Immediately after ephedra was taken off the marketplace in 2004, bitter orange (Citrus aurantium) a herb equivalent to ephedra, began to become a lot more common. It includes compounds equivalent to ephedrine referred to as synephrine and octopamine. Bitter orange may raise hypertension, raise coronary heart amount or lead to irregular coronary heart rhythms. There exists a situation report of ischemic colitis ssociated together with the utilization of bitter orange. People today with coronary heart illness, hypertension, other cardiovascular circumstances or diabetes should stay clear of it; even so, anybody thinking about it should seek the advice of a certified healthcare qualified 1st. It should not be taken with caffeine or herbs containing caffeine (eco-friendly tea, yerba mate), since it could theoretically enhance the chance of adverse effects equivalent to ephedra. It interacts with numerous remedies and can raise or lessen their effect.