Moaddeb Jivan, Tofade Toyin S, Bevins Micheal B
Johnston Health Systems, Clayton, NC, USA.
J Pharm Pract. 2011 Jun 6. doi: 10.1177/0897190011406127.
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.
几种补充剂和草药产品已被证明会增加儿茶酚胺，进而升高平均动脉压和全身血管阻力。由于含麻黄的产品已被撤出市场，减肥草药补充剂制造商必须生产不含麻黄的配方产品。Xenadrine EFX是一种不含麻黄的减肥产品，含有咖啡因、瓜拉那和苦橙（标准化为辛弗林）的混合物。在动物和人类中，辛弗林已被证明会增加全身血管阻力和平均动脉压。我们报告一例患者，她在因头痛和高血压急症（血压[BP]234/130mmHg）就诊于急诊科前服用Xendarine EFX两周。停用Xenadrine并开始静脉滴注硝普钠和口服可乐定后，她的血压得到控制。Naranjo概率评分为6表明药物不良反应很可能发生。临床医生应意识到服用Xenadrine EFX或其他含辛弗林产品的患者可能出现的心血管变化。
