Oxilofrine in Supplements

In April 2016, researchers from NSF, Harvard Medical School, the National Center for Natural Products Research (NCNPR) at the University of Mississippi and the National Institute for Public Health and the Environment in the Netherlands (RIVM) found the unapproved pharmaceutical stimulant oxilofrine in 14 over-the-counter dietary supplement products. The research, published in Drug Testing and Analysis, described the public health implications of this disguised ingredient.

The Research

This is the fourth time in three years that the NSF research team has found unapproved stimulants disguised as botanical ingredients in supplements. Oxilofrine was found in 14 supplements which are used as either dieting aides or pre-workout supplements. As a public health organization, NSF warns consumers about the potential dangers of these supplements.

Adolescents who use these products might be placing themselves at risk of serious harm. In countries where oxilofrine is prescribed by doctors, the usual amount of the drug for adolescents is 24 mg or less. Our research found oxilofrine in supplements at more than three times the usual pediatric dose. Combined with physical activity and other stimulants commonly found in supplements, the consequences could be catastrophic.

According to the research, 26 adverse events have been reported in the Netherlands linked to supplements containing oxilofrine. These supplements led to nausea and vomiting, tachycardia, chest pain and cardiac arrest. Additionally, oxilofrine is often disguised on labels as "methylsynephrine" or "extract of Acacia rigidula."

What You Should Do

The presence of potentially harmful compounds such as oxilofrine, disguised as “methylsynephrine” or “extract of Acacia rigidula,” in over-the-counter supplements is illegal, and consumers should be aware of and avoid products containing these compounds. NSF developed a testing and certification program that verifies supplement labels are accurate and the product itself is free from harmful levels of contaminants such as oxilofrine. We urge consumers to seek NSF certified dietary supplements to avoid unintentionally consuming harmful compounds.

Consumers should avoid the following products containing Oxilofrine:

Dietary Supplement Certification

NSF helped develop the only American National Standard for dietary supplements (NSF/ANSI 173). NSF’s accredited dietary supplement certification program is based on this standard (ANSI-Accredited Product Certification Body - Accreditation #0216). The program includes a label and formulation review, testing to verify the supplement does not contain harmful levels of contaminants and two facility audits annually to confirm compliance to Good Manufacturing Practices (GMPs). Products certified to the stringent NSF Certified for Sport® program include additional steps to screen supplements for 280 athletic banned substances.

NSF’s dietary supplement and Certified for Sport® certification programs help retailers, consumers and athletes to make more educated buying decisions knowing that what is on the label matches what is in the container and that the products do not contain any unintended substances like oxilofrine. The NSF program is used by the NFL, NHL, MLB, PGA, LPGA, the Canadian Centre for Ethics in Sport (CCES) and the New York City Police Department.

The results of this collaborative testing project were published in Drug Testing and Analysis in an article by NSF Senior Research Scientist John Travis; Harvard Medical School’s Dr. Pieter Cohen; Bharathi Avula, Ikhlas A. Khan and Yan-Hong Wang from the National Center for Natural Products Research (NCNPR) at the University of Mississippi and Bastiaan Venhuis from the National Institute for Public Health and the Environment in the Netherlands (RIVM).