Ma Huang

What is Ma Huang?

The 3 species of this shrubby plant that are sources of the drug are native to China, where the aboveground parts are collected in the fall and dried for drug use. The root of E. sinica or E. intermedia is known as ma huang gen and is considered to be a distinct drug, used for its anti-soporific (anti-sleep) properties.

Scientific Name(s)

Ephedra sinica, E. intermedia, E. equisetina

Common Name(s)

Ma Huang also is known as ephedra, yellow horse, yellow astringent.

What is it used for?

Traditional/Ethnobotanical uses

Ma huang is one of the earliest and best known drugs of Chinese traditional medicine, referenced in the Shen Nong Ben Cao Jing, one of the foundation books of Chinese medicine (about 100 AD). It was and still is used to induce perspiration and to treat the symptoms of bronchial asthma, colds, and influenza.

Chemical investigations of ephedra in the early 20th century resulted in the isolation of the alkaloids ephedrine and pseudoephedrine, which were identified as the major pharmacologically active compounds in the aboveground portions of the plant.

Miscellaneous uses

While asthma treatment is one of the classical clinical uses for pure ephedrine as a pharmaceutical drug, dietary supplements promote ephedra as the herb for weight loss and increasing athletic performance. Ephedra has been a major component of herbal supplements for weight loss and athletic performance, often with caffeine also added. However, many manufacturers have recently reformulated products to remove ephedra because of legal liability questions. Because of its potential serious side effects, its use is not recommended.

What is the recommended dosage?

Current guidelines suggest limiting dosage of ephedrine to less than 90 mg/day. Medical supervision may be the most appropriate mode for safe administration of ma huang.

Contraindications

Ma huang is contraindicated with MAO inhibitors.

Pregnancy/Lactation

Documented adverse effects. Avoid use. Ma huang contains ephedrine and related alkaloids, increases blood pressure, heart rate and causes CNS activity, as well as stimulates uterine muscle. Women who are pregnant should exercise particular caution.

Interactions

Ma huang is contraindicated with MAO inhibitors.

Side Effects

Ephedra use has been linked to cardiovascular adverse effects, including hypertension, stroke, and MI. Patients with hyperthyroidism, benign prostatic hyperplasia, glaucoma, diabetes mellitus, and seizures and women who are pregnant should exercise particular caution.