Last update June 12, 2019

Racemic Ephedrine Hydrochloride

Low Risk

Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

An alkaloid derived from ephedra.
It has sympathomimetic properties with direct and indirect effects on adrenergic receptors.
Used parenterally to treat hypotension derived from spinal or epidural anesthesia due to its peripheral vasoconstrictor effects and improvement of heart tone.
Used orally as a bronchodilator and nasal decongestant mixed in preparations for colds, bronchitis and asthma.
Used illegaly as a psychostimulant and for weight loss, with serious health risks (van der Hoof 2002, Gruber 1998).

Since the last update we have not found published data on its excretion in breast milk.

Its large volume of distribution makes it unlikely it will pass into milk in significant amounts.

After a cesarean section with epidural anesthesia and use of ephedrine there were no side effects in 100 newborns; the time of initial breastfeeding was not delayed with respect to newborns after cesareans under general anesthesia (Havas 2013). The use of ephedrine during delivery or cesarean section is not contraindicated with the early initiation of breastfeeding: as well as the unlikely excretion in breast milk there is a low amount of colostrum obtained by the newborn in the first hours of life.

It may be desirable to minimize the continued use of oral preparations for colds/bronchitis which contain ephedrine since a case of crying, irritability and insomnia has been reported in a 3-month-old infant whose mother was taking a medication containing d-isoephedrine and dexbrompheniramine (Mortimer 1977).
Simple preparations (a single active ingredient per drug) are preferable and even more so during breastfeeding.

Abusive use as a psychostimulant or antiobesity product entails serious risks to the health of the mother and the infant and should be avoided (van der Hoof 2002, Gruber 1998).

TOPICAL USE ephedrine as a complement to preparations for local anesthetic, dermatologicals, stomatologicals or ophthalmologicals is compatible with breastfeeding (WHO 2002).

See below the information of these related products:

  • Ephedra ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)
  • Ephedrine Topical Use ( Safe. Compatible. Minimal risk for breastfeeding and infant.)


We do not have alternatives for Racemic Ephedrine Hydrochloride.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Racemic Ephedrine Hydrochloride is also known as Ephedrine. Here it is a list of alternative known names::

Racemic Ephedrine Hydrochloride in other languages or writings:


Main tradenames from several countries containing Racemic Ephedrine Hydrochloride in its composition:


Variable Value Unit
Oral Bioavail. 85 %
Molecular weight 165 daltons
VD 3 l/Kg
Tmax 0.25 - 1 hours
3 - 5 hours


  1. MedlinePlus. Fitoterapia y suplementos para bajar de peso. Información de salud para usted. 2019 Full text (link to original source) Full text (in our servers)
  2. MedlinePlus. Herbal remedies and supplements for weight loss. Trusted Health information for you 2019 Full text (link to original source) Full text (in our servers)
  3. Schalla SC, Witcomb GL, Haycraft E. Body Shape and Weight Loss as Motivators for Breastfeeding Initiation and Continuation. Int J Environ Res Public Health. 2017 Jul 11;14(7). pii: E754. Abstract
  4. Rodríguez JE, Campbell KM. Past, Present, and Future of Pharmacologic Therapy in Obesity. Prim Care. 2016 Mar;43(1):61-7, viii. Abstract
  5. López-Olmedo N, Hernández-Cordero S, Neufeld LM, García-Guerra A, Mejía-Rodríguez F, Méndez Gómez-Humarán I. The Associations of Maternal Weight Change with Breastfeeding, Diet and Physical Activity During the Postpartum Period. Matern Child Health J. 2016 Feb;20(2):270-80. Abstract
  6. Neville CE, McKinley MC, Holmes VA, Spence D, Woodside JV. The relationship between breastfeeding and postpartum weight change--a systematic review and critical evaluation. Int J Obes (Lond). 2014 Apr;38(4):577-90. Abstract
  7. Sámano R, Martínez-Rojano H, Godínez Martínez E, Sánchez Jiménez B, Villeda Rodríguez GP, Pérez Zamora J, Casanueva E. Effects of breastfeeding on weight loss and recovery of pregestational weight in adolescent and adult mothers. Food Nutr Bull. 2013 Jun;34(2):123-30. Abstract
  8. Havas F, Orhan Sungur M, Yenigün Y, Karadeniz M, Kılıç M, Özkan Seyhan T. Spinal anesthesia for elective cesarean section is associated with shorter hospital stay compared to general anesthesia. Agri. 2013 Abstract Full text (link to original source) Full text (in our servers)
  9. Hatsu IE, McDougald DM, Anderson AK. Effect of infant feeding on maternal body composition. Int Breastfeed J. 2008 Aug 6;3:18. Abstract
  10. Dewey KG. Impact of breastfeeding on maternal nutritional status. Adv Exp Med Biol. 2004;554:91-100. Review. Abstract
  11. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  12. van der Hooft CS, Stricker BH. [Ephedrine and ephedra in weight loss products and other preparations]. Ned Tijdschr Geneeskd. 2002 Abstract
  13. Dewey KG, Cohen RJ, Brown KH, Rivera LL. Effects of exclusive breastfeeding for four versus six months on maternal nutritional status and infant motor development: results of two randomized trials in Honduras. J Nutr. 2001 Feb;131(2):262-7. Abstract Full text (link to original source) Full text (in our servers)
  14. Gruber AJ, Pope HG Jr. Ephedrine abuse among 36 female weightlifters. Am J Addict. 1998 Abstract
  15. Kramer FM, Stunkard AJ, Marshall KA, McKinney S, Liebschutz J. Breast-feeding reduces maternal lower-body fat. J Am Diet Assoc. 1993 Apr;93(4):429-33. Abstract
  16. Dewey KG, Heinig MJ, Nommsen LA. Maternal weight-loss patterns during prolonged lactation. Am J Clin Nutr. 1993 Aug;58(2):162-6. Abstract
  17. Mortimer EA Jr. Drug toxicity from breast milk? Pediatrics. 1977 Abstract
  18. Pickup ME, May CS, Ssendagire R, Paterson JW. The pharmacokinetics of ephedrine after oral dosage in asthmatics receiving acute and chronic treatment. Br J Clin Pharmacol. 1976 Abstract

Total visits


Help us improve this entry

How to cite this entry

Do you need more information or did not found what you were looking for?

   Write us at

e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2015 of United States of America

Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM