Ephedra - Advair Diskus (Fluticasone, Salmeterol) Interaction
Herbal: Ephedra
Also Known As: Ephedra distachya, Belcho, Cao Mahuang, Desert Herb, Ephedra Sinisa, Herbal Ecstasy, Indian Jointfir, Joint Fir, Ma Huang, Popotillo, Raisin de Mer, Sea Grape, Teamster's Tea, Yellow Astringent, Yellow Horse, Zhong Mahuang
Drug: Fluticasone, Salmeterol
Brand names:
Advair Diskus
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 25, 2025
Interaction Details
Fluticasone, Salmeterol is classified as belonging to the following category: Qt Interval-Prolonging Drugs
Theoretically, ephedra might have an additive effect with drugs that prolong the QT interval.
Even in healthy volunteers, EKG changes including prolonged QT interval and premature atrial contractions have been reported with ingestion of recommended doses of ephedra. Ephedra may have an additive effect with drugs that prolong the QT interval. This may increase the risk of ventricular arrhythmias.
Interaction Rating
Likelihood of Occurrence
ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
References
- Jenkins DJ, Wesson V, Wolever TM, et al. Wholemeal versus wholegrain breads: proportion of whole or cracked grain and the glycaemic response. BMJ 1988;297:958-60.
- McBride BF, Karapanos AK, Krudysz A, et al. Electrocardiographic and hemodynamic effects of a multicomponent dietary supplement containing ephedra and caffeine: a randomized controlled trial. JAMA 2004;291:216-21.
- Gardner SF, Franks AM, Gurley BJ, et al. Effect of a multicomponent, ephedra-containing dietary supplement (Metabolife 356) on Holter monitoring and hemostatic parameters in healthy volunteers. Am J Cardiol 2003;91:1510-3, A9.
- Gardner, S. F., Franks, A. M., Gurley, B. J., Haller, C. A., Singh, B. K., and Mehta, J. L. Effect of a multicomponent, ephedra-containing dietary supplement (Metabolife 356) on Holter monitoring and hemostatic parameters in healthy volunteers. Am J Card
Interaction Details
Fluticasone, Salmeterol is classified as belonging to the following category: Beta-Adrenergic Agonists
Theoretically, large amounts of ephedra might increase the cardiac inotropic effects of beta-agonists.
Interaction Rating
Likelihood of Occurrence
ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
Ephedra Overview
Ephedra, also known as ma huang, is a plant species in the family Ephedraceae, which is native to Asia and parts of North America. It has been used traditionally in herbal medicine for centuries to treat a variety of conditions, including respiratory problems, allergies, and obesity.
Ephedra contains a number of active compounds, including ephedrine and pseudoephedrine, which are stimulants that affect the central nervous system. The stimulant compounds in ephedra compounds have been used in a number of over-the-counter and prescription medications, including decongestants and weight loss supplements.
While ephedra and related stimulant compounds are still available in a number of over-the-counter medications, such as the inhaler Primatene Mist, and Bronkaid Caplets, it is banned for use in dietary supplements.
Ephedra was once an extremely popular ingredient in dietary supplements for weight loss, but it was linked to a number of serious adverse effects, including increased blood pressure, heart palpitations, stroke, and even death. As a result, the use of ephedra and ephedra-containing products were banned or restricted in many countries.
Ephedra - More Interactions
Ephedra interacts with 801 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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