Skip to content

Sida cordifolia

Sand mallow, better known in the supplement industry as Sida Cordifolia, is a plant whose seeds and root are used to make medicine. Sida Cordifolia contains ephedrine - an amphetamine-like stimulant that can have harmful side effects, which is why its use as a supplement is now banned in many countries. Despite serious safety concerns, Sida Cordifolia is used to treat bronchial asthma, tuberculosis, colds, flu, chills, poor perspiration, headaches, nasal congestion, coughing and wheezing, urinary tract inflammation, mouth sores and water retention. In addition, Sida Cordifolia is used for heart disease, stroke, facial paralysis, tissue pain, inflammatory swelling, sciatic pain, nerve inflammation, persistent joint pain due to chronic rheumatism and unwanted weight loss. Some people use Sida Cordifolia as a stimulant, analgesic and tonic, as well as to increase urine production and sexual arousal. In addition to this, Sida Cordifolia is used before and after chemotherapy treatments for cancer to speed up recovery from these treatments. In herbal combination products, Sida Cordifolia is used to promote weight loss, as well as to treat erectile dysfunction, sinus problems, throat disorders, asthma and bronchitis. These combination products are also used to burn fat, increase energy and promote strong bones. In combination with ginger, Sida Cordifolia is used to treat recurring fevers. In combination with milk and sugar, sida cordifolia is used to treat vaginal discharge. Sida Cordifolia is used for numbness, nerve pain, muscle cramps, skin diseases, tumors, joint diseases, wounds, ulcers, scorpion stings and snake bites, as well as applied directly to the skin as a massage oil.

How does Sida Cordifolia work?

The Sida Cordifolia plant contains ephedrine, an amphetamine-like stimulant. It is not known how Sida Cordifolia might work in other medicinal applications.

How effective is Sida Cordifolia?

There is not enough scientific data to make a statement regarding the effectiveness of Sida Cordifolia for fatigue, erectile dysfunction, asthma and bronchitis, colds, flu, chills, lack of perspiration, headaches and nasal congestion, and to promote weight loss. Further scientific research is needed to evaluate the effectiveness of Sida Cordifolia in these applications.

Safety and side effects

SidaCordifolia is not safe and harmless. Sida Cordifolia contains ephedrine and is therefore banned in some countries due to safety concerns. Another plant that contains ephedrine, called Ephedra, has been linked to high blood pressure, heart attacks, seizures, strokes, irregular heartbeat, unconsciousness and death. Sida Cordifolia may have the same side effects. Sida Cordifolia may cause dizziness, restlessness, irritability, insomnia, headache, loss of appetite, nausea, vomiting, redness of the skin, tingling, difficulty urinating and palpitations. Sida Cordifolia should not be used in combination with other stimulants such as caffeine. Such a combination could increase the risk of side effects, including life-threatening side effects. Sources of caffeine include coffee, tea, guarana and mate.

Precautions and warnings

Pregnancy and breastfeeding: The use of Sida Cordifolia during pregnancy and breastfeeding is not safe and harmless, therefore pregnant and breastfeeding women should not use Sida Cordifolia

Chest pain / angina pectoris: Sida Cordifolia can aggravate an existing angina pectoris as it stimulates the heart. Sida Cordifolia is particularly dangerous for people suffering from angina pectoris.

Anxiety: Sida Cordifolia can stimulate the nervous system. High doses can exacerbate anxiety.

Cardiac arrhythmia, rapid heartbeat or heart disease: Since Sida Cordifolia stimulates the heart, it can aggravate these conditions. For this reason, people who suffer from cardiac arrhythmia, rapid heartbeat or heart disease should not use Sida Cordifolia.

Diabetes: Sida Cordifolia could affect blood sugar control and aggravate pre-existing high blood pressure and other cardiovascular problems in diabetics.

Essential tremor: Sida Cord ifolia may exacerbate essential tremor due to its stimulant effect.

High blood pressure: Sida Cordifolia could aggravate high blood pressure and is therefore particularly dangerous for people who already suffer from high blood pressure.

Thyroid problems: There are concerns that Sida Cordifolia may stimulate the thyroid gland, exacerbating existing thyroid problems.

Kidney stones: The ephedrine contained in Sida Cordifolia could cause kidney stones. This is particularly harmful if you already suffer from kidney stones.

Glaucoma: Sida Cordifolia may aggravate glaucoma by dilating the pupils.

Pheochromocytoma: Sida Cordifolia may aggravate the symptoms of pheochromocytoma.

Interactions

Sida Cordifolia should not be used in combination with the following medications:

Medications that may cause an irregular heartbeat (QT interval prolonging agents).

SidaCordifolia can increase the heart rate. Taking Sida Cordifolia in combination with drugs that can cause an irregular heartbeat could result in serious side effects including a heart attack.

Methylxanthines

SidaCordifolia can stimulate the body. Methylxanthines also stimulate the body. Taking Sida Cordifolia in combination with methylxanthines could cause side effects such as shakiness, nervousness, rapid heartbeat, high blood pressure and anxiety. The group of methylxanthines includes aminophylline, caffeine and theophylline.

Stimulant drugs / stimulants

Stimulants accelerate the function of the nervous system and can cause nervousness and increase the heart rate. Sida Cordifolia can also accelerate the function of the nervous system. Taking Sida Cordifolia in conjunction with stimulants can cause serious problems including accelerated heart rate and high blood pressure. For this reason, Sida Cordifolia should not be combined with stimulants.

Care should be taken when using Sida Cordifolia in combination with the following medications:

Dexamethasone

The body breaks down dexamethasone in order to be able to excrete it. Sida Cordifolia could accelerate the breakdown of dexamethasone and thereby reduce the effectiveness of dexamethasone.

Ergot derivatives

Sida Cordifolia can increase blood pressure. Ergot derivatives can also increase blood pressure. Taking Sida Cordifolia in combination with ergot derivatives could increase blood pressure too much.

Medication for depression (MAO inhibitors (monoamine oxidase inhibitors))

Sida Cordifolia contains chemicals that stimulate the body. Some medications for depression can increase the concentration of these chemicals in the body. Taking Sida Cordifolia in conjunction with these anti-depressant medications could result in over-stimulation. This could cause serious side effects including rapid heartbeat, high blood pressure, seizures, nervousness and more.

Diabetes medication

Sida Cordifolia could lower blood sugar. Diabetes medications are also used to lower blood sugar levels. Taking Sida Cordifolia in combination with diabetes medication could result in an excessive drop in blood sugar levels. For this reason, blood glucose levels should be carefully monitored. It is possible that the dosage of diabetes medication may need to be adjusted.

Dosage

An appropriate dosage of Sida Cordifolia depends on various factors such as age, state of health and others. At the present time, there is insufficient scientific data to make a statement about appropriate dosage ranges for Sida Cordifolia. For this reason, you should follow the dosage instructions on the label and/or consult a doctor or pharmacist before use.

References

  1. Anon. Sida Cordifolia Linn. Available at: http://www.modern-natural.com/sida_cordifolia.htm (Accessed March 9, 2000).
  2. Anon. Sida Cordifolia. Metro Marketing, Inc. Available at: http://metromkt.net/viable/1sidacor.shtml (Accessed March 9, 2000).
  3. Baker J, Zhang X, Boucher T, Keyler D. Investigation of quality in ephedrine-containing dietary supplements. Journal of Herbal Pharmacotherapy 2003;3:5-17.
  4. Bell DG, Jacobs I, Ellerington K. Effect of caffeine and ephedrine ingestion on anaerobic exercise performance. Med Sci Sports Exerc 2001;33:1399-403.
  5. Boozer CN, Daly PA, Homel P, et al. Herbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial. Int J Obes Relat Metab Disord 2002;26:593-604.
  6. Boozer CN, Nasser JA, Heymsfield SB, et al. An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Int J Obes Relat Metab Disord 2001;25:316-24.
  7. Brooks SM, Sholiton LJ, Werk EE Jr, Altenau P. The effects of ephedrine and theophylline on dexamethasone metabolism in bronchial asthma. J Clin Pharmacol 1977;17:308-18.
  8. Caron MF, Hotsko AL, Robertson S, et al. Electrocardiographic and hemodynamic effects of Panax ginseng. Ann Pharmacother 2002;36:758-63.
  9. Doyle H, Kargin M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996;313:756.
  10. Dulloo AG, Miller DS. Ephedrine, caffeine and aspirin: "over-the-counter" drugs that interact to stimulate thermogenesis in the obese. Nutrition 1989;5:7-9.
  11. Dulloo AG, Miller DS. Aspirin as a promoter of ephedrine-induced thermogenesis: potential use in the treatment of obesity. Am J Clin Nutr 1987;45:564-9.
  12. Dulloo AG. Herbal simulation of ephedrine and caffeine in treatment of obesity. Int J Obes Relat Metab Disord 2002;26:590-2.
  13. FDA Takes Aim at Ephedra. The Washington Post. Available at: www.washingtonpost.com/wp-dyn/articles/A33439-2000Mar17.html (Accessed March 19, 2000).
  14. FDA. Proposed rule: dietary supplements containing ephedrine alkaloids. Available at: www.verity.fda.gov (Accessed January 25, 2000).
  15. Food and Drug Administration, HHS. Final rule declaring dietary supplements containing ephedrine alkaloids adulterated because they present an unreasonable risk; Final rule. Fed Regist 2004;69:6787-6854.
  16. For Dieter, Nearly the Ultimate Loss. The Washington Post. Available at: www.washingtonpost.com/wp-dyn/articles/A33421-2000Mar17.html (Accessed March 19, 2000).
  17. Franzotti EM, Santos CV, Rodrigues HM, et al. Anti-inflammatory, analgesic activity and acute toxicity of Sida cordifolia L. (Malva-branca). J Ethnopharmacol 2000;72:273-7.
  18. Gardner SF, Franks AM, Gurley BJ, et al. Effect of a multicomponent, ephedra-containing dietary supplement (Metabolife 356) on Holter monitoring and hemostatic parameters in healthy volunteers. Am J Cardiol 2003;91:1510-3, A9.
  19. Greenway FL, Raum WJ, DeLany JP. The effect of an herbal dietary supplement containing ephedrine and caffeine on oxygen consumption in humans. J Altern Complement Med 2000;6:553-5.
  20. Gunatilaka AA, Sotheeswaran S, Balasubramaniam S, et al. Studies on medicinal plants of Sri Lanka. III. pharmacologically important alkaloids of some sida species. Planta Med 1980;39:66-72.
  21. Gurley BJ, Gardner SF, Hubbard MA. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000;57:963-9.
  22. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8.
  23. Haller CA, Jacob P 3rd, Benowitz NL. Enhanced stimulant and metabolic effects of combined ephedrine and caffeine. Clin Pharmacol Ther 2004;75:259-73.
  24. Haller CA, Jacob P 3rd, Benowitz NL. Pharmacology of ephedra alkaloids and caffeine after single-dose dietary supplement use. Clin Pharmacol Ther 2002;71:421-32.
  25. Homer KA, Manji F, Beighton D. Inhibition of peptidase and glycosidase activities of Porphyromonas gingivalis, Bacteroides intermedius and Treponema denticola by plant extracts. J Clin Periodontol 1992;19:305-10.
  26. Horton TJ, Geissler CA. Aspirin potentiates the effect of ephedrine on the thermogenic response to a meal in obese but not lean women. Int J Obes 1991;15:359-66.
  27. Jacobs KM, Hirsch KA. Psychiatric complications of Ma-huang. Psychosomatics 2000;41:58-62.
  28. Jenkins DJ, Wesson V, Wolever TM, et al. Wholemeal versus wholegrain breads: proportion of whole or cracked grain and the glycaemic response. BMJ 1988;297:958-60.
  29. Kalman D, Incledon T, Gaunaurd I, et al. An acute clinical trial evaluating the cardiovascular effects of an herbal ephedra-caffeine weight loss product in healthy overweight adults. Int J Obes 2002;26:1363-66.
  30. Kanth VR, Diwan PV. Analgesic, anti-inflammatory and hypoglycaemic activities of Sida cordifolia. Phytother Res 1999;13:75-7.
  31. Kockler DR, McCarthy MW, Lawson CL. Seizure activity and unresponsiveness after hydroxycut ingestion. Pharmacotherapy 2001;21:647-51.
  32. Leikin JB, Klein L. Ephedra causes myocarditis. Clin Toxicol 2000;38:353-4.
  33. Levisky JA, Karch SB, Bowerman DL, et al. False-positive RIA for methamphetamine following ingestion of an Ephedra-derived herbal product. J Anal Toxicol 2003;27:123-4.
  34. Louis E. Tremor disorders: identification and treatment. Medical Update for Psychiatrists 1997;2:172-6.
  35. McBride BF, Karapanos AK, Krudysz A, et al. Electrocardiographic and hemodynamic effects of a multicomponent dietary supplement containing ephedra and caffeine: a randomized controlled trial. JAMA 2004;291:216-21.
  36. Morgenstern LB, Viscoli CM, Kernan WN, et al. Use of Ephedra-containing products and risk for hemorrhagic stroke. Neurology 2003;60:132-5.
  37. Okada S, Rohan PJ, Miller FW, et al. Myopathies following ingestion of special nutritional products. Arthritis Rheum 1996;39:349.
  38. Powell T, Hsu FF, Turk J, Hruska K. Ma-huang strikes again: ephedrine nephrolithiasis. Am J Kidney Dis 1998;32:153-9.
  39. Ros JJ, Pelders MG, De Smet PA. A case of positive doping associated with a botanical food supplement. Pharm World Sci 1999;21:44-6.
  40. Samenuk D, Link MS, Homoud MK, et al. Adverse cardiovascular events temporally associated with ma huang, a herbal source of ephedrine. Mayo Clin Proc 2002;77:12-6.
  41. Schweinfurth J, Pribitkin E. Sudden hearing loss associated with ephedra use. Am J Health Syst Pharm 2003;60:375-7.
  42. Soni MG, Carabin IG, Griffiths JC, Burdock GA. Safety of ephedra: lessons learned. Toxicol Lett 2004;150:97-110.
  43. Theoharides TC. Sudden death of a healthy college student related to ephedrine toxicity from a ma-huang containing drink. J Clin Psychopharmacol 1997;17:437-9.
  44. Ujino H, Morimoto O, Yukioka H, Fujimori M. [Acute angle-closure glaucoma after total hip replacement surgery]. Masui 1997;46:823-6.
  45. Vahedi K, Domingo V, Amarenco P, Bousser MG. Ischemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for bodybuilding. J Neurol Neurosurg Psychiatr 2000;68:112-3.
  46. Walton R, Manos GH. Psychosis related to ephedra-containing herbal supplement use. South Med J 2003;96:718-20.
  47. White LM, Gardner SF, Gurley BJ, et al. Pharmacokinetics and Cardiovascular Effects of Ma-Huang (Ephedra sinica) in Normotensive Adults. J Clin Pharmacol 1997;37:116-22.
  48. Wilson BE, Hobbs WN. Case report: pseudoephedrine-associated thyroid storm: thyroid hormone-catecholamine interactions. Am J Med Sci 1993;306:317-9.
  49. Yates KM, O'Connor A, Horsley CA. "Herbal Ecstasy": a case series of adverse reactions. N Z Med J 2000;113:315-7.
  50. Zaacks SM, Klein L, Tan CD, et al. Hypersensitivity myocarditis associated with ephedra use. J Toxicol Clin Toxicol 1999;37:485-9.