The Adverse Effects of Ephedra Herb and the Safety of Ephedrine Alkaloids-free Ephedra Herb Extract (EFE)

Odaguchi, Hiroshi; Hyuga, Sumiko; Sekine, Mariko; Nakamori, Shunsuke; Takemoto, Hiroaki; Huang, Xuedan; Oshima, Naohiro; Shimada, Naoyuki; Yang, Jingping; Amakura, Yoshiaki; Hyuga, Masashi; Uchiyama, Nahoko; Kobayashi, Yoshinori; Hakamatsuka, Takashi; Goda, Yukihiro; Hanawa, Toshihiko

doi:10.1248/yakushi.19-00122

Cited by 15 publications

(11 citation statements)

References 14 publications

(1 reference statement)

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“…Kampo formulas consist of various combinations of crude drugs, traditionally regarded as units, and are often used on the base of ancient experience ( Tanaka et al, 1995 ; Odaguchi et al, 2019 ). In Japan, Kampo formulas are covered by the national health insurance system and are prescribed by doctors under the condition of government subsidies.…”

Section: Discussionmentioning

confidence: 99%

“…These results suggest that the combination of Ephedrae herba with other crude drugs in Kampo formulas has a weaker antiviral effect than that of Ephedrae herba. Ephedra herba has various side effects, and Kampo formulas are shown to contain crude drugs that alleviate the side effects of the strong Ephedra herba ( Odaguchi et al, 2019 ). The reduced suppressive effect of Ephedra herba on virus infection may mean that its side effects on the human body are reduced.…”

Section: Discussionmentioning

confidence: 99%

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In vitro Suppression of SARS-CoV-2 Infection by Existing Kampo Formulas and Crude Constituent Drugs Used for Treatment of Common Cold Respiratory Symptoms

et al. 2022

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Several traditional Japanese Kampo formulas are known to have inhibitory effects on infections with viruses that cause respiratory symptoms. Although some herbs and their components have been reported to suppress SARS-CoV-2 replication in vitro, it is difficult to compare effective Kampo formulas because of the different methods used in studies. Thus, we carried out in vitro experiments on the suppression of SARS-CoV-2 infection by Kampo formulas and crude drugs used for the common cold to compare their suppressive effects on virus infection. After infecting VeroE6/TMPRSS2 cells with SARS-CoV-2, lysates of the Kampo formulas and crude drugs were added, and after 24 h, the infectious titer in the medium was measured by the TCID50 method. Maoto was the most effective among the Kampo formulas, and Ephedrae herba was the most effective among the constituent crude drugs. However, a comparison of the suppressive effects of Ephedrae herba and Kampo formulas containing Ephedrae herba showed that the suppressive effect on virus infection did not depend on the content of Ephedrae herba. Based on the results, we believe that the use of Maoto among Kampo formulas is suitable as a countermeasure against COVID-19.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

In vitro Suppression of SARS-CoV-2 Infection by Existing Kampo Formulas and Crude Constituent Drugs Used for Treatment of Common Cold Respiratory Symptoms

et al. 2022

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“…The safety of Chinese herbal medicines is often queried. Aristolochia fangchi ( Tankeu et al, 2016 ) and Ephedra ( Odaguchi et al, 2019 ) are reported with a number of serious adverse effects on the cardiovascular and nervous system. The herbs of Yuanjiang decoction used in this study have been standard for decades.…”

Section: Discussionmentioning

confidence: 99%

Compassionate Use of Yuanjiang Decoction, a Traditional Chinese Medicinal Prescription, for Symptomatic Bradyarrhythmia

et al. 2022

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Background: No effective medication is available for symptomatic bradyarrhythmia, particularly in low socioeconomic status (SES) population.Objective: To explore the safety and efficacy of Yuanjiang decoction, a traditional Chinese medicinal prescription, for symptomatic bradyarrhythmia on a compassionate-use basis.Methods: This compassionate-use study was conducted in Beijing, China between January 2019 and January 2020. Eligible participants were recruited and treated with Yuanjiang decoction (composed of 6 Chinese herbal medicines), 200 ml twice daily for 16 weeks. Analyses were done with the intention-to-treat (ITT) approach. The primary outcome measure was the proportion of participants who achieved a favorable treatment outcome at 16 weeks.Results: As of January 2020, 184 patients were included. After 16-weeks treatment, 12 participants were lost to contact while 21 participants were terminated from this study, with a drop-out rate of 17.93%. The most common treatment-related adverse events were xerostomia (6.52%), constipation (6.45%) and sleepiness (3.26%). The proportion of participants with favorable treatment outcome was 65.22% at 4 weeks, 59.78% at 8 weeks (OR: 1.11, 95% CI: 0.71–1.73), 61.41% at 12 weeks (OR: 1.16, 95% CI: 0.92–1.45) and 60.87% at 16 weeks (OR: 1.15, 95% CI: 0.98–1.35). In the multifactor regression analysis, the favorable treatment outcome at 16 weeks was significantly associated with completing at least 8 weeks treatment (OR: 2.053, 95% CI: 1.064–3.560), while unfavorable treatment outcome was significantly associated with an atrioventricular block (OR: 0.255, 95% CI: 0.083–0.784), current smoking (OR: 0.343, 95% CI: 0.027–0.487), and syncope in the month before treatment (OR: 0.321, 95%CI: 0.114–0.904).Conclusion: This compassionate-use study showed encouraging outcomes of treatment with Yuanjiang decoction, without serious adverse events. This study identified several key factors that may affect outcomes. These findings helped inform the design and assess the feasibility of a large-scale randomized clinical trial.

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“…One study found 33% of products tested contained unlisted ingredients (Newmaster et al., 2013 ), whilst a 2019 study reported that 27% of the herbal products in the global marketplace were adulterated (Ichim, 2019 ). Many commercially available herbal remedies also have toxic effects when used in larger doses, or in certain circumstances (Chen et al., 2013 ; Cohen & Ernst, 2010 ; De Groot, 2013 ; Ernst, 2000 ; Fu et al., 2008 ; Lee et al., 2020 ; Lynch et al., 2006 ; McEwen, 2015 ; Mei et al., 2017 ; Nazari et al., 2017 ; Odaguchi et al., 2019 ; The Alpha‐Tocopherol Beta Carotene Cancer Prevention Study Group, 1994 ; Venkatramani et al., 2013 ; Werneke et al., 2004 ). Herbal products are usually controlled under different regulations to drugs (e.g., as dietary supplements or natural health products) and have not been subjected to the same scientific scrutiny.…”

Section: Discussionmentioning

confidence: 99%

A taxonomy of risk‐associated alternative health practices: A Delphi study

Garrett

Caulfield

Murdoch

et al. 2021

Health Social Care Comm

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Defining alternative health care and the recording of associated adverse events and harm remains problematic. This Canadian study aimed to establish and classify riskassociated alternative health practices in a Delphi study undertaken with an interdisciplinary panel of 17 health experts in 2020. It provides a new functional definition of alternative health care and an initial taxonomy of risk-associated alternative health care practices. A number of risk-associated practices were identified and categorized into general practices that conflict with biomedical care or largely untested therapies, alternative beliefs systems, physical manipulative alternative therapies, and herbal and nutritional supplements. Some risk significant harms including major physical injuries or even death. The lack of systematic methods for recording adverse events in alternative health care makes establishing the frequency of such events challenging. However, it is important that people engaging with alternative health care understand they are not necessarily risk-free endeavours, and what those risks are.

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The Adverse Effects of Ephedra Herb and the Safety of Ephedrine Alkaloids-free Ephedra Herb Extract (EFE)

Cited by 15 publications

References 14 publications

In vitro Suppression of SARS-CoV-2 Infection by Existing Kampo Formulas and Crude Constituent Drugs Used for Treatment of Common Cold Respiratory Symptoms

In vitro Suppression of SARS-CoV-2 Infection by Existing Kampo Formulas and Crude Constituent Drugs Used for Treatment of Common Cold Respiratory Symptoms

Compassionate Use of Yuanjiang Decoction, a Traditional Chinese Medicinal Prescription, for Symptomatic Bradyarrhythmia

A taxonomy of risk‐associated alternative health practices: A Delphi study

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