title: Hypertensive Urgency Associated With Xenadrine EFX Use.
abstract: Several supplements and herbal products have been shown to increase catecholamines and subsequently mean arterial pressure and systemic vascular resistance. Since ephedra-containing products have been removed from the market, manufacturers of weight loss herbal supplements must produce ephedra-free formulations. Xenadrine EFX is an ephedra-free weight loss product containing a mixture of caffeine, guarana, and bitter orange (standardized to synephrine). Synephrine has been shown in animals and humans to increase systemic vascular resistance and mean arterial pressure. We present a case of a patient who took Xendarine EFX for 2 weeks prior to her presentation to an emergency department with headaches and hypertensive urgency (blood pressure [BP] 234/130 mm Hg). Her BP was controlled after discontinuation of Xenadrine and initiation a nitroprusside drip and oral clonidine. A Naranjo probability score of 6 indicates the adverse drug reaction was probable. Clinicians should be aware of potential cardiovascular changes in patients on Xenadrine EFX or other synephrine-containing products.
authors.affiliation: Johnston Health Systems, Clayton, NC, USA.
authors.forename: Jivan
authors.initials: J
authors.lastname: Moaddeb
authors.forename: Toyin S
authors.initials: TS
authors.lastname: Tofade
authors.forename: Micheal B
authors.initials: MB
authors.lastname: Bevins