Ephedrine
(1R,2S)-2-Methylamino-1-phenylpropan-1-ol
Ma huang, Isofedrol
Ephedra sinica
Ephedrine is a naturally occurring stimulant alkaloid found in plants of the Ephedra genus, with a long history of use in traditional Chinese medicine.1 First isolated in 1885,1 it is a substituted amphetamine that acts as a sympathomimetic agent.2 Ephedrine is used clinically as a decongestant, bronchodilator, and to treat hypotension during anesthesia,3 and is listed on the WHO's List of Essential Medicines.4 Though structurally related to methamphetamine, its central nervous system effects are considerably less potent.5
Contents
Dosage & Duration
Dosage
Threshold~5 mg
Light5-20 mg
Moderate20-30 mg
Strong30-50 mg
Heavy50+ mg
Bioavailability
88%
Duration
Onset15-90 minutes
After Effects2-4 hours
Total2-5 hours
Half-life
~6 hours
Subjective Effects
Ephedrine produces a physically driven central nervous system stimulation with little to no perceptual or psychedelic character. The core experience is one of heightened cardiovascular and metabolic arousal - increased drive and performance, suppressed appetite, and a warming, thermogenic energy - accompanied at most by a mild euphoria. Adverse and overdose states shift the profile toward restlessness, confusion, and paranoia, with hallucinations reported only rarely and largely confined to those with pre-existing psychiatric conditions.
Physical
The body load is dominated by sympathomimetic arousal: elevated heart rate and blood pressure, palpitations, bronchodilation, and a rise in body heat from increased metabolism. Dizziness, headache, tremor, dry mouth, sweating, nausea, and appetite suppression are also common, while urinary urgency or retention reflects its action on smooth muscle.
Cognitive
The headspace is generally clear and goal-oriented, marked by increased motivation and mild euphoria, though anxiety, restlessness, and insomnia are common even at low doses. At higher doses or in overdose, confusion and paranoia can emerge, and continuous use is associated with irritability, nervousness, and impaired memory and concentration.
Reagent Testing
Loading reagent data
Expected colorimetric results are being prepared.
Pharmacology
Pharmacodynamics
Ephedrine is a sympathomimetic amine that acts through both direct and indirect mechanisms.2 Its principal action involves the release of norepinephrine from sympathetic neurons and inhibition of norepinephrine reuptake, thereby increasing norepinephrine signaling at postsynaptic alpha- and beta-adrenergic receptors.32 Ephedrine also directly activates beta-1 and beta-2 adrenergic receptors, though the degree of direct alpha-adrenergic agonism remains controversial.67 It crosses the blood-brain barrier and releases both norepinephrine and dopamine centrally, functioning as a norepinephrine-dopamine releasing agent.
Pharmacokinetics
Ephedrine has an oral bioavailability of approximately 88%3 and low plasma protein binding of roughly 24 to 29%.8 It is largely unmetabolized, with approximately 60% of an oral dose excreted unchanged in urine.9 The metabolized fraction primarily undergoes N-demethylation to form norephedrine (phenylpropanolamine), with smaller amounts oxidatively deaminated to benzoic acid or converted to 1,2-dihydroxy-1-phenylpropane.9 The oral elimination half-life is approximately 6 hours, with considerable inter-individual variability, and elimination is dependent on urinary pH.210
Caution
Use cautionThese combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Synergistic effects may be unpredictable. Care should be taken when choosing to use this combination.
Tolerance
Full Tolerance
Tolerance to the effects of ephedrine develops quickly with repeated and frequent usage. Tachyphylaxis (rapid tolerance development) is a recognized clinical concern with sympathomimetic amines like ephedrine.
Cross Tolerance
Dopaminergic stimulants
Harm Potential
Addiction & Dependence
Psychological
ModerateWith chronic use, ephedrine may be moderately addictive and can produce psychological dependence in some users.10 Regular use can lead to tolerance and dependence, with psychological symptoms being particularly prominent.
Physical
LowPhysical dependence is not well-characterized for ephedrine; dependence that develops with regular use appears to be predominantly psychological in nature.10
Toxicity
Cardiovascular
Ephedrine has particularly strong effects on the cardiovascular system compared to other stimulants; chronic or high-dose use has been associated with heart attacks, strokes, and cardiac arrhythmias,11 with serious events more likely in those with pre-existing cardiovascular conditions.
Hepatic
Liver damage has been reported as a potential consequence of continuous ephedrine use, though detailed characterization is limited.13
Renal
Kidney damage has been reported with continuous use; acute effects include decreased urination due to vasoconstriction of renal arteries.3
Central Nervous System
Continuous use may result in impaired memory and concentration, irritability, and nervousness; these cognitive effects appear associated with chronic heavy use patterns.14
Psychosis Risk
Hallucinations, delusions, paranoia, and mania are possible but rare, occurring primarily in individuals with pre-existing psychiatric conditions or in cases of overdose.15 Confusion and paranoia may occur at high doses.15
History & Culture
Traditional Medicine
Ephedrine's botanical source, the plant Ephedra sinica known as má huáng in Chinese, has been employed in traditional Chinese medicine for over two millennia.1 Documentation of its use as an anti-asthmatic and stimulant dates back to the Han dynasty (206 BC – 220 AD).…
Legality
International
1961 Single Convention on Narcotic Drugs: ephedrine is not individually scheduled.
1971 Convention on Psychotropic Substances: ephedrine is not individually scheduled.
1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances: ephedrine is listed in Table I.
By Country
United StatesControlled precursorList I chemical
The Controlled Substances Act classifies ephedrine, its salts, optical isomers, and salts of optical isomers as a List I chemical. Nonprescription drug products containing ephedrine are scheduled listed chemical products subject to a 3.6 g daily retail limit, behind-the-counter placement, purchaser photo identification, and logbook requirements; mail-order sales are limited to 7.5 g per purchaser in 30 days.
By state
Across the 56 states, territories, and the District of Columbia, 39 had sourced treatment mirroring the federal precursor-control baseline, 10 had sourced divergences, and 7 remained gaps.
AlabamaControlled precursorrestricted purchaser
ArizonaRestrictedstate precursor restriction
LouisianaRestrictedSchedule V
MississippiRestrictedSchedule III
OhioRestrictedSchedule V
OklahomaRestrictedSchedule V
OregonRestrictedSchedule III
South CarolinaControlled precursorTrafficking threshold: 9 grams
South DakotaRestrictedSchedule III (nonexempt ephedrine)
WashingtonRestrictedSchedule II immediate precursor
AustriaControlled precursorCategory 1
Regulation (EC) No 273/2004 on drug precursors20
Ephedrine is a Category 1 scheduled substance under the European Union drug-precursor regulation applicable in Austria. Category 1 substances may be handled only within the regulation’s authorisation and monitoring system.
BrazilControlled precursorLista D1
Portaria SVS/MS nº 344/199821
Brazil lists ephedrine in Lista D1, the list of precursor substances for narcotic drugs and psychotropics. Its manufacture, distribution and use are subject to the special-control rules for listed precursors.
ChinaControlled precursor药品类易制毒化学品品种，第272项
2026年兴奋剂目录（2025年第6号公告）27
China's 2026 Anti-Doping Directory expressly lists Ephedrine (麻黄碱) as item 272 in its category of pharmaceutical precursor chemicals (药品类易制毒化学品品种). The announcement took effect on 1 January 2026 and directs relevant departments to supervise the production, sale, import, export, and anti-doping use of substances in the Directory under the Anti-Doping Regulations. The designation concerns the Directory and its anti-doping regulatory scope; it does not address controls under the separately titled 药品类易制毒化学品管理办法.
CroatiaControlled precursorCategory 1
Regulation (EC) No 273/2004 on drug precursors, Annex I Category 1; Article 3(2)29
Listed as a precursor for illegal drugs under national legislation. Ephedrine hydrochloride is only available to pharmacies where nasal drops are produced in-house. Required to be stored in special locked areas within pharmacies to prevent theft.
DenmarkControlled precursorAnnex I Category 1
Regulation (EC) No 273/2004 on drug precursors (current consolidated text), Annex I Category 1 and Articles 2(a) and 3(2)3029
The directly applicable EU drug-precursor regulation lists ephedrine in Annex I, Category 1. Its definition of a scheduled substance includes Annex I substances and mixtures or natural products containing them, but excludes medicinal products and mixtures or natural products compounded so the substance cannot be readily used or extracted by readily applicable means. Operators and users must obtain a licence before possessing or placing non-exempt Category 1 scheduled substances on the market, subject to the regulation's specified exemptions.
FranceControlled precursorCategory 1
In France, the directly applicable EU drug-precursor regulation lists ephedrine as a Category 1 scheduled substance. Operators and users must obtain a licence from the competent authorities before possessing or placing a Category 1 scheduled substance on the market. The regulation excludes medicinal products from its definition of a scheduled substance, so the Category 1 controls do not apply to medicinal products containing ephedrine.
IndiaControlled precursorSchedule A
India's 2013 Order lists ephedrine and its salts in Schedule A as controlled substances. Manufacturing, distribution, sale, purchase, possession, storage, and consumption of a Schedule A substance require a unique registration number from the relevant Narcotics Control Bureau Zonal Director, subject to the Order's specified institutional exemptions. Schedule B and Schedule C separately list ephedrine, its salts, and preparations for export and import, respectively, which require a Narcotics Commissioner's no-objection certificate; the domestic Schedule A listing itself is limited to ephedrine and its salts.
IrelandControlled precursorCategory 1
Regulation (EC) No 273/2004 on drug precursors (current consolidated text), Annex I Category 1 and Articles 2(a) and 3(2); European Communities (Control of Drug Precursors) Regulations 2009, Regulation 53033
Ephedrine is listed in Category 1 of Annex I to the current EU drug-precursor Regulation, which applies in Ireland. The Regulation excludes medicinal products and compounded mixtures from its definition of a scheduled substance where the scheduled substance cannot be easily used or extracted by readily applicable means; the Category 1 classification therefore concerns non-exempt ephedrine only. Irish Regulation 5 makes it an offence for an operator to possess or place a Category 1 Annex I substance on the market without the licence required under Article 3.
JapanControlled precursorStimulant raw material
Stimulants Control Act34
Japan treats ephedrine as a stimulant raw material under the Stimulants Control Act. Manufacture, import, export, transfer, possession and use of stimulant raw materials are regulated by that Act.
NetherlandsControlled precursorAnnex I Category 1
Regulation (EC) No 273/2004 on drug precursors (current consolidated text), Annex I Category 1 and Articles 2(a) and 3(2)30
The directly applicable EU drug-precursor regulation lists ephedrine in Annex I, Category 1, and therefore controls non-exempt ephedrine in the Netherlands as a precursor. The regulation defines scheduled substances to include listed substances and mixtures or natural products containing them, but excludes medicinal products and compounded mixtures or natural products from which the substance cannot be readily used or extracted by readily applicable means. Operators and users must obtain a licence before possessing or placing non-exempt Category 1 scheduled substances on the market, subject to the regulation's specified exemptions.
NorwayControlled precursorCategory 1
Forskrift om stoffer som kan brukes ved ulovlig fremstilling av narkotika mv. (FOR-2006-02-17-263), §§ 3, 5 and 10; Vedlegg I kategori 137
Norway's current regulation lists ephedrine (Efedrin) in Category 1 of Annex I as a substance that may be used in illicit narcotics manufacture. The regulation applies to marketing and other handling of listed substances, but excludes medicinal products and specified compounded mixtures or natural products from which the substance cannot readily be used or recovered. Operators must hold a Directorate for Medical Products licence before marketing or possessing Category 1 substances; imports from, and exports to, countries outside the EEA also require the permits specified in section 10.
PolandControlled precursorAnnex I Category 1
Ustawa z dnia 29 lipca 2005 r. o przeciwdziałaniu narkomanii (consolidated text, Dz.U. 2023 poz. 1939), Articles 4(16) and 34; Regulation (EC) No 273/2004 on drug precursors (current consolidated text), Annex I Category 1 and Articles 2(a) and 3(2)3930
Poland’s current narcotics-prevention Act defines a precursor as a scheduled substance within Article 2(a) of Regulation (EC) No 273/2004, with its category determined by that Regulation’s Annex I. The current consolidated EU Regulation lists ephedrine in Annex I, Category 1, and requires operators and users to obtain a licence before possessing or placing non-exempt Category 1 scheduled substances on the market. The Polish Act permits possession of Category 1 precursors only by a business, organisational unit, or natural person authorised under the Act or the EU precursor regulations; the EU definition excludes medicinal products and specified compounded mixtures or natural products from which the substance cannot readily be used or extracted.
RussiaControlled precursorList IV Table I
Government Resolution No. 681 of 30 June 199840
Russia lists ephedrine at a concentration of 10 percent or more in List IV, Table I of Government Resolution No. 681. The table covers precursors whose circulation is restricted and subject to control measures.
South KoreaControlled precursorAppendix 8
Narcotics Control Act Enforcement Decree47
South Korea lists ephedrine as a raw material substance in Appendix 8 to the Narcotics Control Act Enforcement Decree. Listed raw materials are subject to transaction reporting and other precursor controls.
SwedenPrescription onlyReceptbelagt
Läkemedelsverket medicinal-product authorization record for Efedrin Unimedic 5 mg/ml injektionsvätska, lösning4950
Classified as a prescription-only medication. Not otherwise controlled but requires valid prescription for legal acquisition.
ThailandRestrictedCategory 2
Narcotics Code (psychotropic substance Category 2)52
Thailand’s Food and Drug Administration states that ephedrine is currently controlled as a Category 2 psychotropic substance under the Narcotics Code and cannot be sold in pharmacies. The FDA further states that no ephedrine-containing formulation is registered; it sells ephedrine powder only to health facilities for preparation of pediatric nasal medicine. This classification concerns ephedrine itself, rather than treating ephedra plants or products generally as controlled.
United Arab EmiratesControlled precursorUN 1988
MOHAP Controlled and Semi-Controlled Medicines List55
The United Arab Emirates lists ephedrine as controlled according to the 1988 United Nations Convention. Its import and handling are subject to the controlled-medicines and precursor requirements administered by the Ministry of Health and Prevention.
AustraliaControlled precursorControlled precursor — item 1
Criminal Code Regulations 2019, section 13 table (Compilation No. 6, F2025C01260)19
Section 13 of the Criminal Code Regulations 2019 lists ephedrine as item 1 in the table of controlled precursors for paragraph 301.3(1)(a) of the Criminal Code. The table sets a commercial quantity of 1.2 kilograms and a marketable quantity of 400 grams; the Regulations note that a salt or ester of a listed substance is also a controlled precursor under paragraph 301.3(1)(b) of the Criminal Code.
BelgiumControlled precursorCategory 1
Regulation (EC) No 273/2004 on drug precursors20
Ephedrine is a Category 1 scheduled substance under the European Union drug-precursor regulation applicable in Belgium. Category 1 substances are subject to authorisation, customer declarations and transaction records under that regime.
CanadaControlled precursorClass A precursor
Controlled Drugs and Substances Act, Schedule VI, Part 1; Precursor Control Regulations, ss. 6 and 91.1–91.32223242526
Canada lists ephedrine, its salts, and any plant containing ephedrine or its salts as a Class A precursor in Part 1 of Schedule VI to the Controlled Drugs and Substances Act. Subject to specified exceptions, only a licensed dealer may produce, package, sell, or provide a Class A precursor. The regulations allow narrowly defined retail provision of ephedrine preparations or mixtures by practitioners, hospitals, and pharmacists; a pharmacist may provide more than 0.4 g per transaction only under a prescription.
ColombiaControlled precursorLista Roja Cuadro I
Resolución 315 de 2020, Anexo Técnico 1 (Efedrina, Lista Roja Cuadro I)28
La Resolución 315 de 2020 incluye la efedrina en el Anexo Técnico 1 como sustancia de control especial sometida a fiscalización, en la Lista Roja, Cuadro I. La resolución extiende esa fiscalización a las mezclas y productos que contengan las sustancias del anexo, incluidos los medicamentos; las sales de las sustancias del Cuadro I también están sometidas a fiscalización cuando puedan existir.
Czech RepublicControlled precursorCategory 1
Regulation (EC) No 273/2004 on drug precursors20
Ephedrine is a Category 1 scheduled substance under Regulation (EC) No 273/2004, which is binding and directly applicable in the Czech Republic as an EU Member State. Operators must obtain a licence before they may possess or place Category 1 scheduled substances on the market, and may supply them only to licensed persons who have signed a customer declaration. The regulation excludes medicinal products and preparations from its definition of scheduled substance where they cannot be easily used or extracted by readily applicable or economically viable means.
FinlandControlled precursorCategory 1
Regulation (EC) No 273/2004 on drug precursors30
Ephedrine is a Category 1 scheduled substance under Regulation (EC) No 273/2004, which applies in Finland. Operators and users must obtain a licence before possessing or placing Category 1 scheduled substances on the market. The regulation excludes medicinal products from its definition of a scheduled substance, so its precursor controls do not themselves classify authorised medicinal products.
GermanyPrescription Only
Controlled under the Grundstoffüberwachungsgesetz (GÜG), which regulates precursor chemicals used in the manufacture of controlled substances. No longer available over-the-counter; can only be obtained through a pharmacy with prescription.
IndonesiaAvailable OTC (unconfirmed)
Reportedly sold over-the-counter at pharmacies in 25 milligram packets of 20 pills. This information has not been independently verified.
ItalyControlled precursorCategory 1
In Italy, the directly applicable EU drug-precursor regulation lists ephedrine in Annex I, Category 1. Operators and users must obtain a licence from the competent authority in the Member State where they are established before possessing or placing Category 1 scheduled substances on the market. Article 2(a) excludes medicinal products and veterinary medicinal products, and also preparations from which the scheduled substance cannot be easily used or extracted by readily applicable or economically viable means; not every ephedrine-containing medicinal product or preparation is therefore a Category 1 scheduled substance.
MexicoControlled precursorPrecursor
Ley Federal para el Control de Precursores Químicos35
Mexico lists ephedrine as a chemical precursor under the federal precursor-control regime. Import, export, transport, storage, production and commercial transactions involving controlled precursors are subject to federal controls.
New ZealandRestrictedClass B2
Misuse of Drugs Act 1975, Schedule 2 Part 2; Medicines Regulations 1984, Schedule 136
Ephedrine is listed as a Class B, Part II controlled drug (Class B2) in Schedule 2 of the Misuse of Drugs Act 1975, so the Act's controlled-drug controls apply. Separately, Schedule 1 to the Medicines Regulations 1984 classifies ephedrine as a prescription medicine; this medicinal classification does not displace its Schedule 2 controlled-drug status.
PhilippinesControlled precursorTable I
Comprehensive Dangerous Drugs Act of 2002 (Republic Act No. 9165)38
Ephedrine is listed in Table I of the annex to the Comprehensive Dangerous Drugs Act of 2002 as a controlled precursor and essential chemical. Unauthorized importation, sale, distribution, transportation, manufacture, and chemical diversion of controlled precursors and essential chemicals are offences under the Act.
PortugalControlled precursorCategory 1
Regulation (EC) No 273/2004 on drug precursors20
Ephedrine is a Category 1 scheduled substance under the European Union drug-precursor regulation applicable in Portugal. Its handling is controlled through the authorisation and monitoring rules for that category.
SingaporeLegal (regulated)First Schedule poison
Poisons Act 1938, sections 5 and 6(3); Poisons Rules, rules 10 and 15, First and Third Schedules414243444546
Singapore’s First Schedule lists ephedrine, its optical isomers, quaternary compounds and salts, subject to stated preparation exceptions; rule 10 applies the purchaser-identification and sale-record restrictions in section 6(3) of the Poisons Act to First-Schedule substances. Section 5 requires a licence to import, possess for sale, sell or offer for sale a poison. The prescription-only rule applies to ephedrine only when contained in aerosol dispensers, so the First-Schedule listing does not make ephedrine generally prescription-only.
SpainControlled precursorCategory 1
Ephedrine is a Category 1 scheduled substance under the European Union drug-precursor regulation applicable in Spain. The category is subject to the regulation’s licensing and transaction-control requirements.
SwitzerlandControlled precursorVerzeichnis f
Verordnung des EDI über die Verzeichnisse der Betäubungsmittel, psychotropen Stoffe, Vorläuferstoffe und Hilfschemikalien (Betäubungsmittelverzeichnisverordnung, BetmVV-EDI), Anhang 7, Verzeichnis f51
The current BetmVV-EDI lists Ephedrin as item 5 of Verzeichnis f in Annex 7, which is the ordinance's list of controlled precursors. The preparation exemption is limited to preparations that contain one or more other active or auxiliary ingredients and, calculated as base, contain no more than 15 mg ephedrine per dosage unit or, when not divided into dosage units, no more than 10 mg/ml; it does not exempt ephedrine preparations solely by concentration.
UkraineControlled precursorTable IV List 1
Cabinet of Ministers Resolution No. 770, Table IV, List No. 1; Law of Ukraine No. 60/95-ВР, Article 25354
Ukraine lists ephedrine in Table IV, List No. 1 of Resolution No. 770, which is the list of precursors whose circulation is restricted and subject to control measures. The schedule's note also includes salts of every listed substance where their formation is possible; this entry concerns ephedrine and those salts under that express note, not ephedra plants or other products generally.
United KingdomLegal (regulated)Schedule 1(f)
Medicinal products containing ephedrine base or salts are prescription-only medicines under Schedule 1 paragraph 1(f) of the Human Medicines Regulations 2012. The Regulations exempt a product from the prescription requirement where it is not supplied with a pseudoephedrine product and the total amount supplied at one time is no more than 180 mg of ephedrine base or salts.
References
Source Pages
Citations
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