Supplement category | Agent name | Alternative name(s) listed on supplement label | Proposed mechanism of activity | Potential adverse effects |
Pre-workout and weight loss supplements | Caffeine | Caffeine source (eg, black tea, cola nut, green tea, guarana, yerba mate) | Increases levels of 3'5' cyclic AMP by inhibiting phosphodiesterase CNS stimulant that increases medullary respiratory center sensitivity to carbon dioxide, stimulates central inspiratory drive, and improves skeletal (including diaphragmatic) muscle contractility | Palpitations, tremor, anxiety/agitation, GI upset[1], diuresis, dependence (chronic use) |
Yohimbine | Yohimbe, Corynanthe johimbe, coryanthe yohimbe, 11-hydroxy yohimbine | Blocks presynaptic alpha-2 adrenergic receptors, resulting in increased cholinergic and decreased adrenergic tone | GI distress, tachycardia, anxiety/agitation, hypertension[2,3] | |
Rauwolscine | Rauwolfia vomitoria, yohimbe, alpha-yohimbine | Alpha-2 adrenergic receptor blocker | Hypotension[3] | |
Higenamine | Aconitum carmichaelii, Nandina domestica, Tinospora crispa, Aconitum japonicum, demethylcoclaurine, norcoclaurine | Beta-agonist activity with chronotropic and inotropic properties | Tachycardia, increased cardiac demand, potential for significant cardiotoxic effects[4,5] | |
1,3-DMAA | 1,3-dimethylamylamine, Geranium extract, Pelargonium graveolens, dimethylpentylamine, pentylamine, Geranamine, Forthane, 2-amino-4-methylhexane, methylhexanamine, methylhexamine | Peripheral sympathomimetic activity | Tachycardia, hypertension, hemorrhagic stroke, sudden death[6-9] | |
DMBA (1,3-DMBA) | 1,3-dimethylbutylamine, 2-amino-4-methylpentane citrate, AMP citrate, 1,3-dimethylbutylamine citrate, 4-amino-2-pentanamine, Pentergy, 4-AMP, pouchong tea, Amperall | Peripheral sympathomimetic activity | Tachycardia, hypertension*[10,11] | |
Octodrine | DHMA, 1,5-dimethylhexylamine, 6-methyl-2-heptanamine, Aconitum kusnezoffii, 2-amino-isoheptane, Aconite extract, Rauwolfia vomitoria, Halostachine | Peripheral sympathomimetic activity | Increased blood pressure and cardiac demand, CNS stimulation[12] | |
BMPEA | Beta-methylphenethylamine, Acacia rigidula, Vachellia rigidula, blackbrush, blackbush, chaparro prieto | Amphetamine analog; peripheral sympathomimetic activity | Increased blood pressure and cardiac demand[13] | |
Phenpromethamine | DHMA, 6-methyl-2-heptanamine, phenylpropylmethylamine, Vonedrine | Sympathomimetic activity; alpha-adrenergic agonist | Increased blood pressure and cardiac demand[14] | |
Oxilofrine | Methylsynephrine, p-hydroxyephedrine, oxyephedrine, 4-HMP, Halostachine | Ephedrine analog; sympathomimetic amine | Hypertension, increased cardiac demand, nausea, vomiting, agitation, tachycardia, chest pain[15,16] | |
Deterenol | Isopropylnorsynephrine, isopropylnorsynephrine HCl, N-iso-propylnorsynephrine HCl and isopropyloctopamine, Betafrine, Halostachine | Beta-agonist; sympathomimetic activity | Flushing, anxiety, increased heart rate, hypotension, nausea, vomiting, blurred vision[14,15,17] | |
DEPEA | Dendrobium orchid extract, Dendrobium nobile, Dendrobe Noble | Methamphetamine analog; presumed sympathomimetic activity (no animal or human studies) | Hypertension, increased cardiac demand[18] | |
1,4-DMAA | 1,4-dimethylamylamine, DHMA, 6-methyl-2-heptanamine, Aconitum kusnezoffii, 2-amino-isoheptane, Rauwolfia vomitoria, Halostachine | Sympathomimetic activity | Increased blood pressure and pulse[12] | |
Supplements exclusively for weight loss | Sibutramine | ¶ | Noradrenergic sympathomimetic agent; blocks norepinephrine and serotonin reuptake | Increased blood pressure and pulse, increased risk of nonfatal MI and nonfatal stroke[19,20], dry mouth, anxiety, insomnia |
2,4-dinitrophenol | DNP, "turmeric powder," Sulfo Black, Nitro Kleenup, Caswell No. 392[21] | Uncouples mitochondrial oxidative phosphorylation[21] | Acute toxicity: Fever, tachycardia, diaphoresis, nausea, vomiting, urticaria, jaundice Less commonly reported: Taste disturbance, hearing change, arthralgia, mental status change, agitation, kidney impairment, seizures, death Chronic exposure associated with agranulocytosis, peripheral neuritis, cataracts, skin lesions, cardiotoxicity[21-23] | |
Phenolphthalein | ¶ | Laxative | Carcinogenic in animal models[24] | |
Benzodiazepines (ie, diazepam) | ¶ | GABA agonist | CNS depression (eg, drowsiness, ataxia, impaired driving, confusion), muscle weakness, physical dependence/addiction[25-27] | |
SSRIs (ie, fluoxetine) | ¶ | Inhibits serotonin reuptake by CNS neurons | Sexual dysfunction, nausea, abnormal dreams[25,26] | |
Diuretics (eg, furosemide, bumetanide) | ¶ | Loop diuretics that inhibit reabsorption of sodium and chloride in kidney | Orthostatic hypotension, hypovolemia, hypokalemia, acute kidney injury, hearing loss, tinnitus[25,26] Hyperkalemia and metabolic acidosis[28] | |
Other | Yellow oleander | Has been found in products labeled as candlenut, "Nuez de la India," tejocote root[30,31] | Cardiac glycoside (similar to digoxin) | Nausea, vomiting, bradycardia, hypotension, frequent premature ventricular complexes, heart blocks, hyperkalemia, and ventricular dysrhythmias and/or asystole in severe cases |
AMP: adenosine monophosphate; BMPEA: beta-methylphenethylamine; CNS: central nervous system; DEPEA: diethylphenethylamine; 1,3-DMAA: 1,3-dimethylamylamine; 1,4-DMAA: 1,4-dimethylamylamine; DMBA: dimethylbutylamine; GABA: gamma-aminobutyric acid; GI: gastrointestinal; MI: myocardial infarction; SSRIs: selective serotonin reuptake inhibitors.
* Based upon animal studies; no human data available.
¶ Typically not declared/listed on supplement label.Do you want to add Medilib to your home screen?