Rauwolfia Information Herb – Uses, Benefits and Dosage for this Herb

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Rauwolfia Information Herb – Uses, Benefits and Dosage for this Herb

6 August 2007

Written by: steve Posted under Herbal Medicines

Taxonomic class

Apocynaceae

Common Trade Names

Harmonyl (deserpidine, U.K.), Raudixin, Rauwiloid (alseroxylon fraction), Serpasil (reserpine)

Common Forms

Injection (reserpine): 250 mg/ml

Tablets: 50 mg (Raudixin)

Also available as crude root, liquid and powdered extract, and tea.

Source

Of more than lOa species of rauwolfia growing in India, Thailand, South America, Asia, and Africa, the root of Rauwolfia serpentina is notable for its medicinal effects.

Chemical Components

More than 50 alkaloids are found in R. serpentina; reserpine has been extensively studied in clinical evaluations. Other alkaloids include rescinnamine, deserpidine, syrosingopine, ajmaline (rauwolfine), ajmalinine, ajmalicine, isoajmaline, serpentine, rauwolfinine, and sarpagine.

Actions

Reserpine is known to have depressant, hypotensive, and sedative properties. It produces a catecholamine-depleting effect in the brain and peripheral sympathetic neurons.

Reported Uses

Rauwolfia alkaloids have been used to lower fevers, calm noisy babies, cure diarrhea and dysentery, and treat some psychiatric illnesses.

Much evidence exists that proves the rauwolfia alkaloids’ success in the treatment of hypertension and psychiatric conditions. Although the use of rauwolfia alkaloids in hypertensive patients has decreased significantly in the United States because of the adverse effects of the drugs, reserpine is still used in countries such as Spainusually with a thiazide diuretic .

Dosage

For hypertension, daily doses of Raudixin 200 mg, Rauwiloid 4 mg, or reserpine 0.25 mg P.O. (100 mg of crude root corresponds to 2 mg alseroxylon fraction, which corresponds to 0.1 mg of reserpine). Average daily dose is 600 mg, which corresponds to 6 mg of total alkaloids.

Adverse Reactions

The following adverse reactions of reserpine can occur with higher doses of rauwolfia:

CNS: depression, hallucinations, nightmares, suicidal ideations, unsteadiness and parkinsonian syndrome (rare).

CV: bradycardia, hypotension (more common with parenteral than oral), premature ventricular beats.

EENT: nasal congestion.

Endocrine: breast cancer .

GI: diarrhea, GI complaints, peptic ulcer disease.

GU: decreased libido.

Metabolic: edema, increased appetite, weight gain.

Interactions

Antihypertensives, nitrates: Additive hypotensive effects. Use cautiously.

Barbiturates, CNS depressants: Pronounced CNS effects and toxicity when rauwolfia alkaloids are used with barbiturates . Avoid administration with rauwolifia.

Cardiac glycosides: Lowered heart rate. Monitor the patient.

Levodopa: Reduced effectiveness of levodopa. Avoid administration with rauwolfia.

NSAIDs, tricyclic antidepressants: May reduce hypotensive effects of rauwolfia derivatives. Monitor the patient.

Sympathomimetics: Initial increase in blood pressure. Monitor the patient.

Contraindications and Precautions

Rauwolfia is contraindicated in active peptic ulcer disease and ulcerative colitis because it increases gastric acid secretion. Use cautiously in ratients with current diagnosis or past history of breast cancer and durmg pregnancy.

Special Considerations

The patient should discontinue rauwolfia ingestion at least 2 weeks before undergoing electroconvulsive therapy.
Monitor blood pressure.
Counsel the patient with a history of or at risk for depression to avoid using rauwolfia derivatives.
Several reports have attempted to link the development of breast cancer with consumption of rauwolfia derivatives. Many reports have failed to verify this association, but the issue remains controversial.
Advise the patient with a history of cancer (especially breast cancer) or peptic ulcer disease to avoid using rauwolfia derivatives.
Caution the patient to avoid hazardous activities until CNS and hypotensive effects of rauwolfia derivatives are known.
Inform the patient that the adverse effects of rauwolfia alkaloids limit their use. Other proven agents exist for treating hypertension and psychiatric illnesses.

Commentary

Rauwolfia alkaloids have proved to be valuable for treating hypertension and some psychoses; the most popular and most studied is reserpine. Extensive application of rauwolfia derivatives is limited by the adverse reactions of the drugs. Other safe and equally effective agents are available.