Shoseiryutogomakyokansekito

What is Shoseiryutogomakyokansekito?

Shoseiryutogomakyokansekito is a prescription Kampo medicine that carries a doubled load of ephedra (ma-huang). Ephedra contains ephedrine, a stimulant drug. It can push blood pressure up, speed the heart, and set off an uneven heartbeat.

The name marks a merger of two older recipes: Shoseiryuto and Makyokansekito. Both of them contain ephedra. Both also contain licorice, so the licorice load is doubled as well.

Doubled licorice matters. It can drive potassium (a salt your muscles and heart need) down low. That can bring on high blood pressure, weak or sore muscles, and heart rhythm trouble.

Two more parts add risk. Apricot kernel (kyonin) holds a compound the body can turn into cyanide. Wild ginger root (saishin) is linked to a plant-acid family tied to kidney damage and cancer.

In Japan this formula is a prescription drug. A physician prescribes it and a pharmacist dispenses it, with the patient screened first. It is not a self-care herb, and this page gives no dose and no way to make it.

It was used in Kampo practice for wheezy, phlegmy coughs. Long standing in a tradition is not proof that a remedy works, and it is not proof that it is safe.

How does Shoseiryutogomakyokansekito work?

The main actions here are stimulant ones, and they are well documented in people.

Ephedrine acts on the fight-or-flight nerve system. It opens the airways, which is why the formula was used for wheeze. The same action raises blood pressure, speeds the pulse, and can cause tremor, sleeplessness and trouble passing urine.

Men with an enlarged prostate (a gland near the bladder) are at real risk of a blocked bladder from this effect. People with heart disease or an overactive thyroid can be tipped into chest pain or a dangerous rhythm.

Glycyrrhizin, the sweet compound in licorice, blocks an enzyme in the kidney. The body then acts as if it has too much salt-holding hormone. Doctors call this pseudoaldosteronism (a salt and potassium imbalance), which simply means a false high-hormone state.

The result is salt and water held in, potassium lost in the urine, and blood pressure pushed up. Low potassium can weaken muscles. In bad cases muscle tissue breaks down and harms the kidneys.

Apricot kernel contains amygdalin, a cyanide-forming compound. Gut bacteria can release cyanide from it. The amount in a dispensed Kampo product is small, but it is one more reason not to improvise with this formula.

Wild ginger root (saishin) is a separate worry. Some plants in its family carry aristolochic acids, which are linked in people to kidney failure and urinary tract cancer. It also holds safrole, a compound restricted in food for cancer concerns.

Gypsum (sekko) is mostly calcium sulfate, a mineral. It is the least active part of the mix. It does nothing to offset the stimulant and licorice risks above.

What forms does Shoseiryutogomakyokansekito come in?

In Japan it is supplied as a dispensed prescription product.

You may see it as a dried extract granule, a fine powder, a capsule or a tablet. Products are made by licensed Kampo manufacturers to set standards.

Raw herb mixes for home brewing also exist in some markets. This page does not describe how any form is made or taken.

Be wary of anything sold online as a supplement under this or a similar name. Such products sit outside the Japanese prescription system. Content and purity are not assured.

Where it comes from:

Kampo is the Japanese form of Chinese herbal medicine, shaped over many centuries.

The two parent recipes come from classical Chinese texts of the Han era. One was used for watery, cold-type wheeze and runny nose. The other was used for hot, wheezy cough with thick phlegm.

Japanese practice later joined the two for patients whose pattern seemed mixed. The combined name simply records that merger.

Practitioners judged the fit by the patient's pattern, build and pulse, not by a lab test. Use was always in the hands of a trained prescriber. That is history, not a reason to try it yourself.

What does Shoseiryutogomakyokansekito help with?

• Wheezy cough in bronchitis: Kampo practice used this mix for a loose, noisy cough with wheeze. Ephedrine does open airways in people, so short-term easing is plausible. That is not the same as proof for this formula. We found no controlled trials of the combined product. Modern inhalers do the same job with far less strain on the heart.
• Asthma-type breathing trouble: The formula was given for tight, wheezy breathing with phlegm. Ephedrine was an early asthma drug and was dropped as safer inhalers arrived. Asthma that is not controlled is dangerous. It needs a diagnosis and a proper treatment plan from a doctor, not a stimulant herb mix.
• Allergic rhinitis (hay fever type nose symptoms): Shoseiryuto, one of the two parent recipes, was widely used in Japan for a runny, blocked nose. Some Japanese studies looked at that single formula, not at this doubled one. For the combined formula, evidence in people is lacking. Standard nasal sprays and antihistamines carry far less heart risk.
• Thick phlegm with a blocked, runny nose: Traditional prescribers chose this mix when cold-type and hot-type signs appeared together. The claim rests on pattern theory, not on trial data. No human study supports it for this use. Persistent phlegm deserves a check for infection, reflux or asthma.

What are the side effects of Shoseiryutogomakyokansekito?

• Pounding, racing or uneven heartbeat
• Raised blood pressure
• Chest pain or tightness
• Trouble sleeping, restlessness or anxiety
• Shaky hands and sweating
• Trouble passing urine, or a fully blocked bladder
• Low potassium, causing weakness, cramps or muscle pain
• Swelling in the face, hands or ankles
• Muscle breakdown with dark urine (rhabdomyolysis)
• Headache and dizziness
• Nausea, stomach upset or loss of appetite
• Rash or other allergic reaction
• Liver injury, seen with some Kampo products
• Interstitial pneumonia (a rare lung inflammation causing dry cough and breathlessness)

Good to know:

Some of these harms come on fast, and some build quietly over weeks.

Heart and blood pressure effects can start within hours. A blocked bladder can also come on quickly, above all in older men.

The licorice effect is slower. Potassium can drift down over days or weeks with no warning sign. The first clue is often weakness, cramps or swelling.

Muscle breakdown and severe low potassium can harm the kidneys and the heart rhythm. Both are medical emergencies.

Is Shoseiryutogomakyokansekito legal where you live?

In Japan it is an approved prescription Kampo medicine, prescribed by a physician and dispensed by a pharmacist; lower-strength versions are sold over the counter there.

Outside Japan, ephedra-containing products face tight control. In the United States, the FDA bans ephedra (ma-huang) in dietary supplements. In the United Kingdom, the European Union, Canada and Australia, ephedrine is a controlled or restricted medicine, and in the United States it is a DEA List I regulated precursor rather than a controlled substance.

Options to discuss with a clinician

Bring the symptom to a clinician first, then pick a treatment with them.

For wheeze or asthma, ask about inhalers. Modern reliever and preventer inhalers open airways with much less effect on the heart. They are the standard of care.

For a runny or blocked nose, ask about steroid nasal sprays, saline rinses and non-drowsy antihistamines. All are far gentler on blood pressure than ephedra.

For a chesty cough, ask about steam, fluids and simple cough care. Ask too whether an infection needs treating.

If you want a herbal route, ask a doctor or pharmacist about Kampo formulas that contain no ephedra and no licorice. A trained prescriber can name one that fits you.

If you already take this formula, do not stop on your own. Ask the prescriber who started it.