Drug & supplement interaction

Ephedra + Lidocaine

Lidocaine brand names: Xylocaine, Dilocaine, Lidoject-1, Xylocaine MPF, Nervocaine, and others.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Ephedra and Lidocaine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Ephedra and Lidocaine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Lidocaine and Ephedra in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Ephedra safety at a glance

Ephedra overall Avoid Banned in dietary supplements in the U.S. due to serious cardiovascular risks, including death.
Pregnancy Likely Unsafe When used orally. Ephedra has been linked to several cases of severe side effects. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally. Ephedra has been linked to several cases of severe side effects. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Lidocaine and Ephedra? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Lidocaine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Lidocaine is filed under 5 classifications — including anesthesia, cytochrome p450 2d6 (cyp2d6) substrates, topical drugs. Ephedra has documented interactions with 11 drug classes — the most serious being methylxanthines (major), qt interval-prolonging drugs (major) and stimulant drugs (major) — and none of Lidocaine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Ephedra Does Interact With Other Medications

Ephedra has 337 major, 496 moderate known drug interactions in our database — Lidocaine isn’t one of them. If you take anything else, check it against the full list below.

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.

What to actually watch for

No Interaction Found — But Data Suggests Ephedra and Lidocaine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 3 of them are worth acting on rather than waiting out — marked below.

  • Seizures Worth acting on Additional detail

    Ephedra

    “Orally, ephedra is frequently associated with adverse reactions and is banned in the US. In some cases, adverse effects can be severe or life-threatening. Large studies looking at the safety of ephedra have not been performed. Since most of the adverse effect data are from case reports, it is impossible to determine the overall incidence of these adverse effects.”

    Ephedra · Natural Medicines adverse-effect record, reported in anorexia.

    “The use of ephedra causes a 2.2- to 3.6-fold increase in the risk of developing psychiatric, autonomic, or gastrointestinal (GI) symptoms and cardiac palpitations. Ephedra most commonly causes dizziness, restlessness, anxiety, irritability, personality changes, difficulty concentrating, insomnia, and headache.

    Ephedra can cause seizures in otherwise healthy people, as well as in people with underlying seizure disorde…”

    Ephedra · Natural Medicines adverse-effect record, reported in anxiety.

    6 sources cited
    1. 9740. Shekelle PG, Hardy ML, Morton SC, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003;289:1537-45.. PubMed
    2. 48878. Shekelle P, Morton, S, Maglione, M, and et al. Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects. Evidence Report/Technology Assessment No. 76 (Prepared by Southern California Evidence-based Pr
    3. 1276. Doyle H, Kargin M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996;313:756. PubMed
    4. 3719. 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
    5. 6008. Gurley BJ, Gardner SF, Hubbard MA. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000;57:963-9. PubMed
    6. 6486. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8. PubMed

    Lidocaine

    Listed in the ADVERSE REACTIONS section of the FDA label for Lidocaine. Read the label on DailyMed ›

  • Bleeding or bruising Worth acting on Additional detail

    Ephedra

    “The use of ephedra causes a 2.2- to 3.6-fold increase in the risk of developing psychiatric, autonomic, or gastrointestinal (GI) symptoms and cardiac palpitations. Orally, ephedra use has been associated with cardiomyopathy, hypersensitivity myocarditis, chest tightness, myocardial infarction, cardiac arrest and sudden death, hypertension, tachycardia, and cardiac arrhythmias.”

    Ephedra · Natural Medicines adverse-effect record, reported in arrhythmia.

    6 sources cited
    1. 9740. Shekelle PG, Hardy ML, Morton SC, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003;289:1537-45.. PubMed
    2. 48878. Shekelle P, Morton, S, Maglione, M, and et al. Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects. Evidence Report/Technology Assessment No. 76 (Prepared by Southern California Evidence-based Pr
    3. 1270. Okada S, Rohan PJ, Miller FW, et al. Myopathies following ingestion of special nutritional products. Arthritis Rheum 1996;39:349.
    4. 48801. Singh, A., Rajeev, A. G., and Dohrmann, M. L. Cardiomyopathy associated with ephedra-containing nutritional supplements. Congest.Heart Fail. 2008;14(2):89-90. PubMed
    5. 1271. Zaacks SM, Klein L, Tan CD, et al. Hypersensitivity myocarditis associated with ephedra use. J Toxicol Clin Toxicol 1999;37:485-9. PubMed
    6. 6487. Leikin JB, Klein L. Ephedra causes myocarditis. Clin Toxicol 2000;38:353-4.

    Lidocaine

    Listed in the ADVERSE REACTIONS section of the FDA label for Lidocaine. Read the label on DailyMed ›

  • An allergic reaction Worth acting on Additional detail

    Ephedra

    Recorded for Ephedra in the same Natural Medicines adverse-effect record shown under Bleeding or bruising above.

    Lidocaine

    Listed in the ADVERSE REACTIONS section of the FDA label for Lidocaine. Read the label on DailyMed ›

  • Flushing / Numbness or tingling Additional detail

    Ephedra

    Recorded for Ephedra in the same Natural Medicines adverse-effect record shown under Seizures above.

    Lidocaine

    Listed in the ADVERSE REACTIONS section of the FDA label for Lidocaine. Read the label on DailyMed ›

  • Anxiety or restlessness Additional detail

    Ephedra

    “The use of ephedra causes a 2.2- to 3.6-fold increase in the risk of developing psychiatric, autonomic, or gastrointestinal (GI) symptoms and cardiac palpitations. Ephedra most commonly causes anxiety, irritability, personality changes, difficulty concentrating, and insomnia.

    Cases of ephedrine-induced psychiatric complications include mania, psychosis, and hallucinations.”

    Ephedra · Natural Medicines adverse-effect record, reported in anxiety.

    6 sources cited
    1. 9740. Shekelle PG, Hardy ML, Morton SC, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003;289:1537-45.. PubMed
    2. 48878. Shekelle P, Morton, S, Maglione, M, and et al. Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects. Evidence Report/Technology Assessment No. 76 (Prepared by Southern California Evidence-based Pr
    3. 1276. Doyle H, Kargin M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996;313:756. PubMed
    4. 3719. 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
    5. 6008. Gurley BJ, Gardner SF, Hubbard MA. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000;57:963-9. PubMed
    6. 6486. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8. PubMed

    Lidocaine

    Listed in the ADVERSE REACTIONS section of the FDA label for Lidocaine. Read the label on DailyMed ›

  • Swelling Additional detail

    Ephedra

    Recorded for Ephedra in the same Natural Medicines adverse-effect record shown under Bleeding or bruising above.

    Lidocaine

    Listed in the ADVERSE REACTIONS section of the FDA label for Lidocaine. Read the label on DailyMed ›

  • Dizziness / Headache reported in 4.6% of FDA reports for Lidocaine Additional detail

    Ephedra

    Recorded for Ephedra in the same Natural Medicines adverse-effect record shown under Seizures above.

    Lidocaine

    Listed in the ADVERSE REACTIONS section of the FDA label for Lidocaine, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Nausea reported in 5.2% of FDA reports for Lidocaine Additional detail

    Ephedra

    “The use of ephedra causes a 2.2- to 3.6-fold increase in the risk of developing psychiatric, autonomic, or gastrointestinal (GI) symptoms and cardiac palpitations. Orally and intravenously, ephedra and ephedrine most commonly cause dry mouth, anorexia, nausea, vomiting, heartburn, abdominal discomfort, and changes in stool consistency.”

    Ephedra · Natural Medicines adverse-effect record, reported in anorexia.

    6 sources cited
    1. 9740. Shekelle PG, Hardy ML, Morton SC, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003;289:1537-45.. PubMed
    2. 48878. Shekelle P, Morton, S, Maglione, M, and et al. Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects. Evidence Report/Technology Assessment No. 76 (Prepared by Southern California Evidence-based Pr
    3. 1276. Doyle H, Kargin M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996;313:756. PubMed
    4. 3719. 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
    5. 6008. Gurley BJ, Gardner SF, Hubbard MA. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000;57:963-9. PubMed
    6. 6486. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8. PubMed

    Lidocaine

    Listed in the ADVERSE REACTIONS section of the FDA label for Lidocaine, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Showing the 10 most notable of 11 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Ephedra but not commonly for Lidocaine: a stroke or mini-stroke, trouble concentrating, fainting and a heart attack.

Effects for Lidocaine come from the ADVERSE REACTIONS section of its FDA label; effects for Ephedra come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 96,036 voluntary FDA FAERS reports for Lidocaine that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Ephedra in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Unsafe

When used orally. Ephedra has been linked to several cases of severe side effects.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With Lidocaine

This page covers Ephedra only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Lidocaine page lists 145 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Fever Bark (major), Grapefruit (major), St. John's Wort (major), 1,3-dmaa (moderate) and Acacia Rigidula (moderate).

By severity: 3 major · 111 moderate · 31 minor.

From our pharmacist’s overview on the Lidocaine page

“Lidocaine (Xylocaine) deserves genuine care on this page, and I would learn its three major-rated entries first. Grapefruit and St.”

Reviewed by 2 · Jul 18, 2026

Open the Lidocaine 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. Even though Ephedra itself has no known interaction with Lidocaine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ephedra and Lidocaine 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

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

29 days ago today
Medication Lidocaine
Top 25%

#430 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Ephedra reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Ephedra and Lidocaine records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Ephedra sinica · Ephedraceae · Dried stems and branches (aerial parts) · Historically: capsules, tablets, teas, and tinctures (now banned in dietary supplements in many countries)

An interaction check asks whether these two react with each other — it does not ask whether Ephedra is a good idea for someone in your situation. Here is what our Ephedra record says about it on its own.

Ephedra: dosing

There is no safe, recommended supplement dose for ephedra. It is banned in dietary supplements in the U.S. and many other countries, so we cannot and do not provide a dose.Some regulated, FDA-approved over-the-counter medicines (for example certain asthma products) contain ephedrine in carefully controlled amounts and come with specific label directions.

From our Ephedra monograph — the full record covers uses, side effects and every documented interaction.

Read the full Ephedra monograph & all interactions
Medication

About Lidocaine Transdermal Patch

What Is Lidocaine Transdermal Patch Used For?

Brand names: Xylocaine, Dilocaine, Lidoject-1, Xylocaine MPF, Nervocaine, Lidoject-2, Duo-Trach Kit, Octocaine, Lidoderm, Ztlido

Lidocaine skin patches are applied directly to the painful area to treat post-herpetic neuralgia (PHN) — the persistent burning or aching nerve pain that can remain after a shingles outbreak.

Lidoderm (lidocaine patch 5%) and ZTlido (lidocaine topical system 1.8%) are both indicated for this use in adults. Note that despite their different strengths, one ZTlido topical system provides equivalent lidocaine exposure to one Lidoderm patch.

Most-Reported Side Effects for Lidocaine

From FAERS, the FDA’s public side-effect reporting system (96,036 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Nausea 4,961 reports
Fatigue 4,867 reports
Headache 4,439 reports
Product quality issue 3,920 reports
Dyspnea 3,658 reports
See full Lidocaine Transdermal Patch 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
496Moderate
0Minor
1,996No known interaction
Major

337 interactions

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

Moderate

496 interactions

Showing 60 of 496 moderate interactions — see all 496 on the Ephedra page.

No interaction 1,996 drugs checked — show the list
Evidence & sources

Ephedra References

The 87 references that drive our Ephedra monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Okada S, Rohan PJ, Miller FW, et al. Myopathies following ingestion of special nutritional products. Arthritis Rheum 1996;39:349.
  2. Zaacks SM, Klein L, Tan CD, et al. Hypersensitivity myocarditis associated with ephedra use. J Toxicol Clin Toxicol 1999;37:485-9. PubMed
  3. Powell T, Hsu FF, Turk J, Hruska K. Ma-huang strikes again: ephedrine nephrolithiasis. Am J Kidney Dis 1998;32:153-9. PubMed
  4. 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.
  5. Theoharides TC. Sudden death of a healthy college student related to ephedrine toxicity from a ma-huang containing drink. J Clin Psychopharmacol 1997;17:437-9. PubMed
  6. Vahedi K, Domingo V, Amarenco P, Bousser MG. Ischemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for bodybuilding. J Neurol Neurosurg Psychiatr 2000;68:112-3.
  7. Doyle H, Kargin M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996;313:756. PubMed
  8. FDA Takes Aim at Ephedra. The Washington Post. Available at: http://www.washingtonpost.com/archive/politics/2000/03/19/fda-takes-aim-at-ephedra/4ce534a7-d291-44ec-88a8-38e97ff27e3b/ (Accessed 19 March 2000).
  9. FDA. Proposed rule: dietary supplements containing ephedrine alkaloids. Available at: www.verity.fda.gov (Accessed 25 January 2000).
  10. 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
  11. Gurley BJ, Gardner SF, Hubbard MA. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000;57:963-9. PubMed
  12. White LM, Gardner SF, Gurley BJ, et al. Pharmacokinetics and Cardiovascular Effects of Ma-Huang (Ephedra sinica) in Normotensive Adults. J Clin Pharmacol 1997;37:116-22.
  13. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8. PubMed
  14. Leikin JB, Klein L. Ephedra causes myocarditis. Clin Toxicol 2000;38:353-4.
  15. Jacobs KM, Hirsch KA. Psychiatric complications of Ma-huang. Psychosomatics 2000;41:58-62. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Ephedra and Lidocaine Together: Common Questions

Is it safe to take Ephedra with Lidocaine?
We do not list a known interaction between Ephedra and Lidocaine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Ephedra and Lidocaine have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Ephedra and Lidocaine combination checked?
Interactions in our licensed database are recorded against drug classes. Lidocaine is filed under 5 classifications, and Ephedra has documented interactions with 11 drug classes — none of Lidocaine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Ephedra interact with any other medications?
Yes. Ephedra has 833 documented drug interactions in our database — Lidocaine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Lidocaine interact with any supplements?
Yes. Lidocaine has documented interactions with 145 supplements in our database — Ephedra is not one of them. The Lidocaine interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Lidocaine and Ephedra?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.