Pokeweed (Phytolacca americana)

Category

Herbs & Supplements

Synonyms

American nightshade, American spinach, bear's grape, branching phytolacca, cancer jalap, chongras, coakum, coakum-chorngras, cokan, crowberry, endod, fitolaca, garget, hierba carmine, inkberry, jalap, kermesbeere, mitogenic lectins, monodesmosidic serjanic acid saponin, monodesmosidic spergulagenic acid saponin, PAP, phytolacain (G, R) Phytolacca acinosa, Phytolacca acinosa Esculenta, Phytolacca americana, phytolacca berry, Phytolacca decandra, Phytolacca dioica, Phytolacca dodecandra (Endod), Phytolacca icosandra, Phytolacca octandra, Phytolacca rigida, Phytolaccaceae (family), phytolaccagenin, phytolaccatoxin, phytolaccosides, pigeonberry, pocan, poke, poke root, poke salad, pokeberry, pokeweed antiviral protein (PAP), pokeweed berry, proteinaceous mitogens, raisin d'amérique, red-ink plant, red plant, red weed, resin, saponin glycosides, scoke, skoke, tannin, teinturiére, TXU-PAP, Virginian poke.

Background

In folk medicine, pokeweed leaves have been used for rheumatism, arthritis, emesis (vomiting) and purging. Unsubstantiated reports describe the toxicity of pokeweed root and berries, which may be due to the saponin content of the plant.

One derivative of pokeweed, pokeweed antiviral protein (PAP) from the spring leaves of Phytolacca Americana, shows promising therapeutic effects. Interest in PAP is growing due to its use as a potential anti-HIV agent. However, the clinical use of native PAP is limited due to inherent difficulties in obtaining sufficient quantities of homogeneously pure active PAP without batch-to-batch variation from its natural resource.

The United Kingdom allows pokeweed in medicinal products where toxic constituents are absent and the product adheres to mandated limits. Ongoing research is investigating the use of pokeweed for the flu, HSV-1, and polio.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Abortifacient (induces abortion), abscesses (mammary), acne, anthrax, antimicrobial, antiviral, arthritis, cancer, contraception, dysmenorrhea (painful menstruation), earache, edema, emetic (induces vomiting), fatigue, fertility, food uses, gonorrhea, headache, HIV, inflammation (upper and lower respiratory tract), intestinal worms, laryngitis, laxative, leeches, leukemia, lymphadenitis (inflammation of lymph nodes), mastitis (inflammation of the breast), pruritus (severe itching), purgative (laxative), rabies, rheumatism, ringworm, scabies, schistosomiasis (tropical parasitic infection), skin disorders, stimulant (cardiac), skin ailments (sycosis), syphilis (STD), tonsillitis.

Dosing

Adults (18 years and older):

There is no proven safe or effective dose for pokeweed. Traditionally, 1 gram of dried pokeweed root has been used as an emetic (induces vomiting) or purgative (laxative). For immune stimulation or rheumatism, 60 to 100 milligrams daily of the root and berries has been used.

Children (younger than 18 years):

There is no proven safe or effective dose for pokeweed in children, and use in not recommended.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to pokeweed or its constituents.

Side Effects and Warnings

All parts of the pokeweed plant are considered toxic. Pokeweed antiviral protein (PAP) appears to have fewer side effects, which include transient elevation of the liver enzyme alanine aminotransferase. Use PAP cautiously in patients with liver disorders. Use PAP cautiously and only under the guidance of a medical professional for HIV. Dosing and efficacy are unclear based on currently available literature.

When taken by mouth, all parts of the pokeweed plant may cause nausea, vomiting, cramping, abdominal pain, diarrhea, hypotension (low blood pressure), blood abnormalities, burning sensations in the mouth and throat, weakness, bloody emesis (vomiting), bloody diarrhea, salivation, respiratory failure, difficulty breathing, tachycardia (fast heart rate), Mobitz type I heart block, transient blindness, urinary incontinence, spasm, convulsion, severe thirst, somnolence (sleepiness/drowsiness), or death.

Protective gloves should be used to handle the plant because when the root comes in contact with broken skin or is ingested, pokeweed may cause changes in the blood. Use pokeweed cooked leaves cautiously in adult patients, as only cooked early spring leaves are considered nontoxic.

Pregnancy and Breastfeeding

Pokeweed is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. The berry may have uterine stimulant and abortifacient (abortion inducing) effects.

Interactions

Interactions with Drugs

Pokeroot may lower blood pressure and thus increase the action of antihypertensive herbs and supplements. Patients taking blood pressure lowering herbs should consult with a qualified healthcare professional, including a pharmacist.

Pokeweed root may have anti-inflammatory effects, and therefore may interact additively with anti-inflammatory drugs.

Pokeweed may have antiviral effects, and therefore may interact with antiviral medications.

Pokeweed may cause Mobitz type I heart block, and may therefore interact with cardiac glycosides, such as digoxin or digitoxin.

Theoretically, pokeweed may have diuretic activity, and may interact additively with other diuretics. Caution is advised.

Phytolaccosides from Phytolacca americana may increase the intestinal absorption of hydrophilic drugs, or heparin, having difficulty crossing the intestinal epithelium. Consult with a qualified healthcare professional, including a pharmacist, for a full list of interactions.

Interactions with Herbs and Dietary Supplements

Pokeroot may lower blood pressure and thus increase the action of antihypertensive herbs and supplements. Patients taking blood pressure lowering herbs should consult with a qualified healthcare professional, including a pharmacist.

Pokeweed root may have anti-inflammatory effects, and therefore may interact additively with herbs and supplements with anti-inflammatory effects.

Pokeweed may have antiviral effects, and therefore may interact with antiviral herbs.

Pokeweed may cause Mobitz type I heart block, and may therefore interact with cardiac glycoside herbs, such as foxglove.

Theoretically, pokeweed may have diuretic activity, and may interact additively with other diuretics. Caution is advised.

Phytolaccosides from Phytolacca americana may increase the intestinal absorption of hydrophilic herbs having difficulty crossing the intestinal epithelium. Consult with a qualified healthcare professional, including a pharmacist, for a full list of interactions.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Idy Chu, PharmD (Massachusetts College of Pharmacy); Nicole Giese, MS (Natural Standard Research Collaboration); Sooyoun Kang, PharmD (Massachusetts College of Pharmacy); Lisa Scully, PharmD (Natural Standard Research Collaboration); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Barkhordari A, Stoddart RW, McClure SF, McClure J. Lectin histochemistry of normal human lung. J Mol.Histol. 2004;35(2):147-156.

Cho SY, Sim JS, Kang SS, et al. Enhancement of heparin and heparin disaccharide absorption by the Phytolacca americana saponins. Arch Pharm Res 2003;26(12):1102-1108.

D'Cruz OJ, Uckun FM. Pokeweed antiviral protein: a potential nonspermicidal prophylactic antiviral agent. Fertil.Steril. 2001;75(1):106-114.

D'Cruz OJ, Waurzyniak B, Uckun FM. Mucosal toxicity studies of a gel formulation of native pokeweed antiviral protein. Toxicol.Pathol. 2004;32(2):212-221.

Erko B, Abebe F, Berhe N, et al. Control of Schistosoma mansoni by the soapberry Endod (Phytolacca dodecandra) in Wollo, northeastern Ethiopia: post-intervention prevalence. East Afr.Med J 2002;79(4):198-201.

Esser KB, Semagn K, Wolde-Yohannes L. Medicinal use and social status of the soap berry endod (Phytolacca dodecandra) in Ethiopia. J Ethnopharmacol. 2003;85(2-3):269-277.

Ndekha A, Hansen EH, Molgaard P, et al. Community participation as an interactive learning process: experiences from a schistosomiasis control project in Zimbabwe. Acta Trop. 2003;85(3):325-338.

Rajamohan F, Doumbia SO, Engstrom CR, et al. Expression of biologically active recombinant pokeweed antiviral protein in methylotrophic yeast Pichia pastoris. Protein Expr.Purif. 2000;18(2):193-201.

Rau E. Treatment of acute tonsillitis with a fixed-combination herbal preparation. Adv.Ther 2000;17(4):197-203.

Schlick J, Dulieu P, Desvoyes B, et al. Cytotoxic activity of a recombinant GnRH-PAP fusion toxin on human tumor cell lines. FEBS Lett. 4-28-2000;472(2-3):241-246.

Sussner U, Abel G, Schulte R, Kreis W. Isolation and characterisation of a cysteine protease (phytolacain G), from Phytolacca americana roots. Planta Med 2004;70(10):942-947.

Tadeg H, Mohammed E, Asres K, et al. Antimicrobial activities of some selected traditional Ethiopian medicinal plants used in the treatment of skin disorders. J Ethnopharmacol. 8-22-2005;100(1-2):168-175.

Treyvaud V, Marston A, Dyatmiko W, et al. Molluscicidal saponins from Phytolacca icosandra. Phytochemistry 2000;55(6):603-609.

Woldeamanuel Y, Abate G, Chryssanthou E. In vitro activity of Phytolacca dodecandra (Endod) against dermatophytes. Ethiop.Med J 2005;43(1):31-34.

Yang WH, Wieczorck M, Allen MC, et al. Cytotoxic activity of gonadotropin-releasing hormone (GnRH)-pokeweed antiviral protein conjugates in cell lines expressing GnRH receptors. Endocrinology 2003;144(4):1456-1463.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.