I am currently taking antibiotics for a slight case of
bronchitis (Zithromax). After taking a single dose (a pill)
of ephedra while on the antibiotic, I experienced rapid
heart rate, the shakes, and extreme nervousness.
I have never experienced anything like this before on ephedra
(I take it on average of maybe once every 2 weeks), and so I'm
wondering if the side effects had anything to do with my antibiotics.
Could you let me know what you think?
Great question- two thoughts-
Macrolides and Alkaloids
#1, azithromycin (zithromax) can increase levels of alkaloids
among other things... ephedrine (the constituent of ephedra that
helps with respiration, etc.) is an alkaloid. Macrolides like
azithromycin can inhibit your liver's ability to metabolize herbs.
So, this interaction made it as if you had taken a higher dosage
Ephedra and the Sympathetic Nervous System
Ephedrine works much like other asthma meds (e.g. albuterol)
in that it stimulates the sympathetic nervous system. This is
the "fight or flight" mode of the nervous system. That's
why you experienced those side effects.
The best thing would be to avoid the ephedra until the azithromycin
is out of your system, which would be 68 hours after you stop
Predicting Drug Herb Interactions
I would tell you to consult your doc or herbalist before you
combine herbs and drugs in the future, but they are unlikely to
know... check out my drug herb interaction article, and watch
for another one explaining how you can find out this kind of interaction
ahead of time.
Another Thought - Qi Deficiency
#2 - When you have a disease like bronchitis, your qi is depleted
(you're tired and your immune system isn't as strong)... an herb
like ephredra can be hard to deal with at a time like that. Chinese
herbs are almost always taken in combination with other chinese
herbs... in this case, some strengthening herbs and herbs that
moderate the toxicity of ephedra could have been used in a formula.
That plus the drug-herb interaction is likely what caused your
All the Controversy About Ma Huang (Ephedra)
Ma Huang has gotten a bad rap in the press- mostly because most
people use it for the wrong things! Unethical supplement companies
have marketed it for use in "energy" and weight loss
products. However, Ma Huang is traditional used for asthma, coughing,
and wheezing. In small doses, especially as part of a traditional
chinese herbal formula, it is an important and safe medicine.
You won't get great results if you take one self-prescribed herb
at the time. To get the best out of herbs, request the guidance
of a trained professional- most acupuncturists have this kind
of training. To find one, check our "Resources
for Finding Acupuncurists and Herbalists" article.
All the best!