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Xenadrine RFA is an over-the-counter dietary supplement that was marketed for weight loss and athletic performance enhancement. Its primary active ingredients were ma huang (a source of ephedra alkaloids) and guarana seed (a source of caffeine). The mechanism of action involves stimulation of the sympathetic nervous system through direct agonism at alpha- and beta-adrenergic receptors by ephedrine alkaloids, leading to increased heart rate, blood pressure, metabolism, appetite suppression, and enhanced fat breakdown. Guarana provides additional stimulant effects via caffeine. The product was associated with serious cardiovascular adverse events including myocardial infarction, stroke, seizures, hypertension, arrhythmias, coronary thrombosis and even death. Due to safety concerns related to its ephedra content—especially heightened risk for cardiovascular complications—the FDA banned the sale of supplements containing ephedra in 2004[1][2][3][6]. Claims regarding its efficacy for weight loss were not substantiated by rigorous clinical evidence[5].
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