妊娠中・授乳中のエフェドラ含有漢方「麻黄湯、葛根湯など」

減肥的薬効を謳うエフェドラ含有「ナイシトール」の宣伝に眉をひそめている医療関係者も多いと思うが、医師たち自身が、この時期になると麻黄や葛根湯などを多く処方する。


エフェドラ（Ephedra）、「マオウ」の潜在的有害性に関して多くが語られている


せめて、“「漢方」だから妊婦でも安全”という間違いだけは正すべき


Periconceptional use of weight loss products including ephedra and the association with birth defects.
Bitsko RH et al. A; National Birth Defects Prevention Study.
Birth Defects Res A Clin Mol Teratol. 2008 Aug;82(8):553-62. doi: 10.1002/bdra.20472.

全ての減量目的製品使用は、無脳症:anencephaly (aOR 2.6; 95% CI: 1.3-5.3)、右旋性大血管転位 (aOR 2.1; 95% CI: 1.1-4.3)、大動脈狭窄(aOR 3.4; 95% CI: 1.5-7.9)と相関。さらに、
エフェドラ含有製品では、無脳症aOR増加  (aOR 2.8; 95% CI: 1.0-7.3)と関連
他の減量製品は、大血管転位  (aOR 1.8; 95% CI: 1.2-2.7)、大動脈狭窄(aOR 2.1; 95% CI: 1.3-3.5)と関連

オリンピック他のスポーツ競技において、麻黄は禁止薬物
業界団体の反対に対し、米国FDAは、2003年12月に翌2004年のエフェドラ製品の中止を宣言、業界団体の訴訟を経て、中止指示撤回回避されている。
さらに、FDAはエフェドラ製品の不当表示への注意喚起行っている。

"There has been a lot of debate about the safety of ephedra and legal wrangling over its status.
In June 1997, the FDA proposed restrictions on the ephedrine content of dietary supplements, new warning labels for products that contain the active ingredients in ephedra, and a ban on combination products containing ephedra and other natural stimulants, such as guarana and cola nut, both of which contain significant amounts of caffeine. These proposals were dropped after the link between ephedra use and serious adverse effects was challenged by the General Accounting Office (GAO) and the dietary supplement industry.
According to the Dietary Supplement Health and Education Act of 1994, FDA must prove a supplement is unsafe before it can be withdrawn from the market.
 The FDA reviewed numerous adverse event reports involving ephedra-containing products, with 140 of the reports receiving in-depth clinical review by FDA and outside experts. Findings from experts outside the FDA support the FDA's initial finding that ephedra is likely the cause of many of the events noted in the reports.

 On December 30, 2003, the FDA announced the ban of ephedra products in the U.S., effective April 2004. In April 2005, the dietary supplement industry successfully challenged the FDA ban on ephedra. A year after the ban on ephedra began, a federal judge in Utah struck down the FDA's action saying that FDA didn't prove that low doses of ephedra are harmful.
In August 2006, an appeals court reversed the Utah judge's decision and upheld the FDA's ban of ephedra-containing dietary supplements.
 Ephedra use is banned by the National Collegiate Athletic Association, International Olympic Committee, and National Football League. Ephedra is sometimes marketed as a recreational drug "herbal ecstasy."
The FDA has announced that ephedra products marketed as recreational drugs are unapproved and that misbranded drugs can be taken by the authorities."

 https://www.webmd.com/vitamins-supplements/ingredientmono-847-EPHEDRA.aspx

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　改めて思うに、私は妊婦や授乳中の方に、麻黄湯や葛根湯処方する勇気を持てない！