the risk of arrhythmia (irregular heartbeat).
Culinary Uses:
Fruits are edible when ripe.
Ephedra species are subject to legal restrictions in some countries. Ephedrine-containing substances are listed as addictive by the Internationally Olympic Committee and by the German Sports Association.
Encyclopedia of Herbs by Deni Brown Copyright © 1995, 2001 Dorling Kindersley Limited Pg 201-202
The Essential Herb-Drug-Vitamin Interaction Guide by Geo. T. Grossberg,MD and Barry Fox,PhD Copyright©2007 Barry Fox,PhD. Pp.322-327