Is an ephedrine caffeine treatment contraindicated in hypertension?

Abstract

OBJECTIVES: To examine how the slimming drug, Letigen 1 , containing ephedrine (E) 20 mg and caffeine (C) 200 mg (E C), affects blood pressure in normotensive and hypertensive patients treated with adrenergic b-receptor blocking drugs and/or other antihypertensive agents, during a period of six weeks. DESIGN: A double-blind, randomised, placebo controlled study of ®ve parallel groups of overweight patients from general practices. SUBJECTS: One hundred and thirty-six patients with Body Mass Index (BMI) b 25 kg/m 2 were included consecutively by 25 general practitioners in Denmark and randomized into ®ve groups: (1) Hypertensive patients treated with betablockers and E C; (2) Hypertensive patients treated with antihypertensive agents other than betablockers, and E C; (3) Normotensive patients treated with E C; (4) Hypertensive patients under any antihypertensive treatment placebo; and (5) Normotensive patients placebo. All patients were instructed in a 1200 kcal ( 5040 kj) diet. RESULTS: Of a total of 136 patients aged 20±74 y, 112 completed the study protocol. Fluctuations in systolic and diastolic blood pressure were seen in all groups. The systolic blood pressure was reduced signi®cantly (5.5 mmHg) in the patients treated with antihypertensive agents other than betablockers, plus E C. In the other hypertensive groups the reduction in blood pressure was not signi®cant. In normotensive patients treated with E C, the systolic and the diastolic blood pressure declined signi®cantly (4.4/3.9 mmHg). At the end of the treatment period heart rate had increased signi®cantly (4.9 beats/min) in the group of normotensive patients treated with E C. Blood pressure and heart rate measured by the patient at home showed similar¯uctuations from baseline prior to and during treatment with E C or placebo.A mean loss of weight of approximately 4 kg in 6 weeks was signi®cant for all the groups. There was no signi®cant difference between the groups during this short period of treatment. In 56% of the patients treated with E C complaints/side-effects related to the medical treatment were found at questioning. Corresponding complaints occurred in 21% of the placebo treated patients. In the E C treated group 7% dropped out due to side-effects. In the placebo group there were no drop-outs. CONCLUSIONS: This study does not support the assumption that E C should cause rises in blood pressure, acutely or during shortterm treatment, in either normotensive or hypertensive obese patients. The antihypertensive effect of the betablockers was not reversed by E C.

β-Phenylethylamines and the isoquinoline alkaloids

“…The pharmacological properties and physiological effects of ephedrine, [8][9][10][11] of (+)-and (±)-norephedrine 12 and of pseudoephedrine 13 have been studied.…”

Effects of Ephedrine-Containing Products on Weight Loss and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…It also increases metabolism and suppresses appetite, thus promoting body fat decomposition [12,13]. Several studies have shown that single or mixed preparations of ephedrine can lead to weight loss and increased energy [14][15][16][17]. According to Douglas et al, patients taking ephedrine-containing capsules had a greater weight loss than those taking placebo (−3.1 kg vs. −2.1 kg in 8 weeks) [15].…”