The FDA proposed the warning labels — reviving an attempt the powerful dietary supplement industry had blocked for years — while saying a ban on at least some ephedra-containing products remains under discussion.
CBS News Correspondent Elizabeth Kaledin reports, Secretary of Health and Human Services Tommy Thompson made his personal feelings about ephedra products clear.
"I would not take this. I don't know why anyone would take these products," he said.
"Throughout America, there continue to be tragic incidents that link dietary supplements containing ephedra to serious health problems in consumers that use these products," said Thompson.
The law makes it extremely difficult for the FDA to control or ban dietary supplements, which are not considered drugs, but Thompson said the effort against ephedra "isn't over."
The action came less than two weeks after a medical examiner announced the heatstroke death of Baltimore Orioles pitcher Steve Bechler was probably linked to his use of ephedra. The FDA, which has reports of at least 100 deaths linked to ephedra supplements, had been under pressure from doctors for years to ban the herb — but Bechler's death renewed the scrutiny.
The FDA said it had warned 24 companies that target the amphetamine-like stimulant to athletes and bodybuilders that there is no scientific evidence that ephedra helps athletic performance — letters that signal the government is considering a bigger crackdown.
The FDA also released results of a long-awaited ephedra review by the Rand Corp., which concluded the herb probably has killed at least occasionally, while giving users very little weight-loss benefit.
"The current scientific evidence strongly suggests that at least some ephedra products present an unreasonable risk," said FDA Commissioner Mark McClellan.
Meanwhile, makers of Ephedra are expressing relief that the Food and Drug Administration has called for warning labels on the product rather than banning it.
An industry group says it won't fight the new labels, although it had lobbied intensely for weaker ones.
But an industry spokesman argued that Thompson was reacting to political pressure.
Anticipating the announcement, a leading ephedra manufacturer, Metabolife International, issued a statement condemning "irresponsible marketing practices" that result in athletes misusing the product and called for limited government regulations such as banning sales to minors.
"I believe it is imperative that consumers continue to have the choice to use these beneficial weight-loss products, safely and effectively, as millions have done, in their battle to control and maintain their weight," said David Brown, president of Metabolife.
Ephedra has been linked to lifethreatening side effects, even when used by outwardly healthy people at recommended doses, because it speeds heart rate and constricts blood vessels. Those effects can be exacerbated by exercise and use of other stimulants such as caffeine, and they're particularly risky if the user has certain underlying medical conditions such as heart disease.
Canada has long warned consumers not to use ephedra, and it has been banned in professional football, college athletics, the Olympics and, earlier this week, in minor-league baseball.
Manufacturers blocked a 1997 FDA attempt to restrict sales of certain doses by arguing the agency lacked enough proof of danger. More recently, companies have intensely lobbied the Bush administration to settle the controversy with warning labels that urge consumers to consult a doctor before using the herb.
The FDA first proposed stronger warning labels in 1997. Friday, it reopened that proposal for public comment — a step required before the agency can mandate the warnings. The proposal suggests every ephedra bottle list death, heart attacks and strokes as potential side effects, and caution consumers about exercise, caffeine and people who should never use the herb.
The FDA said Friday it will seek public comment on whether ephedra poses enough risk to justify banning a dietary supplement — leaving in question just how big a crackdown the agency intends.
"The standard for regulating the safety of dietary supplements is largely untested, but we are committed to finding the right public health solution," McClellan said.