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Uses and Benefits of Condurango - Side Effects of Condurango

Taxonomic Class

Asclepiadaceae

Common Trade Names

Conduran, Condurango, Condurango Bark

Common Forms

Available as dried or powdered bark, liquid extract, and tincture.

Source

Condurango is the dried bark of Marsedenia condurango, a member of the milkweed family that is native to Ecuador and other parts of South America.

Chemical Components

Condurango contains tannin, small quantities of a strychnine-like alkaloid, caoutchouc, conduragin, condruit, essential oil, phytosterin, resin, sitosterol, and condurangoglycoside (an aglycone). Other components of the bark include catteic acid, chlorogenic acid, cichorin, p-coumaric acid, coumarin, esculetin, flavonoids, 7-hydroxycoumarin, neochlorogenic acid, and vanillin.

Actions

Tannic acid has local astringent properties that act on the GI mucosa; it also forms insoluble complexes with some heavy metal ions, alkaloids, and glycosides. Tannic acid has also been shown to have antiu1cerative and antisecretory effects within the GI tract.

Saponin glycosides, referring to condurangoglycoside, have a bitter taste and are irritating to the mucous membranes. In humans, they are generally nontoxic after oral ingestion, but they act as potent hemolytics when given LV. Coumarin is converted to 7 -hydroxycoumarin by the cytochrome P-450 2A6 enzyme system . Although coumarin is considered a less active anticoagulant than warfarin, doses of 4 g have been shown to decrease sympathetic nerve activity. The presence of a strychnine-like compound may also contribute to the herb's proposed uses because strychnine (from the dried ripe seed of Strychnos Nux-vomica) has been used medicinally as a bitter.

Reported Uses

Condurango is mainly used as an appetite stimulant, an astringent, and a bitter and promotes functional stomach activity. Its bark is claimed to relax the nerves of the stomach, thus making it suitable for tension- or anxiety-induced indigestion. The herb has also been suggested for use as an analgesic, a diuretic, a hemostatic, and a tonic .

In the late 1800s, condurango was considered a cure in the early stages of cancer of the breast, epithelium, esophagus, face, lips, neck, pylorus, skin, stomach, and tongue and for lymphadenomas. Although human studies are lacking, two glycosides were isolated from condurango bark and found to have antitumorigenic activity against sarcoma­180 and Ehrlich cancers in rats. Natives of South America have used condurango to treat chronic syphilis.

Dosage

Tincture: 1 to 2 ml P.O. t.i.d.

Adverse Reactions

  • CNS: CNS stimulation (stiff neck and facial muscles, restlessness, excitable reflexes, seizures).

  • Hepatic: hepatic dysfunction.

Other: increased urine output, sweating, vertigo, and visual disturbances have occurred after ingestion of 12 g of bark.

Interactions

Drugs using the CYP2A6 enzyme system (carbamazepine, paroxetine, ritonavir, sertraline): Altered metabolism of these drugs because coumarin also uses this pathway. Avoid administration with condurango.

Ironcontaining products, alkaloid-related substances (atropine copolamine)

Medicinal glycosides (digoxin): Absorption prevented when used with condurango. Avoid concomitant use.

Contraindications And Precautions

Condurango is contraindicated in patients with a history of seizures or other CNS disorders and in pregnant or breast -feeding patients. Use cautiously in patients with hepatic disease and those who are taking drugs that are metabolized by the cytochrome P-450 2A6 enzyme system. Parenteral administration of tannic acid has been used as an experimental hepatotoxin.

Special Considerations

Instruct the patient to discontinue condurango immediately if liver transaminase levels become elevated or muscle stiffness or rigidity, excitable reflexes, or seizures occur.

A change in the therapeutic levels of other concurrent drugs can occur because of competition for metabolism through the cytochrome P-450 2A6 enzyme system.

Urge the patient to report symptoms of hepatic dysfunction (fever, jaundice, right upper quadrant pain) and other adverse reactions immediately.

Alert: Inform the patient that poisoning from conduragin ingestion is possible because the bark compound is believed to be a violent toxin.

Alert: Seizures resulting in paralysis have occurred after conduragin ingestion and overdoses of bark itself.

Caution the patient to avoid hazardous activities, such as driving, until tolerance to the herb is known.

Advise women to avoid using condurango during pregnancy or when breast-feeding.

Commentary

Human studies are lacking. Antitumorigenic activity was reported in rats . Excessive amounts of condurango are not recommended because of the risk of adverse effects on the liver, interactions with drugs metabolized through the cytochrome P-450 enzyme system and, possibly, stimulant effects on the CNS.

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