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Synephrine, a sympathetic a – adrenergic agonist, is structurally related to ephedrine so bitter orange extract can obtain a spectrum of adverse reactions which are similar to those associated with the use of Ephedra/ephedrine.4 In animals, synephrine use with dose-related cardiotoxicity has been associated, in particular ventricular arrhythmias levitra 4 mg . All cases weremyocardial infarction in patients with no history of heart disease has been reported in connection with synephrine containing products.6 Health Canada issued an advisory to contain a natural health product synephrine and other stimulants that can synephrine cardiovascular effects similar to those of ephedrine.4 Synephrine have cardiovascular – effects may be increased when other stimulants like caffeine.7 be combined Previously, Health Canada warned consumers about the use of ephedra products that contain caffeine, for the same reasons, and two other ratings confirmed this security concern.8. Canadian Adverse Reaction Newsletter Volume 14, Issue 4.

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