Drug & supplement interaction

Ephedra + Glyburide

Glyburide brand names: Diabeta, Micronase, Glynase, Glycron, Micronized, and others.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Glyburide falls into 2 drug categories that Ephedra can interact with; the most serious is rated moderate. Theoretically, concomitant use might have additive adverse hepatotoxic effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ephedra and Glyburide

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Ephedra interacts with whole categories of medication. Glyburide falls into 2 of those categories, so it can interact with Ephedra in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

HEPATOTOXIC DRUGS

1 of 2

Why this applies to Glyburide

Glyburide falls under HEPATOTOXIC DRUGS — the group Ephedra interacts with.

Theoretically, concomitant use might have additive adverse hepatotoxic effects.
There are numerous cases of liver toxicity from ephedra-containing supplements.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with pairing ephedra and glyburide: both can put stress on your liver. Glyburide is processed through the liver and, in rare cases, has been linked to liver injury. Ephedra has its own track record of causing liver problems, with quite a few real-world reports. So the worry is that using them together could add up and burden your liver more than either one alone.

I'll be honest, this is a theoretical interaction based on how these substances behave, not something proven by strong studies. Still, ephedra is banned in U.S. supplements for good reason, including its heart and liver risks. Watch for warning signs like yellowing skin or eyes, dark urine, belly pain, or unusual tiredness, and please talk with your pharmacist or doctor before using any ephedra product.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Nadir A, Agrawal S, King PD, Marshall JB. Acute hepatitis associated with the use of a Chinese herbal product, ma-huang. Am J Gastroenterol 1996;91:1436-8.
  2. Borum, M. L. Fulminant exacerbation of autoimmune hepatitis after the use of ma huang. Am J Gastroenterol. 2001;96(5):1654-1655. PubMed
  3. Vigano, M., Lampertico, P., and Colombo, M. Acute hepatitis following assumption of a herbal remedy. Eur.J.Gastroenterol.Hepatol. 2008;20(4):364-365. PubMed
  4. Neff, G. W., Reddy, K. R., Durazo, F. A., Meyer, D., Marrero, R., and Kaplowitz, N. Severe hepatotoxicity associated with the use of weight loss diet supplements containing ma huang or usnic acid. J Hepatol. 2004;41(6):1062-1064. PubMed
  5. Bajaj J, Knox JF, Komorowski R, Saeian K. The irony of herbal hepatitis: Ma-Huang-induced hepatotoxicity associated with compound heterozygosity for hereditary hemochromatosis. Dig Dis Sci. 2003;48(10):1925-8.
  6. Charalampopoulos A, Karatsourakis T, Tsiodra P. Acute hepatitis associated with the use of Ma-huang in a young adult. Eur J Intern Med. 2007;18(1):81. PubMed
  7. Skoulidis F, Alexander GJ, Davies SE. Ma huang associated acute liver failure requiring liver transplantation. Eur J Gastroenterol Hepatol. 2005;17(5):581-4. PubMed
  8. Drug record: Ma huang. U.S. National Library of Medicine: Livertox Database. https://livertox.nlm.nih.gov/Ephedra.htm. Updated October 16, 2017. Accessed November 1, 2017.
Moderate

ANTIDIABETES DRUGS

2 of 2

Glyburide also falls under ANTIDIABETES DRUGS.

Theoretically, taking ephedra with antidiabetes drugs might interfere with blood glucose control.
One study in animals shows that some components of ephedra may lower blood glucose levels. However, most human research suggests that ephedra and ephedrine, a component of ephedra, can raise blood glucose levels and might decrease the effectiveness of drug therapy. Monitor blood glucose concentrations closely.
Severity Moderate Likelihood Probable Evidence B

Interaction 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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the practical side of this one. Glyburide works by nudging your pancreas to release more insulin, which brings your blood sugar down. Ephedra, on the other hand, contains stimulants (ephedrine and pseudoephedrine) that tend to push blood sugar up. So the two can work against each other, and ephedra may blunt how well your glyburide controls your numbers, leaving you with higher readings than you'd expect.

Most of the human evidence points this direction, though it isn't rock solid, so think of it as a real but moderate concern. Beyond that, ephedra itself is banned in U.S. supplements because it can raise blood pressure and stress the heart. I wouldn't recommend using it at all. Please talk with your pharmacist or doctor about safer options and keep an eye on your blood sugar.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Boozer CN, Nasser JA, Heymsfield SB, et al. An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Int J Obes Relat Metab Disord 2001;25:316-24. PubMed
  2. Haller CA, Jacob P 3rd, Benowitz NL. Enhanced stimulant and metabolic effects of combined ephedrine and caffeine. Clin Pharmacol Ther 2004;75:259-73.
  3. Astrup, A., Toubro, S., Cannon, S., Hein, P., and Madsen, J. Thermogenic synergism between ephedrine and caffeine in healthy volunteers: a double-blind, placebo-controlled study. Metabolism 1991;40(3):323-329. PubMed
  4. Konno, C., Mizuno, T., and Hikino, H. Isolation and hypoglycemic activity of ephedrans A, B, C, D and E, glycans of Ephedra distachya herbs. Planta Med 1985;(2):162-163.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • 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.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ephedra Also Interacts With Other Medications

Ephedra has 337 major, 495 moderate known drug interactions in our database — the Glyburide one above is among them. If you take anything else, check it against the full list below.

Major 337 Moderate 495 No known interaction 1,998 (incl. Glyburide)
Taking anything else?

Check Another of Your Medications Against Ephedra

Covers the 2,830 medications we’ve checked against Ephedra. Pick one to open its full report.

From our Q&A

Questions About Ephedra or Glyburide

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ephedra or Glyburide, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Glyburide

This page covers Ephedra only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Glyburide page lists 331 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Beer (major), Grapefruit (major) and Siberian Cocklebur (major).

By severity: 7 major · 279 moderate · 45 minor.

Open the Glyburide interaction page

One more smart check

Taking Ephedra as Part of a Dietary Supplement Product? Check It for Interactions

We hold 37 real supplement products containing Ephedra, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ephedra. Your product may carry other ingredients that interact with Glyburide too, on top of Ephedra — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ephedra and Glyburide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ephedra
Top half

#521 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Glyburide
Top half

#785 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Ephedra

What is Ephedra?

Ephedra
  • Weight loss
  • Nasal and sinus congestion
  • Asthma and breathing problems
  • Boosting energy and athletic performance
  • Allergies

Ephedra (ma huang) contains powerful stimulants like ephedrine that affect the heart and nervous system. Because it has been linked to serious harms including high blood pressure, stroke, and death, it is banned for use in dietary supplements in the U.S. and many other countries. We do not recommend using ephedra-containing supplements; talk to your pharmacist or doctor about safer, approved options.

Read the full Ephedra monograph & all interactions
Medication

About Glyburide

What Is Glyburide Used For?

Brand names: Diabeta, Micronase, Glynase, Glycron, Micronized, Glynase PresTab, Albert Glyburide

Glyburide tablets are used alongside diet and exercise to help control blood sugar in adults with type 2 diabetes. It is not for type 1 diabetes or diabetic ketoacidosis (a serious complication where the body produces dangerous levels of acids called ketones).

Glyburide may be used alone or combined with metformin when metformin alone is not enough. It can also be used to help transition patients who are moving from insulin or other diabetes pills to a new regimen, under a doctor's guidance.

See full Glyburide drug information
Keep checking

Other Drugs & Ephedra

Browse every other medication we’ve checked against Ephedra — both the ones with a known interaction and the ones without. Select any drug for the full detail.

337Major
495Moderate
0Minor
1,997No known interaction
337 Major 495 Moderate 1,997 No interaction
Major

337 interactions

Showing 60 of 337 major interactions — see all 337 on the Ephedra page.

Moderate

495 interactions

Showing 60 of 495 moderate interactions — see all 495 on the Ephedra page.

No interaction 1,997 drugs checked — show the list

We also checked Ephedra against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,997 medications checked with no known interaction — see the full Ephedra list.

See the full Ephedra interactions page
See every supplement checked against Glyburide, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

Keep exploring
Ephedra monograph › Uses, safety, and every drug interaction in one place Glyburide supplement interactions › Every supplement checked against Glyburide, ranked by severity Glyburide drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Ephedra and Glyburide Together: Common Questions

Can you take Ephedra with Glyburide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Ephedra and Glyburide?
Glyburide belongs to more than one drug category, and Ephedra interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Ephedra and Glyburide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Glyburide and Ephedra?

Our pharmacists answer your medication & supplement questions — free.

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.