Key result
Use of the ephedra-free weight loss supplement Xenadrine EFX for 2 weeks was associated with a probable adverse drug reaction presenting as hypertensive urgency (blood pressure 234/130 mm Hg).
Why the study?
Does Xenadrine EFX use cause hypertensive urgency?
Case Report (n=1)
Does Xenadrine EFX use cause hypertensive urgency?
Clinicians should be aware that ephedra-free weight loss supplements containing synephrine, such as Xenadrine EFX, can cause severe cardiovascular adverse effects including hypertensive urgency.
Hypertensive urgency was associated with Xenadrine EFX in this case; leaves open causality and need for controlled safety studies.
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.
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Moaddeb et al. (2011) conducted a case report in Hypertensive urgency (n=1). Xenadrine EFX was evaluated on Hypertensive urgency. Use of the ephedra-free weight loss supplement Xenadrine EFX for 2 weeks was associated with a probable adverse drug reaction presenting as hypertensive urgency (blood pressure 234/130 mm Hg).
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