Tylophora (Tylophora indica)

Category

Synonyms

Anta-mul (Hindi), Indian ipecac, Indian ipecacuahna, Jangli-pikavan, Tylophora asthmatica, Tylophora pubescens, Tylophora vomitoria, Voight, wall.

Background

Tylophora is a climbing perennial plant that grows in India. The leaves of tylophora have been traditionally used for treating asthma, earning the name of Tylophora asthmatica. In folk medicine, it has been used for other respiratory problems such as allergies, bronchitis and the common cold. It is also believed by some to have laxative and other purgative properties. Additionally, it has been employed to treat dysentery and joint pain.

The only available clinical trials done on tylophora test its effectiveness in bronchial asthma. To date, there are no trials available examining its effectiveness in treating other conditions.

The occurrence of adverse events that occur when the leaf of tylophora is taken orally seems to be reduced when the leaves are taken in capsule form instead of chewing.

Evidence

Asthma: Available studies of tylophora for asthma show conflicting results and therefore efficacy remains unproven.
Grade: C

Tradition

Dosing

Adults (over 18 years old)

There is no proven effective dose for tylophora. Traditionally, doses of 250 milligrams 1-3 times daily, standardized to 0.1% of tylophorine per dose, and doses of 30-60 milligrams twice daily standardized to 0.15% of tylophorine have been used. One clinical trial reports using 350 milligrams of tylophora leaf placed in a capsule and given once daily for seven days. Some experts have used tylophora leaf taken in the amount of 200-400 milligrams dried herb daily. A clinical trial reports the use of one tylophora leaf taken orally daily in the morning for six days. One clinical trial reports the use of 40mg of alcoholic extract of Tylophora indica daily for six days.

There are reports using 400-500 milligrams of alkaloid tylophora in powder form given once daily to asthmatic patients for six days. Another trial used one leaf of tylophora daily for up to 12 days in asthmatic patients.

Children (under 18 years old)

There is no proven effective dose for tylophora in children.

Safety

Allergies

Avoid in individuals with a known allergy or hypersensitivity to tylophora.

Side Effects and Warnings

Tylophora has been reported to cause infrequent nausea, vomiting, change in taste perception and mouth soreness. Rare instances of drowsiness and respiratory distress have also been reported.

Use cautiously in patients with diabetes, congestive heart failure, arrhythmia, hypertension and edema.

Avoid in patients with serious infections, organ transplantation, major systemic disease or major recent surgery.

Pregnancy & Breastfeeding

Tylophora is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Tylophora asthmatica has been reported to have abortion-inducing properties. Many tinctures contain high levels of alcohol, and should be avoided during pregnancy.

Interactions

Interactions with Drugs

Tylophora was found to have central nervous system (CNS) depressant effects in high doses. Caution is advised when taking tylophora with antidepressants or other CNS stimulants.

Tylophora may increase bronchodilation, and caution is advised when taking with bronchodilators.

Although not well studied in humans, tylophora may antagonize dextmethasone/hypophysectomy-induced suppression of the pituitary. Caution is advised when taking tylorphora with corticosteroids (steroids).

Tylophora leaf extract of Tylophora conspicua may exhibit dose-dependent inhibition of indomethacin-induced gastric ulceration, possibly through gastric acid inhibition. Use caution when taking with indomethacin or other antacids.

Many tinctures contain high levels of alcohol, and may cause nausea or vomiting when taken with metronidazole (Flagyl®) or disulfiram (Antabuse®).

Interactions with Herbs & Dietary Supplements

Tylophora leaf extract of Tylophora conspicua exhibits dose-dependent inhibition of indomethacin-induced gastric ulceration, possibly through gastric acid inhibition. Use caution when taking with other antacids.

Tylophora was found to have central nervous system (CNS) depressant effects in high doses. Caution is advised when taking tylophora with herbs or supplements with antidepressant or CNS stimulant effects.

Although not well studied in humans, tylophora may antagonize dextmethasone/hypophysectomy-induced suppression of the pituitary. Caution is advised when taking tylorphora with herbs or supplements with corticosteroid-like effects.

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): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Anait Gasparyan, PharmD (Northeastern University); Nicole Giese, MS (Natural Standard Research Collaboration); Mary McGarry, PharmD (University of Kansas); David Sollars, MAc, HMC (New England School of Acupuncture); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

Dikshith TS, Raizada RB, Mulchandani NB. Toxicity of pure alkaloid of Tylophora asthamatica in male rat. Indian J Exp Biol 1990;28(3):208-212.

Farnsworth NR, Bingel AS, Cordell GA, et al. Potential value of plants as sources of new antifertility agents I. J Pharm Sci 1975;64(4):535-598.

Gopalakrishnan C, Shankaranarayanan D, Nazimudeen SK, et al. Effect of tylophorine, a major alkaloid of Tylophora indica, on immunopathological and inflammatory reactions. Indian J Med Res 1980;71:940-948.

Gupta S, George P, Gupta V, et al. Tylophora indica in bronchial asthma--a double blind study. Indian J Med Res 1979;69:981-989.

Mathew KK, Shivpuri DN. Treatment of asthma with alkaloids of Tylophora indica - a double blind study. Aspects of Allergy Appl Immunol 1974;7:166-179.

Raji Y, Hammed AI, Adesanwo JK, et al. Antiulcerogenic effects of Tylophora conspicua in male rats. Phytother Res 2000;14(5):378-380.

Shivpuri DN, Menon MP, Prakash D. A crossover double-blind study on Tylophora indica in the treatment of asthma and allergic rhinitis. J Allergy 1969;43(3):145-150.

Shivpuri DN, Menon MP, Parkash D. Preliminary studies in Tylophora indica in the treatment of asthma and allergic rhinitis. J Assoc Physicians India 1968;16(1):9-15.

Shivpuri DN, Singhal SC, Parkash D. Treatment of asthma with an alcoholic extract of tylophora indica: a cross-over, double-blind study. Ann Allergy 1972;30(7):407-412.

Thiruvengadam KV, Haranath K, Sudarsan S, et al. Tylophora indica in bronchial asthma (a controlled comparison with a standard anti-asthmatic drug). J Indian Med Assoc 10-1-1978;71(7):172-176.

Udupa AL, Udupa SL, Guruswamy MN. The possible site of anti-asthmatic action of Tylophora asthmatica on pituitary-adrenal axis in albino rats. Planta Med 1991;57(5):409-413.

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.