Interaction Details

Niacin (prescription drug) is classified as belonging to the following category: Hepatotoxic Drugs

Theoretically, concomitant use might have additive adverse hepatotoxic effects.
There are numerous cases of liver toxicity from ephedra-containing supplements.

Interaction Rating

Moderate

Likelihood of Occurrence

Possible

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

References

  • 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.
  • Borum, M. L. Fulminant exacerbation of autoimmune hepatitis after the use of ma huang. Am J Gastroenterol. 2001;96(5):1654-1655.
  • Vigano, M., Lampertico, P., and Colombo, M. Acute hepatitis following assumption of a herbal remedy. Eur.J.Gastroenterol.Hepatol. 2008;20(4):364-365.
  • 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.
  • 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.
  • 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.
  • Skoulidis F, Alexander GJ, Davies SE. Ma huang associated acute liver failure requiring liver transplantation. Eur J Gastroenterol Hepatol. 2005;17(5):581-4.
  • 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.

Ephedra Overview

Ephedra 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.
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Niacin (prescription drug) Overview

  • Niacin is used with diet changes (restriction of cholesterol and fat intake) to reduce the amount of cholesterol (a fat-like substance) and other fatty substances in your blood and to increase the amount of high density lipoprotein (HDL; ''good cholesterol''). Niacin can be used in a number of situations including the following:

    • alone or in combination with other medications, such as HMG-CoA inhibitors (statins) or bile acid-binding resins;

    • to decrease the risk of another heart attack in patients with high cholesterol who have had a heart attack;

    • to prevent worsening of atherosclerosis (buildup of cholesterol and fats along the walls of the blood vessels) in patients with high cholesterol and coronary artery disease;

    • to reduce the amount of triglycerides (other fatty substances) in the blood in patients with very high triglycerides who are at risk of pancreatic disease (conditions affecting the pancreas, a gland that produces fluid to break down food and hormones to control blood sugar).

  • Niacin is also used to prevent and treat pellagra (niacin deficiency), a disease caused by inadequate diet and other medical problems. Niacin is a B-complex vitamin. At therapeutic doses, niacin is a cholesterol-lowering medication.

  • Results of a clinical study in people with heart disease and well-controlled cholesterol levels that compared people who took niacin and simvastatin with people who took simvastatin alone and found similar results for the two groups in the rate of heart attacks or strokes. Taking niacin along with simvastatin or lovastatin also has not been shown to reduce the risk of heart disease or death compared with the use of niacin, simvastatin, or lovastatin alone. Talk to your doctor if you have questions about the risks and benefits of treating increased amounts of cholesterol in your blood with niacin and other medications.

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Ephedra - More Interactions

Ephedra interacts with 802 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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