Drug & supplement interaction

Ephedra + Selegiline

Selegiline brand names: Carbex, Eldepryl, Emsam, Zelapar.

Moderate Interaction
The bottom line Moderate

Ephedra has a moderate interaction with Selegiline. Theoretically, concomitant use might increase the risk of serious adverse effects.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ephedra and Selegiline

Here is the interaction we found between these two, with the evidence behind it.

Moderate

MONOAMINE OXIDASE INHIBITORS (MAOIs)

Why this applies to Selegiline

Selegiline falls under MONOAMINE OXIDASE INHIBITORS (MAOIs) — the group Ephedra interacts with.

Theoretically, concomitant use might increase the risk of serious adverse effects.
Concomitant use of ephedra with MAOIs might increase the risk of hypertension or hypotension, hyperpyrexia, hallucinations, convulsions, rhabdomyolysis, and urinary problems.
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

This is a combination I'd really want you to avoid. Selegiline is an MAO inhibitor, meaning it slows down the enzyme that normally breaks down stimulating brain chemicals like dopamine and norepinephrine. Ephedra is packed with stimulants (ephedrine and pseudoephedrine) that push those same chemicals up. When you block the cleanup crew and flood the system at the same time, the stimulant effects can pile up fast.

In real terms, that can mean a dangerous spike in blood pressure, racing heart, severe headache, sweating, agitation, or confusion, and in serious cases very high fever or seizures. Keep in mind ephedra is actually banned in U.S. supplements for safety reasons, so there's really no good reason to use it. Please talk with your pharmacist or doctor about safer options rather than starting or stopping anything on your own.

References
  1. 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.
  2. Dawson, J. K., Earnshaw, S. M., and Graham, C. S. Dangerous monoamine oxidase inhibitor interactions are still occurring in the 1990s. J Accid.Emerg.Med 1995;12(1):49-51. PubMed

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 Selegiline one above is 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.

Everything else you take

See Every Supplement That Interacts With Selegiline

This page covers Ephedra only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Selegiline page lists 102 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Bitter Orange (major), Brewer's Yeast (major) and Cowhage (major).

By severity: 14 major · 75 moderate · 13 minor.

Open the Selegiline 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 Selegiline 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 Selegiline 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

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

29 days ago today
Medication Selegiline
Steady interest

#2,142 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 Selegiline

What Is Selegiline Used For?

Brand names: Carbex, Eldepryl, Emsam, Zelapar

Selegiline is used as an add-on treatment for people with Parkinson's disease who are already taking levodopa/carbidopa but are finding that the medication's effects are wearing off or becoming less reliable. It is not used alone — it only works as part of a combination approach.

In clinical studies, adding selegiline helped reduce the amount of daily levodopa needed, cut down on "off" time (periods when symptoms break through), and improved things like tremor, speech, movement, and overall daily function.

See full Selegiline 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
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
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

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Pharmacist Counseling Corner

Taking Ephedra and Selegiline Together: Common Questions

Can you take Ephedra with Selegiline?
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.
How serious is the Ephedra and Selegiline 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 Selegiline and Ephedra?

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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.