Enhanced stimulant and metabolic effects of combined ephedrine and caffeine
Haller CA, Jacob P, Benowitz NL
Clinical pharmacology and therapeutics · 41 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute on Drug Abuse
- Gobierno
- National Center for Research Resources
- Gobierno
- National Center for Complementary and Integrative Health
- Gobierno
- NCRR NIH HHS
- Gobierno
- NCCIH NIH HHS
- Gobierno
- NIDA NIH HHS
- Subvenciones
- National Institute on Drug Abuse (DA02277); National Center for Research Resources (5-M01-RR-00083-40); National Center for Complementary and Integrative Health (K23AT00069-01); National Institute on Drug Abuse (DA 012393)
Según 6 financiadores declarados.
Publicación
- Publicado
- 2004-04-01 · Clin Pharmacol Ther · vol. 75 · número 4 · págs. 259–273
- Editorial
- Wiley
- Citado
- 86 citas · más que el 93% de estudios similares · 3.7× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 34 trabajos
- Acceso
- De pago
- Áreas de investigación
- Coffee research and impacts · Pharmacology and Obesity Treatment · Alkaloids: synthesis and pharmacology
- Palabras clave
- ephedrine, caffeine, combination therapy, pharmacodynamic interactions, stimulant effects, cardiovascular effects, blood pressure, heart rate, glucose and insulin, free fatty acids, lactate, epinephrine, sex differences, oral contraceptives, herbal weight loss supplements
- MeSH
- cardiovascular system, humans, ephedrine, caffeine, central nervous system stimulants, drug administration schedule, area under curve, confidence intervals, risk assessment, sensitivity and specificity, cross-over studies, double-blind method, biological availability, blood pressure, heart rate, dose-response relationship, drug, drug interactions, adolescent, adult, middle aged, female, male, hemodynamics
1 autor
- C HALLER🇺🇸 · autor de correspondenciaSan Francisco General Hospital; University of California, San Francisco
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
Herbal weight loss and athletic performance-enhancing supplements that contain ephedrine and caffeine have been associated with serious adverse health events. We sought to determine whether ephedrine and caffeine have clinically significant pharmacologic interactions that explain these toxicities.
Methods
Sixteen healthy adults ingested 25 mg ephedrine, 200 mg caffeine, or both drugs in a randomized, double-blind, placebo-controlled crossover study. Plasma and urine samples were collected over a 24-hour period and analyzed by liquid chromatography-tandem mass spectrometry for ephedrine and caffeine concentrations. Heart rate, blood pressure, and subjective responses were recorded. Serum hormonal and metabolic markers were serially measured during a 3-hour fasting period.
Results
Ephedrine plus caffeine increased systolic blood pressure (peak difference, 11.7 +/- 9.4 mm Hg; compared with placebo, P =.0005) and heart rate (peak difference, 5.9 +/- 8.8 beats/min; compared with placebo, P =.001) and raised fasting glucose, insulin, free fatty acid, and lactate concentrations. Ephedrine alone increased heart rate and glucose and insulin concentrations but did not affect systolic blood pressure. Caffeine increased systolic blood pressure and plasma free fatty acid and urinary epinephrine concentrations but did not increase heart rate. Compared with ephedrine, caffeine produced more subjective stimulant effects. Clinically significant pharmacokinetic interactions between ephedrine and caffeine were not observed. Women taking oral contraceptives had prolonged caffeine elimination (mean elimination half-life, 9.7 hours versus 5.0 hours in men; P =.05), but sex differences in pharmacodynamic responses were not seen.
Conclusions
The individual effects of ephedrine and caffeine were modest, but the drugs in combination produced significant cardiovascular, metabolic, and hormonal responses. These enhanced effects appear to be a result of pharmacodynamic rather than pharmacokinetic interactions.
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