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July 26, 2019

Properties and mechanism of action

Ephedrine is an alkaloid, which accelerates and stimulates the sympathetic nervous system. Ephedrine is isolated from the ephedra bush. Ephedrine is also a pharmaceutical substance and it resembles amphetamine [1]. Compared with amphetamine, the effects of ephedrine on the central nervous system are milder, however. The vitality-increasing and fatigue-reducing effects of ephedrine are mediated through the central nervous system. The effect of ephedrine could be compared with long-lasting adrenaline [2].

By contrast with amphetamine, however, the effects of ephedrine beyond the central nervous system are stronger. Some examples of these effects include increased blood pressure, an increased heart rate, enlarged bronchi, enlarged blood vessels in striated, or voluntary muscles, the reduction of other blood vessels, and accelerated energy metabolism.


In Finland, ephedrine is not classified as a doping substance, but as a pharmaceutical substance. Ephedrine is used in the treatment of asthma, coughs and head colds in doses of 10–50 mg. It is also used in conjunction with anesthesia for the treatment of hypotension, or low blood pressure [3]. In the field of Chines medicine, ephedrine has been used for the treatment of asthma for thousands of years [4].

In the field of competitive sports, ephedrine is used as a doping substance to improve exercise tolerance and, in the case of long-lasting performances, to prevent fatigue [2]. Ephedrine and other stimulants are often used in resistance training to provide explosiveness and power to the practices and especially due to their effect of accelerating metabolism and fat burning.

The performance capacity-enhancing effect of ephedrine has not been researched very much. According to the evidence currently available, ephedrine could slightly increase weight loss by approximately 0.9 kg per month in comparison with a placebo [5].  Using caffeine together with ephedrine may enhance the thermogenic effect, meaning that the two of them together may slightly boost the basic metabolism. Evidence for the performance capacity-enhancing or slimming effect of ephedrine is weak [1, 6].

Adverse effects

The adverse effects of ephedrine include tremors, restlessness, insomnia, palpitations, and an increase in blood pressure. It can cause the states of confusion or paranoia, as well as severe arrhythmias in sensitive individuals or if taken in excessive doses. The risk of adverse effects grows during a sports performance especially when combined with dehydration or increased body temperature [1, 6, 7, 8].

Some known trade names (7/2019): Sir Ephedrin, Efedrina level comprimidos, Ephedrine hydrochloride.

Timo Seppälä
Medical Director
Finnish Center for Integrity in Sports FINCIS (previously the Finnish Antidoping Agency FINADA)

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[1] Powers M. Ephedra and its application to sport performance: another concern for the athletic trainer? J Athl Train. 2001;36(4):420–424

[2] Docherty J. Pharmacology of stimulants prohibited by the World Anti-Doping Agency (WADA). Br J Pharmacol. 2008; 154(3): 606-22

[3] Duodecim lääketietokanta. 2019. Efedriini. Terveysportti

[4] Lehtimäki L, Moilanen E. 2019. Hengityselimistöön vaikuttavat lääkeaineet: Keuhkoputkia laajentavat β2-sympatomimeetit. In Ruskoaho H, Hakkola J, Huupponen R, Kantele A, Korpi E, Moilanen E, Piepponen P, Savontaus E, Tenhunen O, Vähäkangas K. Lääketieteellinen farmakologia ja toksikologia (5. painos). Duodecim. Helsinki

[5] Shekelle P, Hardy M, Morton S, Maglione M, Mojica W, Suttorp M, Rhodes S, Jungvig L, Gagné J. Efficacy and safety of ephedra and ephedrine for weight lossa and athletic performance: a meta-analysis. JAMA. 2003;289(12):1537–45

[6] Sellami M, Slimeni O, Pokrywka A, Kuvačić G, Hayes L, Milic M, Padulo J. Herbal medicine for sports: a review. J Int Soc Sports Nutr. 2018; 15:14

[7] Soni, Carabin, Griffiths & Burdock. Safety of ephedra: lessons learned. Toxicology Letters. 2004; 150(1): 97–110

[8] Bättig. Acute and chronic cardiovascular and behavioural effects of caffeine, aspirin and ephedrine. International Journal of Obesity Related Metabolic Disorder 1993; 17(1): 61–4