The main active ingredients in ephedra are ephedrine and pseudoephedrine which account for the medicinal properties of the herb. Both ephedrine and pseudoephedrine are central nervous system stimulants that act as decongestants but, in high doses, can raise the blood pressure.
Contraindications for taking ephedra include anxiety, hypertension, heart disease, glaucoma, hyperthyroidism, and prostate enlargement. Ephedra can stimulate uterine contractions and so is hazardous during pregnancy.
Ephedra was widely promoted as a natural stimulant and appetite suppressant. There were reports of strokes, heart attacks and death in patients with no prior history of vascular disease. The misuse and overdose of ephedra also resulted in seizures and psychosis. Ephedra represented about 5% of all diet supplements sold but about 45% of the adverse events associated with diet supplements in the US.
The US Food and Drug Administration first issued warnings against the consumption of dietary supplements that contain ephedra. Then, after the death on Feb. 17, 2003 of a young baseball pitcher who had used ephedra, the FDA proposed labels warning consumers that ephedra had been linked to heart problems and strokes. And, finally, on Dec. 30, 2003 the FDA banned ephedra from the marketplace because of the health risks it posed.