title: Evaluation of the stimulant content of dietary supplements marketed as "ephedra-free".
abstract: BACKGROUND
  With the removal of stimulant herb ephedra from the market, dietary supplement manufacturers are coming out with many ephedra-free products. Some of these products appear to simply replace ephedra with stimulants by another name.
  
  
  OBJECTIVE
  To determine the stimulant content of dietary supplements marketed as ephedra-free.
  
  
  METHODS
  Survey of the ingredients of dietary supplements that are stated as "ephedra-free" in the label or promotional material.
  
  
  RESULTS
  Out of 36 products marketed as ephedra-free, 32 (89%) contained a methylxanthine such as caffeine or theobromine, 21 (58%) contained the stimulant synephrine, and 20 (56%) contained both a methylxanthine and synephrine.
  
  
  CONCLUSIONS
  The results of this evaluation pertain only to products discovered through Internet and database searching.
  
  
  CONCLUSIONS
  Most dietary supplement makers have substituted stimulants by a different name for ephedra in their "ephedra-free" products. Patients need to be advised that ephedra-free products are not necessarily stimulant free and may present a significant risk.
authors.affiliation: Thomas J. Long School of Pharmacy & Health Professions, Omaha, NE, USA.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Gregory
mesh_terms: D000470:Alkaloids / Q000032:analysis; D019440:Anti-Obesity Agents / Q000032:analysis*; D002110:Caffeine / Q000032:analysis; D000697:Central Nervous System Stimulants / Q000032:analysis; D019587:Dietary Supplements / Q000032:analysis*; D004348:Drug Labeling / Q000592:standards; D004335:Drug and Narcotic Control; D004365:Drugs, Chinese Herbal / Q000032:analysis*; D004809:Ephedrine / Q000032:analysis; D006801:Humans; D013058:Mass Spectrometry; D019216:Metals, Heavy / Q000032:analysis; D008517:Phytotherapy / Q000592:standards*; D028321:Plant Preparations / Q000737:chemistry
chemical_list: D000470:Alkaloids; D019440:Anti-Obesity Agents; D000697:Central Nervous System Stimulants; D004365:Drugs, Chinese Herbal; D019216:Metals, Heavy; D028321:Plant Preparations; D002110:Caffeine; D004809:Ephedrine