Smoke yohimbe. Yohimbe: A Comprehensive Guide to Uses, Side Effects, and Health Considerations
What are the potential benefits and risks of using yohimbe supplements. How does yohimbe interact with other medications. What precautions should be taken when considering yohimbe supplementation.
Understanding Yohimbe: Origin and Composition
Yohimbe is an evergreen tree native to western and central Africa, scientifically known as Pausinystalia yohimbe. The tree’s bark contains a compound called yohimbine, which has been used for various purposes throughout history. Manufacturers process yohimbe bark into various forms, including capsules, extracts, and tablets, making it widely available as a dietary supplement.
It’s important to note that the quality and potency of yohimbe supplements can vary significantly due to the lack of regulation by the Food and Drug Administration (FDA). This inconsistency in product quality highlights the need for caution when considering yohimbe supplementation.
The Active Compound: Yohimbine
Yohimbine is the primary active compound found in yohimbe bark. Some pharmaceutical companies utilize a derivative called yohimbine hydrochloride in prescription medications for erectile dysfunction. However, it’s crucial to understand that this prescription-grade compound differs from the yohimbine found in over-the-counter supplements.

Traditional and Modern Uses of Yohimbe
Historically, yohimbe bark has been used to prepare teas with purported aphrodisiac properties. In contemporary times, people use yohimbe supplements for various purposes, including:
- Treating erectile dysfunction
- Enhancing athletic performance
- Promoting weight loss
- Managing depression
Despite its widespread use, the National Center for Complementary and Integrative Health (NCCIH) notes that there is limited to no scientific evidence supporting many of the claimed benefits of yohimbe supplements. In fact, newer medications have largely replaced yohimbe-based treatments for erectile dysfunction.
Potential Side Effects and Risks of Yohimbe Supplementation
While some individuals may experience benefits from yohimbe supplementation, it’s crucial to be aware of the potential side effects and risks associated with its use. These can range from mild discomfort to severe health complications.
Common Side Effects
- Gastrointestinal issues (diarrhea, nausea)
- Anxiety
- Elevated blood pressure
- Tachycardia (rapid heartbeat)
- Insomnia
- Dizziness
Severe Side Effects
In some cases, yohimbe supplementation can lead to more serious health issues, including:

- Psychiatric symptoms (severe anxiety or nervousness)
- Urinary problems
- Cardiotoxicity (damage to heart muscle)
- Irregular heartbeat
The NCCIH reports that individuals who contacted poison control centers regarding yohimbe supplement side effects were more likely to require medical intervention compared to those seeking help for other substances. This underscores the potential risks associated with yohimbe use.
Precautions and Contraindications for Yohimbe Use
Given the potential risks associated with yohimbe supplementation, certain individuals should exercise extreme caution or avoid its use entirely. It’s essential to consult with a healthcare professional before incorporating yohimbe into your regimen, especially if you have pre-existing health conditions or are taking medications.
Who Should Avoid Yohimbe?
The following groups should not take yohimbe supplements due to the increased risk of adverse effects:
- Pregnant or breastfeeding women
- Individuals with heart disease
- Those with psychiatric disorders
- People with Parkinson’s disease
- Individuals with stomach ulcers
- Those with kidney, thyroid, or liver disease
- People with arrhythmias
- Individuals with sexual organ inflammatory disorders
- Those with high blood pressure
- People with seizure disorders
- Individuals with an enlarged prostate
Drug Interactions and Yohimbe: What You Need to Know
Yohimbe can interact negatively with various medications, potentially leading to harmful effects. Understanding these interactions is crucial for anyone considering yohimbe supplementation.

Medications to Avoid with Yohimbe
According to the Memorial Sloan Kettering Cancer Center, individuals taking the following medications should not use yohimbe supplements:
- Antidepressants
- Decongestants
- Diet aids
- Clonidine (Catapres)
- Methamphetamine (Desoxyn)
- Bupropion (Wellbutrin)
- Phenothiazines
- Anxiety medications
- Strong pain relievers (opioids)
- Blood pressure medications
The potential for drug interactions highlights the importance of discussing yohimbe use with a healthcare provider, especially if you are currently taking any medications.
Selecting and Using Yohimbe Supplements Safely
Given the lack of FDA regulation for dietary supplements, choosing a yohimbe product requires careful consideration. A 2016 study revealed that only 2 out of 49 yohimbe brands available in the United States provided accurate information about both the amount of yohimbine in their product and its known adverse effects.
Tips for Safe Yohimbe Use
- Consult with a healthcare professional before starting yohimbe supplementation.
- Choose reputable brands that provide clear information about yohimbine content and potential side effects.
- Start with a low dose and monitor your body’s response.
- Discontinue use immediately if you experience any adverse effects.
- Never exceed the recommended dosage.
- Avoid combining yohimbe with other stimulants or medications without medical supervision.
Alternatives to Yohimbe: Exploring Safer Options
Given the potential risks associated with yohimbe supplementation, many individuals may be interested in exploring safer alternatives for addressing similar health concerns. While it’s always best to consult with a healthcare professional for personalized advice, here are some potential alternatives to consider:

For Erectile Dysfunction
- Prescription medications (e.g., sildenafil, tadalafil)
- Lifestyle changes (e.g., regular exercise, stress reduction)
- Pelvic floor exercises
- L-arginine supplements
For Athletic Performance
- Creatine
- Beta-alanine
- Caffeine
- Proper nutrition and hydration
For Weight Management
- Green tea extract
- Conjugated linoleic acid (CLA)
- High-protein diet
- Regular exercise routine
Remember that these alternatives may also have their own set of benefits and risks. Always research thoroughly and consult with a healthcare provider before starting any new supplement regimen.
The Future of Yohimbe Research: Potential Applications and Concerns
While current evidence for many of yohimbe’s purported benefits is limited, ongoing research continues to explore its potential applications in various fields of medicine and health. However, these studies also aim to better understand the risks associated with yohimbe use.
Areas of Current Research
- Yohimbine’s effects on fat metabolism and weight loss
- Potential applications in treating sexual dysfunction
- Use in managing certain types of anxiety disorders
- Interactions with other compounds and medications
As research progresses, it’s possible that new applications for yohimbe may be discovered, or that existing claims may be further substantiated or refuted. However, it’s crucial to approach any new findings with caution and always prioritize safety when considering supplement use.

In conclusion, while yohimbe has a long history of traditional use and continues to be popular as a dietary supplement, its potential benefits must be weighed against its significant risks and side effects. Anyone considering yohimbe supplementation should thoroughly research the topic, consult with a healthcare professional, and carefully monitor their body’s response if they choose to use it. As with any supplement, prioritizing safety and making informed decisions is paramount to maintaining overall health and well-being.
Uses, side effects, and warnings
Yohimbe is an evergreen tree that is native to western and central Africa. People have used compounds in the bark as an aphrodisiac, to treat erectile dysfunction, and for improved athletic performance.
Although it is widely available as a supplement, there is limited evidence to support many manufacturers’ claims about yohimbe.
Keep reading for more information on yohimbe, including its uses and the possible side effects.
Yohimbe is a type of evergreen tree. Its scientific name is Pausinystalia yohimbe.
The yohimbe tree’s bark contains a compound called yohimbine. Manufacturers make yohimbe bark into capsules, extracts, and tablets.
Some drug companies use a compound called yohimbine hydrochloride as part of their erectile dysfunction medications. This product is different than the commercial supplements.
As with all supplements, the Food and Drug Association (FDA) do not regulate the quality of yohimbe supplements. As a result, the strength and quality of different products may differ.
According to the National Center for Complementary and Integrative Health (NCCIH), people have long used yohimbe bark to make teas as an aphrodisiac.
In addition, people use yohimbe as a dietary supplement for:
According to the NCCIH, the prescription medications that use the plant generally contain yohimbine hydrochloride, which is not an ingredient in over-the-counter supplements.
The Memorial Sloan Kettering Cancer Center note that newer medications have replaced the use of yohimbe-based medication for erectile dysfunction.
Both the NCCIH and the Memorial Sloan Kettering Cancer Center indicate that there is limited-to-no evidence to support yohimbe supplements’ purported uses.
Potential side effects of yohimbe include:
- stomach problems, such as diarrhea and nausea
- anxiety
- high blood pressure
- tachycardia (rapid heartbeat)
Other side effects may include:
- sleeplessness
- psychiatric symptoms, such as feeling anxious or nervous
- dizziness
- urinary problems
- cardiotoxicity, or damage to the heart muscle
- irregular heartbeat
The NCCIH indicate that people who called poison control officials about yohimbe supplement side effects were more likely to need medical intervention than people who sought poison control help for other substances.
People should stop using yohimbe supplements if they notice any negative side effects. If the side effects are severe, it is important to call Poison Control or seek emergency medical help.
People considering taking yohimbe supplements should talk to their doctor before doing so. A doctor may be able to offer a safer regulated alternative.
People should also approach selecting a yohimbe supplement with caution. The label may or may not list the amount of yohimbe present in the product, which can vary among brands.
A 2016 study found that only 2 of 49 brands available in the United States reported both the amount of yohimbine in their product and the known adverse effects.
Yohimbe could increase the risk of dangerous health issues, including heart attacks and seizures.
Pregnant or breastfeeding women should not take yohimbe supplements due to the risk of serious adverse effects.
In addition, people with the following conditions should not take yohimbe supplements:
- heart disease
- psychiatric disorders
- Parkinson’s disease
- stomach ulcers
- kidney, thyroid, or liver disease
- arrhythmias
- sexual organ inflammatory disorders
- high blood pressure
- seizure disorders
- an enlarged prostate
Yohimbe can interact negatively with several drugs. According to the Memorial Sloan Kettering Cancer Center, a person should not use yohimbe supplements if they are taking antidepressants, decongestants, or diet aids.
A person taking any of the following medications should avoid taking yohimbe supplements:
- clonidine (Catapres)
- methamphetamine (Desoxyn)
- bupropion (Wellbutrin)
- phenothiazines
- drugs for anxiety
- strong pain relievers called opioids
- other drugs for lowering blood pressure
Yohimbe supplements have many possible side effects, warnings, and potential medication interactions.
As a result, a person should talk to their doctor before purchasing or using yohimbe supplements.
A person who is currently taking yohimbe should let their doctor know. Anyone who notices adverse side effects while taking these supplements should discontinue their use immediately or call an emergency number for severe reactions.
Yohimbine (PIM 567)
Yohimbine (PIM 567)
| 1. NAME |
| 1.1 Substance |
| 1.2 Group |
| 1.3 Synonyms |
| 1.4 Identification numbers |
| 1.4.1 CAS number |
| 1.4.2 Other numbers |
| 1.5 Brand names, Trade names |
| 1.6 Manufacturers, Importers |
| 1.7 Presentation, Formulation |
| 2. SUMMARY |
| 2.1 Main risks and target organs |
| 2.2 Summary of clinical effects |
| 2.3 Diagnosis |
| 2.4 First aid measures and management principles |
| 3. PHYSICO-CHEMICAL PROPERTIES |
| 3.1 Origin of the substance |
| 3.2 Chemical structure |
| 3.3 Physical properties |
| 3.3.1 Properties of the substance |
| 3.3.1.1 Colour |
| 3.3.1.2 State/Form |
| 3.3.1.3 Description |
3. 3.2 Properties of the locally available formulation |
| 3.4 Other characteristics |
| 3.4.1 Shelf-life of the substance |
| 3.4.2 Shelf-life of the locally available formulation(s) |
| 3.4.3 Storage conditions |
| 3.4.4 Bioavailability |
| 3.4.5 Specific properties and composition |
| 4. USES |
| 4.1 Indications |
| 4.1.1 Indications |
| 4.1.2 Description |
| 4.2 Therapeutic dosage |
| 4.2.1 Adults |
| 4.2.2 Children |
| 4.3 Contraindications |
| 5. ROUTES OF ENTRY |
| 5.1 Oral |
| 5.2 Inhalation |
| 5.3 Dermal |
| 5.4 Eye |
| 5.5 Parenteral |
| 5.6 Other |
| 6. KINETICS |
| 6.1 Absorption by route of exposure |
| 6.2 Distribution by route of exposure |
| 6.3 Biological half-life by route of exposure |
| 6.4 Metabolism |
| 6.5 Elimination by route of exposure |
7. PHARMACOLOGY AND TOXICOLOGY |
| 7.1 Mode of action |
| 7.1.1 Toxicodynamics |
| 7.1.2 Pharmacodynamics |
| 7.2 Toxicity |
| 7.2.1 Human data |
| 7.2.1.1 Adults |
| 7.2.1.2 Children |
| 7.2.2 Relevant animal data |
| 7.2.3 Relevant in vitro data |
| 7.3 Carcinogenicity |
| 7.4 Teratogenicity |
| 7.5 Mutagenicity |
| 7.6 Interactions |
| 7.7 Main adverse effects |
| 8. TOXICOLOGICAL AND BIOMEDICAL INVESTIGATIONS |
| 8.1 Material sampling plan |
| 8.1.1 Sampling and specimen collection |
| 8.1.1.1 Toxicological analyses |
| 8.1.1.2 Biomedical analyses |
| 8.1.1.3 Arterial blood gas analysis |
| 8.1.1.4 Haematological analyses |
| 8.1.1.5 Other (unspecified) analyses |
| 8.1.2 Storage of laboratory samples and specimens |
| 8.1.2.1 Toxicological analyses |
| 8.1.2.2 Biomedical analyses |
8. 1.2.3 Arterial blood gas analysis |
| 8.1.2.4 Haematological analyses |
| 8.1.2.5 Other (unspecified) analyses |
| 8.1.3 Transport of laboratory samples and specimens |
| 8.1.3.1 Toxicological analyses |
| 8.1.3.2 Biomedical analyses |
| 8.1.3.3 Arterial blood gas analysis |
| 8.1.3.4 Haematological analyses |
| 8.1.3.5 Other (unspecified) analyses |
| 8.2 Toxicological analyses and their interpretation |
| 8.2.1 Tests on toxic ingredient(s) of material |
| 8.2.1.1 Simple qualitative test(s) |
| 8.2.1.2 Advanced qualitative confirmation test(s) |
| 8.2.1.3 Simple quantitative method(s) |
| 8.2.1.4 Advanced quantitative method(s) |
| 8.2.2 Tests for biological specimens |
| 8.2.2.1 Simple qualitative test(s) |
| 8.2.2.2 Advanced qualitative confirmation test(s) |
| 8.2.2.3 Simple quantitative method(s) |
| 8.2.2.4 Advanced quantitative method(s) |
| 8.2.2.5 Other dedicated method(s) |
| 8.2.3 Interpretation of toxicological |
8. 3 Biomedical investigations and their interpretation |
| 8.3.1 Biochemical analysis |
| 8.3.1.1 Blood, plasma or serum |
| 8.3.1.2 Urine |
| 8.3.1.3 Other fluids |
| 8.3.2 Arterial blood gas analyses |
| 8.3.3 Haematological analyses |
| 8.4 Other biomedical (diagnostic) investigations and their interpretation |
| 8.5 Overall interpretation of all toxicological analyses and toxicological investigations |
| 8.6 References |
| 9. CLINICAL EFFECTS |
| 9.1 Acute poisoning |
| 9.1.1 Ingestion |
| 9.1.2 Inhalation |
| 9.1.3 Skin exposure |
| 9.1.4 Eye contact |
| 9.1.5 Parenteral exposure |
| 9.1.6 Other |
| 9.2 Chronic poisoning |
| 9.2.1 Ingestion |
| 9.2.2 Inhalation |
| 9.2.3 Skin exposure |
| 9.2.4 Eye contact |
| 9.2.5 Parenteral exposure |
| 9.2.6 Other |
| 9.3 Course, prognosis, cause of death |
9. 4 Systematic description of clinical effects |
| 9.4.1 Cardiovascular |
| 9.4.2 Respiratory |
| 9.4.3 Neurological |
| 9.4.3.1 Central nervous system (CNS) |
| 9.4.3.2 Peripheral nervous system |
| 9.4.3.3 Autonomic nervous system |
| 9.4.3.4 Skeletal and smooth muscle |
| 9.4.4 Gastrointestinal |
| 9.4.5 Hepatic |
| 9.4.6 Urinary |
| 9.4.6.1 Renal |
| 9.4.6.2 Others |
| 9.4.7 Endocrine and reproductive systems |
| 9.4.8 Dermatological |
| 9.4.9 Eye, ears, nose, throat: local effects |
| 9.4.10 Haematological |
| 9.4.11 Immunological |
| 9.4.12 Metabolic |
| 9.4.12.1 Acid-base disturbances |
| 9.4.12.2 Fluid and electrolyte disturbances |
| 9.4.12.3 Others |
| 9.4.13 Allergic reactions |
| 9.4.14 Other clinical effects |
| 9.4.15 Special risks |
| 9.5 Other |
9. 6 Summary |
| 10. MANAGEMENT |
| 10.1 General principles |
| 10.2 Relevant laboratory analyses |
| 10.2.1 Sample collection |
| 10.2.2 Biomedical analysis |
| 10.2.3 Toxicological analysis |
| 10.3 Life supportive procedures and symptomatic/specific treatment |
| 10.4 Decontamination |
| 10.5 Elimination |
| 10.6 Antidote treatment |
| 10.6.1 Adults |
| 10.6.2 Children |
| 10.7 Management discussions |
| 11. ILLUSTRATIVE CASES |
| 11.1 Case reports from literature |
| 11.2 Internally extracted data on cases |
| 11.3 Internal cases |
| 12. ADDITIONAL INFORMATION |
| 12.1 Availability of antidotes |
| 12.2 Specific preventive measures |
| 12.3 Other |
| 13. REFERENCES |
| 14. AUTHOR(S), REVIEWER(S), DATE(S) (INCLUDING UPDATES), COMPLETE ADDRESS(ES) |
1. NAME
1.1 Substance
Yohimbine1.2 Group
ATC classification index
All other therapeutic products (V03)/Other therapeutic
products (V03AX).
(WHO, 1992)
1.3 Synonyms
Aphrodine HydrochlorideChlorhydrate de QubrachineCorynine HydrochlorideYo Yo
(Reynolds, 1993)
1.4 Identification numbers
1.4.1 CAS number
Yohimbine 146-48-5
Yohimbine Hydrochloride 65-19-01.4.2 Other numbers
RTECS
Yohimbine ZG10000001.5 Brand names, Trade names
Monocomponent products
Actibine, Aphrodyne, Dayto Himbin, Revervyl, Reverzine,
Yobine, Yocon, Yohimex, Yohydrol
Combination products
Afrodex, Ictho-Himbin, Pasuma, Pluriviron, Potensan, Potensan
Forte, Prowess, Vikonon
(To be completed by each Centre using local data)
1.6 Manufacturers, Importers
To be completed by each Centre using local data
1.7 Presentation, Formulation
Tablets, either as single ingredient or in combination with
other ingredients, for human use.
Sterile injectable solution for veterinary use.
Street drug (as a powder)
(To be completed by each Centre using local data)
2. SUMMARY
2.1 Main risks and target organs
Yohimbine is a centrally acting alpha-2-adrenoceptor blocking
agent. It may also interact with alpha-1-adrenoceptors and,
in high concentrations, serotonin and dopamine receptors.
Yohimbine is a monoamine oxidase inhibitor, and has the
potential to interact with tyramine-containing foods and
stimulants such as phenylephrine and phenylpropanolamine.
Yohimbine affects the gastrointestinal, genito-urinary,
respiratory, cardiovascular and central nervous systems.
2.2 Summary of clinical effects
Yohimbine produces cardiovascular effects, including
increases in heart rate and blood pressure.
Bronchospasm and increased mucous secretion has been
reported.
CNS effects include anxiety, hallucinations and manic
reactions.
Gastrointestinal effects include nausea, anorexia and
diarrhoea.
Dysuria, and back and genital pain have occurred.
Yohimbine has been used for its alleged aphrodisiac
properties but evidence of such an effect is lacking.
2.3 Diagnosis
There are no significant signs or symptoms which are a key to
clinical diagnosis.
Qualitative tests are available, and include Thin Layer
Chromatography and Gas Chromatography.
Although yohimbine may be quantified in the plasma by HPLC,
toxic levels have not yet been established.
2.4 First aid measures and management principles
Support respiratory and cardiovascular function. Emesis may
be indicated for substantial ingestions, especially if
initiated within 30 minutes of ingestion. Activated charcoal
may also be administered. Diazepam may be useful in reducing
anxiety.
3. PHYSICO-CHEMICAL PROPERTIES
3.1 Origin of the substance
Yohimbine is the principal indole alkaloid derived from the
bark of the Yohimbe Tree (Pausinystalia yohimbe = Corynanthe
yohimbi) (Rubiaceae).
It is also found in the Rauwolfia root
and the dried bark of Aspidosperma quebracho.
(Reynolds, 1993)
3.2 Chemical structure
Structural formula
Molecular formula
Yohimbine C21H26N2O3
Yohimbine C21H26N2O3,HCl
Hydrochloride
Molecular weight
Yohimbine 354.4
Yohimbine 390.9
Hydrochloride
Structural Chemical names
Methyl 17alpha-hydroxy-yohimban-16alpha-carboxylate
hydrochloride.
(16alpha, 17alpha)-17-Hydroxyyohimban-16-carboxylic acid
methyl ester.
(Reynolds, 1993; Budavari, 1989)
3.3 Physical properties
3.3.1 Properties of the substance
3.3.1.1 Colour
No data available
3.3.1.2 State/Form
Yohimbine Hydrochloride
Orthorhombic plates
Prisms from alcohol
Yohimbine
Orthorhombic needles
3.3.1.3 Description
Yohimbine Hydrochloride
Decomposes at 302 C
Soluble 1 in 120 of water and 1 in 400 of
alcohol
Aqueous solution pH approximately neutral
Yohimbine
Melting point 234 C
Very slightly soluble in water
Soluble in ethanol and chloroform
Sparingly soluble in ether
3.
3.2 Properties of the locally available formulation
To be completed by each Centre using local data.
3.4 Other characteristics
Store in a cool place. Do not freeze. Protect from light.
3.4.1 Shelf-life of the substance
No data available.
3.4.2 Shelf-life of the locally available formulation(s)
To be completed by each Centre using local data.
3.4.3 Storage conditions
Store in a cool place. Do not freeze. Protect from
light.
3.4.4 Bioavailability
To be completed by each Centre using local data.
3.4.5 Specific properties and composition
To be completed by each Centre using local data.
4. USES
4.1 Indications
4.1.1 Indications
In humans, yohimbine has been used for the treatment of
impotence.
In street use, Yohimbine has been misused as a mild
hallucinogen, and as an aphrodisiac.
As a veterinary preparation, yohimbine is used to
reverse xylazine-induced anaesthesia in animals
including deer, steers, dogs, cats and horses.
4.1.2 Description
Not relevant
4.2 Therapeutic dosage
4.2.1 Adults
Oral
0.1 mg/kg may produce stimulant effects.
6 mg three times daily has been used to treat
impotence.
Yohimbine has been given in doses up to 30 mg daily
(Moffat, 1986) and the German Pharmacopoeia states a
human dose of up to 100 mg/day (Dukes, 1988).
4.2.2 Children
No data available.
4.3 Contraindications
Yohimbine should not be used in cardiac, hepatic and renal
disease. It is a monoamine oxidase inhibitor, therefore
tyramine-containing foods and stimulants such as
phenylephrine and phenylpropanolamine should be avoided.
5. ROUTES OF ENTRY
5.1 Oral
Most common in humans.
5.2 Inhalation
The powdered street drug may be smoked.
5.3 Dermal
No data available.
5.4 Eye
No data available.
5.5 Parenteral
Yohimbine has been administered intravenously in clinical
research.
Accidental injection may occur, especially inveterinary
practice.
5.6 Other
No data available.
6. KINETICS
6.1 Absorption by route of exposure
The kinetic disposition of yohimbine was examined in 8 young
male subjects following a single oral dose of 10 mg yohimbine
hydrochloride. Oral absorption was rapid, with an oral
absorption half-life of 0.17 +/- 0.11 hours (approximately 11
minutes)(Owen et al, 1987). In a similar study the absorption
half-life was approximately 7 minutes (Guthrie et al., 1990).
Absorption is complete and peak plasma levels occur at 45 to
60 minutes after 10 mg orally (Owen et al, 1987; Guthrie et
al., 1990). The bioavailability showed a great variability,
ranging from 7 to 87% (Guthrie et al., 1990).
6.2 Distribution by route of exposure
Oral
Studies on the volume of distribution showed a very wide
range (mean 2.
4 +/- 1.25 L/kg (Owen et al., 1987).
Parenteral
Rapid distribution phase after intravenous injection of 10
mg, alpha half-life approximately 6 minutes. Volume of
distribution was small (mean 0.26 L/kg) (Guthrie et al.,
1990).
6.3 Biological half-life by route of exposure
Yohimbine was rapidly eliminated from the plasma in 8 young
male patients receiving a single 10 mg dose of yohimbine
(half-life was 0.60 +/- 0.26 hours) (Owen et al., 1987).
After 10 mg yohimbine intravenously, half-life (beta) was
0.68 +/- 0.2 hours (Guthrie et al., 1990).
6.4 Metabolism
Since yohimbine is stable in blood, the rapid clearance of
yohimbine from human plasma suggests metabolism of the drug
by an organ with high blood flow, such as liver or kidney,
and a high extraction efficiency (Owen et al., 1987).
Ho et al. (1971) suggest that in mice the rapid metabolism of
yohimbine is primarily due to the hydrolysis of the 16-alpha
carboxylic acid methyl ester bond to yield yohimbinic acid.
However, the hydrolysis of yohimbine to yohimbinic acid is
unlikely to be a major metabolic route in humans. This is
based on data obtained from pharmacokinetic studies on
reserpine and raubasine, two indole alkaloids structurally
related to yohimbine.
Although both reserpine and raubasine contain a 16-alpha
carboxylic acid methyl ester moiety, de-esterification of
this group does not appear to be a significant metabolic
route for reserpine, and is not a rapid route for elimination
for raubasine in humans (Owen et al.
, 1987).
6.5 Elimination by route of exposure
Oral
Clearance after 10 mg yohimbine
Range 2.81 to 200 mL/min/kg
Mean 55.9 mL/min/kg
Less than 1% of unchanged drug was recovered in the urine in
24 hours.
(Owen et al., 1987).
Parenteral
Clearance after 10 mg yohimbine intravenously
Range 2.44 to 15.8 mL/min/kg
Mean 9.77 mL/min/kg
7. PHARMACOLOGY AND TOXICOLOGY
7.1 Mode of action
Yohimbine is a competitive antagonist selective for alpha
2-andrenoceptors, which are thought to be located on nerve
terminals and receptors and to mediate inhibition of
transmitter release. The presynaptic release of noradrenaline
is increased by an alpha-2-antagonist resulting in increased
sympathetic outflow. Yohimbine may also interact with alpha-
1-adrenoceptors and, in high concentrations, serotonin and
dopamine receptors (Dukes, 1988). Yohimbine has monoamine
oxidase inhibitory effects (Bhattacharya et al., 1991).
7.1.1 Toxicodynamics
It has been suggested that a central beta-origin
toxicity exists, since only beta blockers which cross
the blood-brain barrier are capable of antagonizing
this activity (Bourin et al., 1988).
7.1.2 Pharmacodynamics
Yohimbine is an alpha-2-adrenergic antagonist. It
increases the heart rate and blood pressure and causes
CNS stimulation and anti-diuresis (Reynolds et al.
,
1989).
7.2 Toxicity
7.2.1 Human data
7.2.1.1 Adults
An ingested dose of 1.8 g (100 times the
average daily dose) resulted in unconsciousness
for some hours, with priapism. The patient
recovered fully within a few days (Roth et al.,
1984; as cited in Dukes, 1988).
7.2.1.2 Children
No data available.
7.2.2 Relevant animal data
LD50 Oral (mouse) 43 mg/kg
LDLO Intravenous (mouse) 16 mg/kg
LDLO Intravenous (rabbit) 11 mg/kg
LD50 Subcutaneous (mouse) 20 mg/kg
LDLO Subcutaneous (rabbit) 50 mg/kg
(RTECS,1987)
7.2.3 Relevant in vitro data
No data available.
7.3 Carcinogenicity
No data available.
7.4 Teratogenicity
No data available.
7.5 Mutagenicity
No data available.
7.6 Interactions
Yohimbine has monoamine oxidase inhibitory effects, and
thus has the potential to interact with tyramine-containing
foods and stimulants such as phenylephrine and
phenylpropanolamine (Bhattacharya et al., 1991).
7.7 Main adverse effects
Principal adverse effects to be expected in humans with the
use of moderate doses are emotional arousal and a rise in
blood pressure and heart rate. An oral dose of 6 mg three
times per day resulted in only minimal adverse effects such
as dizziness and nervousness (Dukes, 1988).
8. TOXICOLOGICAL AND BIOMEDICAL INVESTIGATIONS
8.1 Material sampling plan
8.1.1 Sampling and specimen collection
8.1.1.1 Toxicological analyses
8.1.1.2 Biomedical analyses
8.1.1.3 Arterial blood gas analysis
8.1.1.4 Haematological analyses
8.1.1.5 Other (unspecified) analyses
8.1.2 Storage of laboratory samples and specimens
8.1.2.1 Toxicological analyses
8.1.2.2 Biomedical analyses
8.1.2.3 Arterial blood gas analysis
8.1.2.4 Haematological analyses
8.1.2.5 Other (unspecified) analyses
8.1.3 Transport of laboratory samples and specimens
8.1.3.1 Toxicological analyses
8.1.3.2 Biomedical analyses
8.1.3.3 Arterial blood gas analysis
8.1.3.4 Haematological analyses
8.1.3.5 Other (unspecified) analyses
8.2 Toxicological analyses and their interpretation
8.2.1 Tests on toxic ingredient(s) of material
8.2.1.1 Simple qualitative test(s)
Colour tests: Liebermann's Test - blue
Mandelin's Test - blue > green
8.2.1.2 Advanced qualitative confirmation test(s)
Thin-Layer Chromatography: system TA-Rf 63;
system TB-Rf 05; system TC-Rf 38 (Dragendorff
spray, positive; acidified iodoplatinate
solution, positive; Marquis Reagent, grey).
Gas Chromatography: system GA-RI 3296.
8.
2.1.3 Simple quantitative method(s)
8.2.1.4 Advanced quantitative method(s)
High Pressure Liquid Chromatography. In plasma:
sensitivity 10 ng/mL, electrochemical
detection.
8.2.2 Tests for biological specimens
8.2.2.1 Simple qualitative test(s)
8.2.2.2 Advanced qualitative confirmation test(s)
8.2.2.3 Simple quantitative method(s)
8.2.2.4 Advanced quantitative method(s)
8.2.2.5 Other dedicated method(s)
8.2.3 Interpretation of toxicological
8.3 Biomedical investigations and their interpretation
No specific laboratory test are necessary unless clinically
indicated.
8.3.1 Biochemical analysis
8.3.1.1 Blood, plasma or serum
"Basic analyses"
"Dedicated analyses"
"Optional analyses"
8.3.1.2 Urine
"Basic analyses"
"Dedicated analyses"
"Optional analyses"
8.3.1.3 Other fluids
8.3.2 Arterial blood gas analyses
8.3.3 Haematological analyses
"Basic analyses"
"Dedicated analyses"
"Optional analyses"
8.4 Other biomedical (diagnostic) investigations and their
interpretation
8.5 Overall interpretation of all toxicological analyses and
toxicological investigations
8.6 References
Goldberg MR et al. (1984) J Liq Chromat, 7: 1003-1004.
9. CLINICAL EFFECTS
9.1 Acute poisoning
9.1.1 Ingestion
Fatalities resulting from acute overdosage of yohimbine
have not been reported. Signs of overdosage include CNS
depression, ranging from drowsiness to coma.
Respiratory depression, hypothermia, diarrhoea,
vomiting, mental depression, flushing of the skin,
hypertension, cardiac arrhythmias, tachycardia and
short-term reversible paraesthesias of the legs and
feet may occur.
9.1.2 Inhalation
Mild hallucinations, including a disassociative state,
can occur when yohimbine is smoked (Linden et al.,
Siegel, 1976).
9.1.3 Skin exposure
Not relevant.
9.1.4 Eye contact
No data available.
9.1.5 Parenteral exposure
Symptoms would be as for those listed in Section 9.1.1
(Ingestion).
9.1.6 Other
No data available.
9.2 Chronic poisoning
9.2.1 Ingestion
No data available.
9.2.2 Inhalation
No data available.
9.2.3 Skin exposure
No data available.
9.2.4 Eye contact
No data available.
9.2.5 Parenteral exposure
No data available.
9.2.6 Other
No data available.
9.3 Course, prognosis, cause of death
Fatalities resulting from acute overdosage of yohimbine have
not been reported.
Large overdoses may impair cardiac
function and cause CNS depression, including coma.
9.4 Systematic description of clinical effects
9.4.1 Cardiovascular
Tachycardia, atrial fibrillation and hypertension are
features of yohimbine toxicity. Systolic blood pressure
increased significantly in subjects given oral doses of
yohimbine. The differences for diastolic pressure were
not significant (Henauer et al., 1984).
Patients with orthostatic hypotension appear to be very
sensitive to the effects of yohimbine. A 5 mg dose may
increase blood pressure, while greater than 20 mg is
needed in a healthy volunteer (to raise the blood
pressure 40 mmHg systolic)(Brosse et al., 1983).
9.4.2 Respiratory
Bronchospasm and increased mucous secretion have been
reported (Landis & Shore, 1989).
9.4.3 Neurological
9.4.3.1 Central nervous system (CNS)
Dizziness, insomnia, headache and irritability
have been reported (Goldberg & Robertson,
1983).
Yohimbine produced manic reactions in bipolar
psychiatric patients. Symptoms included
tremulousness, restlessness, giddiness, rapid
speech, laughing, increased energy and euphoria
(Price et al., 1984).
Mild hallucinations, including a disassociative
state, can occur when yohimbine is smoked or
used in a tea (Linden et al, 1985; Siegel,
1976).
Inco-ordination was observed following abuse of
yohimbine (Linden et al., 1985). It is commonly
reported to cause anxiety (Charney et al.,
1983).
9.4.3.2 Peripheral nervous system
Short-term reversible paraesthesias of the legs
and feet were reported in diabetics being
treated for impotency and in overdoses (Morales
et al., 1982; Linden et al., 1985).
9.4.3.3 Autonomic nervous system
Not relevant
9.4.3.4 Skeletal and smooth muscle
Not relevant
9.4.4 Gastrointestinal
Nausea, vomiting, diarrhoea and anorexia have been
reported (Goldberg & Robertson, 1983).
9.4.5 Hepatic
No data available.
9.4.6 Urinary
9.4.6.1 Renal
Dysuria has been reported (Goldberg &
Robertson, 1983).
9.4.6.2 Others
Genital pain has been reported (Goldberg &
Robertson, 1983).
9.4.7 Endocrine and reproductive systems
Studies have shown yohimbine to be 3 to 3.4 times as
effective as placebo in relieving male impotency
(Sobotka, 1969).
9.4.8 Dermatological
Not relevant
9.4.9 Eye, ears, nose, throat: local effects
No data available.
9.4.10 Haematological
No data available.
9.4.11 Immunological
No data available.
9.4.12 Metabolic
9.4.12.1 Acid-base disturbances
No data available.
9.4.12.2 Fluid and electrolyte disturbances
No data available.
9.4.12.3 Others
Yohimbine is a monoamine oxidase inhibitor,
and thus has the potential for reacting with
tyramine-containing foods.
9.4.13 Allergic reactions
No data available.
9.4.14 Other clinical effects
No data available.
9.4.15 Special risks
No data available.
9.5 Other
No data available.
9.6 Summary
Not relevant
10. MANAGEMENT
10.1 General principles
Treatment is symptomatic and supportive, including
maintaining respiratory and cardiovascular function.
10.2 Relevant laboratory analyses
10.2.1 Sample collection
Not relevant
10.2.2 Biomedical analysis
No specific analyses unless clinically indicated.
10.2.3 Toxicological analysis
Qualitative tests are available, and include Thin
Layer Chromatography and Gas Chromatography.
Although yohimbine may be quantified in the plasma
by HPLC, toxic levels have not yet been established.
10.3 Life supportive procedures and symptomatic/specific
treatment
Support respiratory and cardiovascular function.
Diazepam has been shown to be useful in treating yohimbine-
induced anxiety. Dose is given either orally or by slow
intravenous injection:
Adult 5 to 10 mg
Child 0.1 - 0.3 mg/kg bodyweight
If priapism is prolonged (more than 4 hours) then specific
treatment may be required, e.g. aspiration of the corpus
may be required.
10.4 Decontamination
Emesis should be considered following recent ingestion of
amounts exceeding the maximum therapeutic dose or if there
is evidence of any overdose, if the patient is not
comatose, is not convulsing, and has not lost the gag
reflex.
Where emesis is contraindicated, gastric lavage should be
considered.
Administer activated charcoal orally (adults 50 g; children
1 g/kg).
10.5 Elimination
No data available.
10.6 Antidote treatment
10.6.1 Adults
Clonidine has been used experimentally as an
antidote in normal volunteers to eliminate
yohimbine-induced anxiety (see Section 10.7).
10.6.2 Children
No data available
10.7 Management discussions
Clonidine 5 micrograms/kg bodyweight was found to eliminate
not only yohimbine-induced anxiety but also the increases
in blood pressure, plasma MHPG, and other autonomic
symptoms in a study using normal volunteers who ingested
30 mg yohimbine.
However, before clonidine can be
recommended as a routine antidote for yohimbine toxicity,
further clinical evaluation is required (Charney et al.,
1983).
11. ILLUSTRATIVE CASES
11.1 Case reports from literature
Case 1
An ingested dose of 1.8 g yohimbine (100 times the average
daily rate) resulted in unconsciousness for some hours with
priapism. The patient recovered fully within a few days
(Roth et al., 1984; as cited in Dukes, 1988).
Case 2
A 38-year-old man with insulin dependent diabetes was
admitted two hours after taking 350 mg yohimbine. The drug
had been prescribed by a consultant psychiatrist for
erectile impotence complicated by depression.
On admission to hospital he was alert and oriented. His
blood pressure was 130/80 mmHg and his pulse was regular at
88 beats/minute. Six hours after admission he discharged
himself, but was readmitted 17 hours later in a drowsy and
confused state. He was having rigors and complained of
retrosternal pain. He did not appear to have taken any
other drug. His rectal temperature as 35.5C and his blood
pressure was 135/85 mmHg. His hands and feet were warm and
well-perfused. Blood urea was 12.8 mmol/L, serum creatine
175 umol/L, and blood glucose 16.7 mmol/L. An electro-
cardiogram showed atrial fibrillation with a ventricular
rate of 150 beats/minute. The day after admission an
electrocardiogram showed sinus rhythm, and retrograde
amnesia for the preceding 24 hours persisted for four days.
Case 3
A 16-year-old female took an estimated 250 mg of a white
powder alleged to be yohimbine. Within 20 minutes she was
weak, had generalized paraesthesia, loss of coordination,
and was disassociative. She had a severe headache, was
dizzy, and had no tremors. A severe pressure-like
substernal chest pain was noted 4 hours post-ingestion, and
remained for 2 hours before subsiding spontaneously. The
next day, the patient remained weak and dizzy, with nausea,
sweating, severe headache and intermittent palpitations. On
examination more than 30 hours after ingestion, she had a
blood pressure of 150/80, pulse of 116 and respiration rate
of 24. She was anxious, with a blotchy erythematous rash on
her back and submucosal haemorrhage in the right tympanic
membrane. Symptoms resolved spontaneously but had lasted 36
hours (Linden et al., 1985).
11.2 Internally extracted data on cases
No data available.
11.3 Internal cases
To be completed by each Centre using local data.
12. ADDITIONAL INFORMATION
12.1 Availability of antidotes
No specific antidote is available (see Section 10.7).
12.2 Specific preventive measures
Store in a cool place out of direct sunlight. Keep out of
reach of children.
12.3 Other
Not relevant.
13. REFERENCES
Bhattacharya SK, Clow A, Przuborowska A, Halket J, Glover V, &
Sandler M (1991) Effect of aromatic amino acids,
pentylenetetrazole and yohimbine on isatin and tribulin activity
in rat brain.
Neurosci-Lett 28, 132(1): 44-6.
Brodd OE, Anlauf M, & Arroyo J (1983) Hypersensitivity of
adrenergic receptors and blood pressure response to oral
yohimbine in orthostatic hypotension. New Engl J Med, 17: 1033-
1034.
Bourin M, Malinge M, Colombel MC, & Larousse C (1988) Influence
of alpha stimulants and beta blockers on yohimbine toxicity.
Prog Neuropsychopharmacol Biol Psychiatry, 12: 569-574.
Budavari S ed. (1989) The Merck index, an encyclopedia of
chemicals, drugs, and biologicals, 11th ed. Rahway, New Jersey,
Merck and Co., Inc. p 1594.
Charney DS, Heninger GR, & Redmond DE (1983) Yohimbine -induced
anxiety and increased non-adrenergic function in humans: effects
of diazepam and clonidine: Life Sci, 33: 19-29.
Dukes MNG ed. (1988) Meyler's Side Effect of Drugs. Amsterdam,
Elsevier, pp. 1024-1028.
Goldberg MR & Robertson D (1983) Yohimbine: a pharmacological
probe for study of the alpha-2-adrenoreceptor. Pharmacol Rev,
35: 143-180.
Guthrie SK, Hariharan M, & Grunhaus LJ (1990) Yohimbine
bioavailability in humans. Eur J Clin Pharmacol, 39: 409-411.
Henauer SA, Gillespie HK, & Hollister LE (1984) Yohimbine and
the model anxiety state. J Clin Psychiatry, 45: 512-515.
Ho AKJ, Hoffman DB, Gershon S, & Loh HH (1971) Distribution and
metabolism of tritiated yohimbine in mice. Arch Int Pharmacodyn,
194: 304-315.
Linden CH, Vellman WP, & Rumack B (1985) Yohimbine a new street
drug.
Am Emerg Med, 14: 1002-1004.
Moffat AC ed. (1986) Clarke's isolation and identification of
drugs (in pharmaceuticals, body fluids and post-mortem
material), 2nd ed., London, Pharmaceutical Press.
Morales A, Surridge DHC, Marshall PG , & Fenemore J (1982) Non-
hormonal pharmacological treatment of organic impotence. J Urol,
128(1): 45-47.
Owen JA, Nakatsu SL, Fenemore J, Condra M, Surridge DH, &
Morales A (1987) The pharmacokinetics of yohimbine in man. Eur J
Clin Pharmacol, 32(6): 577-582.
Price HL, Charney DS, & Heninger K (1984) Three cases of manic
symptoms following Yohimbine administration. Am J Psychiatry,
141: 1267-1268.
Reynolds JEF ed. (1989) Martindale, the extra pharmacopoeia,
29th ed. London, The Pharmaceutical Press, p 1630.
Reynolds JEF ed. (1993) Martindale, the extra pharmacopoeia,
30th ed. London, The Pharmaceutical Press, p 1428.
Roth L, Daunderer M, & Kormann K (1984) In: Giftplanzen -
Planzengifte: Vorkommen, Wirkung, Therapie, IV-P, p. 4.
Landberg, Munich, Ecomed.
RTECS (1987) Registry of Toxic Effects of Chemical Substances.
1985-1986 Edition. US Department of Health and Human Services,
Public Health Service, Centres for Disease Control, National
Institute for Occupational Safety and Health, pp 5132-5133.
Siegel RK (1976) Herbal intoxication. Psycho-active effects from
herbal cigarettes, tea and capsule. JAMA, 236: 473-376.
Sobotka JJ (1969) An evaluation of Afrodex TM in the management
of male impotency: a double-blind cross-over study.
Curr Ther
Res, 2: 87-94.
WHO (1992) Anatomical Therapeutic Chemical (ATC) classification
index. Oslo, WHO Collaborating Centre for Drug Statistics
Methodology, p 106.
14. AUTHOR(S), REVIEWER(S), DATE(S) (INCLUDING UPDATES), COMPLETE
ADDRESS(ES)
Authors Dr Wayne A. Temple
National Toxicology Group
University of Otago Medical School
Dr Nerida A. Smith
Pharmacy School
University of Otago
PO Box 913
Dunedin
New Zealand
Tel: 64-3-4797244
Fax: 64-3-4770509
Date July 1992
Reviewer Poisons Unit
New Cross Hospital
Avonley Road
London SE14 5ER
United Kingdom
Tel: 44-71-9555095
Fax: 44-71-6392101
Date July 1992
Peer Review Drs Deng, Ferner, Landoni, Maramba, Shintani,
Wickstrom. London, July, 1992.
See Also:
Toxicological Abbreviations
Yohimbe Bark Supplement for ED: Side Effects and Safety
Traditionally, people in western Africa have used the bark of the yohimbe tree as an aphrodisiac and to boost general health as well as athletic performance.
Now you can get yohimbe bark extract as a dietary supplement that you can buy without a prescription. Its promoters claim it can help erectile dysfunction (ED), low sex drive in women, and the unwanted sexual side effects of some antidepressant medicines.
But the science around modern claims shows mixed results or not enough research.
Not the Same as Prescription
Yohimbe bark extract isn’t the same as yohimbine hydrochloride, the prescription treatment for impotence that’s been around since the 1930s. So you can’t take it instead of the medication, or expect that it will work the same way.
Prescription drugs are strictly regulated by the FDA around testing and labeling, and they have to be approved before they can be sold. But supplements don’t have the same requirements, and they don’t need FDA approval before you can buy them. The companies that make and sell them are responsible for their safety and truthful labeling.
Researchers analyzed several yohimbe supplements and found that the amount of the key compound, yohimbine, was less than it would be in the tree’s bark. They also found that many of the products had things that aren’t normally in yohimbe bark.
Safety and Side Effects
Yohimbe may affect medications you’re taking and other supplements. It can make you bleed easier if you’re taking a blood thinner, like warfarin (Coumadin). You shouldn’t use yohimbe if you’re taking medicine for diabetes, or if you have kidney, liver, or heart problems. Avoid it if you have seizures or a mental illness, including ADHD.
Side effects can include:
You could:
- Feel dizzy, nervous, worried, or cranky
- Get a headache
- Get an upset stomach or lose your appetite
- Have trouble sleeping
Yohimbe is not recommended to be used without medical supervision.
Yohimbe Powder | Pausinystalia Yohimbe
Alternative Names
11-hydroxy Yohimbine, Alpha Yohimbine HCl, Coryanthe Yohimbe, Corynanthe Johimbe, Johimbi, Yohimbehe, Yohimbehe Cortex, Yohimbine, Yohimbine HCl, Yohimbinum Muriaticum
Scientific Name
Pausinystalia Yohimbe
Why Do People Use Yohimbe?
Oral preparations of pausinystalia yohimbe (Yohimbe Bark), like yohimbe powder, are used for impotence, as an aphrodisiac, athletic performance, erectile dysfunction, for exhaustion, weight loss, hypertension complaints, angina, postural hypotension and diabetic neuropathy.
Yohimbe powder is also used orally for sexual dysfunction because of selective-serotonin reuptake inhibitors (SSRI), general sexual dysfunction in women and men and as an adjunct to conventional antidepressants for refractory depression.
Yohimbe bark is also snuffed or smoked because it has hallucinogenic effects.
Is It Safe To Use?
Possibly Unsafe – Oral usage of Yohimbe powder is considered unsafe. Yohimbe has been related with severe adverse effects such as agitation, cardiac arrhythmia, seizure, myocardial infarction and others. Yohimbine is the basic constituent of Yohimbe, which is regulated as a prescription drug in the North America. There are some confirmations that it can be safe if cautiously used for up to 10 weeks. But because of potentially serious safety concerns, yohimbe should not be taken without any medical supervision.
Possibly Unsafe For Children – Oral consumption for infants could possibly be unsafe. Especially those children should avoid yohimbe who are over-sensitive to it.
Possibly Unsafe In Pregnancy and Lactation- Oral consumption can lead to various
adverse effect for those women who are pregnant or breastfeeding. Yohimbe may have uterine relaxant effects and can result in fetal toxicity.
How Effective Is Yohimbe?
Pausinystalia Yohimbe is possibly effective for following conditions:
• Erectile dysfunction (ED)
• Sexual dysfunction.
To rate the effectiveness of yohimbe for other purposes, there is scarce and unreliable information available.
How Yohimbe Works?
The most effective part of Pausinystalia yohimbe is the bark. The constituent believed responsible for yohimbe’s activities is the alkaloid yohimbine.
This herb’s bark consist of 6% yohimbine. Sexual enhancer action of yohimbe has been ascribed to genital vein expansion, expanded reflex volatility and nerve impulse transmission to genital tissue in the sacral region. The yohimbine constituent promptly enters the central nervous system (CNS) and works essentially through alpha 2-adrenergic receptor barricade. It also has calcium channel blocking, monoamine oxidase (MOA) inhibiting and peripheral serotonin receptor blocking effects.
What Are The Side Effects /Adverse Reactions of Yohimbe?
The most regularly reported side effects are tachycardia, stomach upset, hypertension, anxiety or agitation, profuse sweating (diaphoresis), flushing, chest pain, tremor, tachypnea, chills or shivering, altered mental behavior or status and mydriasis issues as well. Other symptoms reported in individuals taking Yohimbe powder are insomnia, excitation, salivation, dizziness, irritability, sinusitis, urinary frequency, headache, rash, fluid retention, vomiting and nausea.
According to some recent reports most severe side effects include atrial fibrillation, myocardial infarction, renal failure, QT-interval prolongation, seizure amd priapism, issues. There is only one case reported of hypersensitivity reaction including chills, fever, itchy, malaise, progressive renal failure, scaly skin and lupus-like syndrome related with ingestion of a one-day dose of yohimbine.
Over dosage of yohimbine constituent can also lead to major toxicity issue such as paralysis, respiratory depression, cardiac failure, cardiac conduction disorders, severe hypotension and even death as well.
How Yohimbe Interacts With Other Herbs and Supplements?
Herbs & Supplements Containing Caffeine – Usage of yohimbe with over dosage of caffeine-containing products or herbs can boost the potential risks of hypertensive crisis.
Things containing caffeine are cola, coffee, mate, guarana and tea.
Ephedra – Usage of excessive dosage of ephedra can enhance potential risk of hypertensive crisis because there is ephedrine content in yohimbe.
How Yohimbe Interacts With Drugs?
Antihypertensive Drugs – Interaction rating between yohimbe and antihypertensive drugs is moderate, so be careful about this mixture. Usage of yohimbe powder can affect the blood pressure control and should be use cautiously.
Clonidine (Catapres) – Interaction rating between clonidine containing drugs and yohimbe is moderate, be careful about this mixture. Avoid concomitant utilization because yohimbine antagonizes the effect of clonidine.
Guanabenz (Wytensin) – Interaction rating between yohimbe and drugs containing guanabenz (wytensin) is moderate, so be careful about this mixture. Health advisor do not recommend this concomitant use because yohimbine antagonizes the effect of guanabenz.
MONOAMINE OXIDASE INHIBITORS (MAOIS) – Interaction rating between yohimbe and monoamine oxidase inhibitors (MAOIS) is major, so NEVER use this blend. Concomitant use of this drug with yohimbe can result in additive results.
Naloxone (Narcan) – Interaction rating between yohimbe and naloxone is moderate, so be careful about this mixture. Concomitant use can have additive therapeutic effects in user.
Phenothiazines – Interaction rating between Pausinystalia yohimbe and phenothiazines is moderate, so be careful about this blend. Yohimbe is contraindicated with phenothiazines use because of enhanced risk of alpha 2-adrenergic antagonism.
Stimulant Drugs – Interaction rating between yohimbe powder and stimulant drugs is moderate, so be careful about this mixture. Yohimbe is contraindicated because concomitant use may enhance the hypertensive crisis risks because of yohimbe monoamine oxidase inhibitor MAOI activity.
Tricyclic Antidepressants (TCAs) – Interaction rating between yohimbe and drugs containing tricyclic antidepressants (TCAS) is moderate, so be careful about this mixture.
How Yohimbe Interacts With Foods?
Tyramine-Containing Foods – Stop using large amounts of food containing tyramine because it can exacerbate the potential risk of hypertensive crisis. Foods containing Tyramine include red wines, fermented meats, aged cheeses and others.
Vasopressor-Containing Foods – Large dosage of vasopressor-containing foods should be avoided because of potential risks of hypertensive crisis. Foods containing vasopressor include coffee, overripe fava beans, colas, tea and chocolate.
How Yohimbe Interacts With Lab Tests?
Not known.
How Yohimbe Interacts With Diseases and Conditions?
Angina, Heart Disease – Use of Yohimbe powder is contraindicated in these conditions because of the negative cardiovascular effects.
Anxiety – Use of Pausinystalia Yohimbe may lead to anxiety.
Benign Prostatic Hyperplasia (BPH) – Yohimbe may exacerbate Benign Prostatic Hyperplasia (BPH) symptoms because of decreased circulation and antagonism of alpha-2 receptors.
Depression – Yohimbine may elicit mania-like symptoms in suicidal tendencies in individuals with endogenous depression or persons suffering from bipolar depression.
Some other diseases or conditions which may be effected by using yohimbe are:
• Diabetes
• Hypertension
• Hypotension
• Kidney Disease
• Liver Disease
• Post-Traumatic Stress Disorder (PTSD)
• Schizophrenia
• Yohimbe Hypersensitivity
What Should Be the Dose/Administration of Yohimbe?
ORAL For the treatment of sexual dysfunction issues such as impotence, yohimbe is typically used in a dose giving yohimbine within the range of 15 to 30 mg every day.
Amount of yohimbine up to 100 mg every day have been used.
Comments
It is an evergreen tree that is native to Zaire, Gabon and Cameroon. The bark part of the yohimbe tree contains the alkaloid yohimbine.
General Certificate of Analysis (COA)
Specification sheet links below are a standard copy of the COA less the batch or lot number and manufactures dates. Specification sheet can be dated and should only be considered as a general information. Please contact and request an up to date COA if needed for specific updated information before placing order by filling out the contact form with product name and SKU number. If ordering quantities of twenty five kilos or more contact for availability.
Benefits, Side Effects, Dosage and Safety
If there’s one thing modern and traditional medicine agree on, it’s the value of a good penis pill. Centuries before Viagra, men in West Africa used the bark of the yohimbe tree to get hard and stay that way, and modern-day users pop yohimbe pills to beat back erectile dysfunction (and to lose weight).
But the harder they come, the harder they fall, and the potential benefits of yohimbe also carry some risks.
Yohimbe, the “love tree,” is an evergreen found in West Africa. Traditionally, the bark could be chewed or boiled to reap the benefits of the yohimbine compound inside.
Now you can find concentrated yohimbe powder or pills sold over the counter in natural foods stores and pharmacies. There are also prescription drugs (Aphrodyne and Yocon) that contain a processed version of the compound, yohimbine hydrochloride.
While Aphrodyne and Yocon are prescribed for erectile dysfunction, dietary supplements containing yohimbine may have a number of other benefits.
But only two claims are supported by research, and much of that research is relatively old.
Say adiYos to erectile dysfunction
The yohimbine compound found in the bark of the yohimbe tree seems to block chemicals in the body responsible for preventing erections. (Where were those chemicals when you needed them in seventh grade gym class?)
Yohimbine also dilates blood vessels by releasing nitric oxide, increasing all-important blood flow to the penis, among other places.
Some research from the ’80s suggests yohimbine can help you pop a chubby, but that’s not enough for it to get an official nod from the American Urology Association.
And while Aphrodyne and Yocon are typically prescribed with a dosage of one 5.4-milligram caplet three times per day, there’s no standard dosage for the less-concentrated natural yohimbine.
Some sources suggest taking no more than the equivalent of 30 milligrams of yohimbine hydrochloride daily, or around 10 milligrams three times per day.
Give your weight loss plan a boost
If you’re looking for a supplement to help you lose fat, yohimbine might be worth a try. The same alpha-2 adrenergic receptors it blocks to stimulate erections are also found in fat cells.
But it’s not a done deal. A small 1991 study suggested that yohimbine could help with weight loss and fat loss, but earlier research didn’t find any noticeable effect.
Yohimbine has been around for a long time, so its side effects are pretty well known. You could experience:
- dizziness
- nausea
- insomnia
- anxiety
- elevated blood pressure
- rapid heartbeat
Additionally, yohimbine isn’t recommended if you have a panic disorder or post-traumatic stress disorder, since the drug’s side effects could make those conditions worse.
If you’re pregnant or breastfeeding, have kidney disease or peptic ulcers, or are taking antidepressants, you shouldn’t use yohimbine.
And you might want to skip red wine and cheese if you’re using yohimbine for better sex — both contain tyramine, an amino acid that, like yohimbine, raises blood pressure.
It depends. Some yohimbine users have reported stomach problems, rapid heartbeat, anxiety, high blood pressure, and even seizures and heart attacks.
As with many other dietary supplements, you can only guess whether the ingredients listed on the label match what’s in the bottle.
A 2016 study of 49 supplements containing yohimbine found that the products varied widely in the amount they contained. Some had natural yohimbine, but others had different levels of processed yohimbine extract.
If you’re struggling with erectile dysfunction and don’t want to use a prescription drug like Viagra or Cialis, or you just want an erection that lasts longer and stays harder, you could try yohimbine.
In typical doses, the risk of serious side effects is low, and yohimbine could be a natural solution to the age-old issue of perking up a soft penis.
Other natural remedies for ED include:
Yohimbine has been used for centuries to treat erectile dysfunction and enhance sexual pleasure. More recently, it’s also been used for weight loss. It’s available as an over-the-counter dietary supplement or a prescription drug.
If you decide to try yohimbine, watch out for the possible side effects. They’re generally mild with low doses, but it can be tricky to know what you’re getting because yohimbine supplements may not always be accurately labeled.
Benefits, Side Effects, Dosage and Safety
If there’s one thing modern and traditional medicine agree on, it’s the value of a good penis pill. Centuries before Viagra, men in West Africa used the bark of the yohimbe tree to get hard and stay that way, and modern-day users pop yohimbe pills to beat back erectile dysfunction (and to lose weight).
But the harder they come, the harder they fall, and the potential benefits of yohimbe also carry some risks.
Yohimbe, the “love tree,” is an evergreen found in West Africa. Traditionally, the bark could be chewed or boiled to reap the benefits of the yohimbine compound inside.
Now you can find concentrated yohimbe powder or pills sold over the counter in natural foods stores and pharmacies. There are also prescription drugs (Aphrodyne and Yocon) that contain a processed version of the compound, yohimbine hydrochloride.
While Aphrodyne and Yocon are prescribed for erectile dysfunction, dietary supplements containing yohimbine may have a number of other benefits. But only two claims are supported by research, and much of that research is relatively old.
Say adiYos to erectile dysfunction
The yohimbine compound found in the bark of the yohimbe tree seems to block chemicals in the body responsible for preventing erections. (Where were those chemicals when you needed them in seventh grade gym class?)
Yohimbine also dilates blood vessels by releasing nitric oxide, increasing all-important blood flow to the penis, among other places.
Some research from the ’80s suggests yohimbine can help you pop a chubby, but that’s not enough for it to get an official nod from the American Urology Association.
And while Aphrodyne and Yocon are typically prescribed with a dosage of one 5.4-milligram caplet three times per day, there’s no standard dosage for the less-concentrated natural yohimbine.
Some sources suggest taking no more than the equivalent of 30 milligrams of yohimbine hydrochloride daily, or around 10 milligrams three times per day.
Give your weight loss plan a boost
If you’re looking for a supplement to help you lose fat, yohimbine might be worth a try. The same alpha-2 adrenergic receptors it blocks to stimulate erections are also found in fat cells.
But it’s not a done deal. A small 1991 study suggested that yohimbine could help with weight loss and fat loss, but earlier research didn’t find any noticeable effect.
Yohimbine has been around for a long time, so its side effects are pretty well known. You could experience:
- dizziness
- nausea
- insomnia
- anxiety
- elevated blood pressure
- rapid heartbeat
Additionally, yohimbine isn’t recommended if you have a panic disorder or post-traumatic stress disorder, since the drug’s side effects could make those conditions worse.
If you’re pregnant or breastfeeding, have kidney disease or peptic ulcers, or are taking antidepressants, you shouldn’t use yohimbine.
And you might want to skip red wine and cheese if you’re using yohimbine for better sex — both contain tyramine, an amino acid that, like yohimbine, raises blood pressure.
It depends. Some yohimbine users have reported stomach problems, rapid heartbeat, anxiety, high blood pressure, and even seizures and heart attacks.
As with many other dietary supplements, you can only guess whether the ingredients listed on the label match what’s in the bottle.
A 2016 study of 49 supplements containing yohimbine found that the products varied widely in the amount they contained. Some had natural yohimbine, but others had different levels of processed yohimbine extract.
If you’re struggling with erectile dysfunction and don’t want to use a prescription drug like Viagra or Cialis, or you just want an erection that lasts longer and stays harder, you could try yohimbine.
In typical doses, the risk of serious side effects is low, and yohimbine could be a natural solution to the age-old issue of perking up a soft penis.
Other natural remedies for ED include:
Yohimbine has been used for centuries to treat erectile dysfunction and enhance sexual pleasure. More recently, it’s also been used for weight loss. It’s available as an over-the-counter dietary supplement or a prescription drug.
If you decide to try yohimbine, watch out for the possible side effects. They’re generally mild with low doses, but it can be tricky to know what you’re getting because yohimbine supplements may not always be accurately labeled.
Unauthorized sexual enhancement product “Black Mamba Premium” seized from JJ Smoke Centre in North York
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Issue
Health Canada is advising Canadians that the unauthorized sexual enhancement product “Black Mamba Premium” may pose serious health risks because its label says it contains a drug called yohimbe. Health Canada seized the product from JJ Smoke Centre in North York, Ontario (5429 Yonge Street).
Products affected
Black Mamba Premium
What you should do
- Stop using this product. Consult with your health care professional if you have used this product and have health concerns.
- Read product labels to verify that health products have been authorized for sale by Health Canada. Authorized health products have an eight-digit Drug Identification Number (DIN), Natural Product Number (NPN) or Homeopathic Drug Number (DIN-HM). You can also check whether products have been authorized for sale by searching Health Canada’s Drug Product Database and Licensed Natural Health Product Database.
- Report adverse events to health products to Health Canada by calling toll-free at 1-866-234-2345, or by reporting online, by mail or by fax.
- Report complaints about health products to Health Canada by calling toll-free at 1-800-267-9675, or complete an online complaint form.
Who is affected
Consumers who have bought or used Black Mamba Premium.
Background
Yohimbine is a prescription drug and should be used only under the supervision of a health care professional. Yohimbine is derived from yohimbe, a bark extract. The use of yohimbine or yohimbe may result in serious adverse reactions, particularly in people with high blood pressure, or heart, kidney or liver disease.
Side effects include increased blood pressure and heart rate, anxiety, dizziness, tremors, headache, nausea and sleep disorders. It should not be used by children, or pregnant or nursing women.
Health Canada
(613) 957-2983
Public enquiries
(613) 957-2991
1-866 225-0709
What Health Canada is doing
Health Canada seized the product from the retail location. Should additional retailers or distributors be identified, Health Canada will take appropriate action and inform Canadians as necessary.
Images
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For more information
Stay connected with Health Canada and receive the latest advisories and product recalls using social media tools.
To learn more about natural health products and other self-care products, visit Canada.ca/selfcare-products.
90,000 Yohimbe Forte Caps. 0.2g 30 pcs
Active substance:
Yohimbe extract, zinc oxide, ginseng extract
1 capsule contains: yohimbe extract 70 mg, including yohimbine hydrochloride, not less than 4.5 mg, zinc oxide 20 mg, including zinc, not less 15 mg, ginseng extract 10 mg.
Description:
It’s no secret that sexual activity changes with age. But at any age, taking into account individual capabilities and within the boundaries of the norm, male sexual activity can and should be regulated, even against the background of complete sexual health.
Yohimbe bark extract is a popular and effective natural stimulant of male potency and strength.
Its biologically active substance yohimbine – an alkaloid from the bark of the West African tree Corynanthe yohimbe – activates adrenergic neurons of the central nervous system, increases motor activity and reactivity, causes blood flow to the pelvic organs, which helps to increase sexual desire, maintains the efficiency of the nerve nodes of the spinal cord which are responsible for male erection.
Yohimbe forte – a source of yohimbine, an additional source of zinc, contains an extract of ginseng roots, which support: – normal sexual function – sexual activity in men – vitality of the body – sexual stamina
Information on active ingredients and their properties:
Contained in the bark yohimbe alkaloid yohimbine has general tonic and tonic properties, supports the reproductive system of men, improves efficiency and physical activity.
The mild tonic properties of ginseng determine its biologically active substances panaxosides, and ginseng also helps to maintain the blood supply to organs and tissues, and takes part in maintaining the sexual function of men.
Zinc is involved in the functioning of the male reproductive glands. It is found in the greatest amount in the tissues of the testes and plays an important role in the realization of sexual function.
Release form:
Capsules of 0.2 g. No. 30.
Yohimbe, ground bark (Yohimbe Bark, Pausinystalia Johimbe)
Yohimbe (Pausinystalia Johimbe) is an evergreen tree, a species of the Pausinystalia genus of the Rubiaceae family, which grows mainly in Africa (one species in North America).A unique plant-based sexuality stimulant (Yohimbe Bark) is obtained from the bark of the tree (“love tree”).
Since ancient times, African tribes have used bark in various ways: they smoked, rubbed into the body, added to food, and smelled. The main active ingredient in the bark is the alkaloid yohimbine.
COMPOSITION:
Yohimbine is an indole alkaloid, an antagonist of alpha-2-adrenergic receptors that regulate the content of norepinephrine, its content in the bark of a tree is in the range of 2-15%.
In small doses, less than 10 mg of yohimbine, it is used therapeutically to treat impotence. Recent research has shown promising potential for the alkoloid to combat fatigue in AIDS patients without any noticeable side effects.
Yohimbine lowers blood pressure and is used to treat hypertension. This effect can have serious consequences for people with low blood pressure. On the other hand, it can be used as a stimulant by people who usually cannot take most of these substances due to high blood pressure.The alkoloid causes the blood vessels in the lower abdomen to dilate, which contributes to a long and strong erection in men.
In addition to yohimbine, the bark contains yohimbiline, yamalin, as well as tannins and dyes, dihydrocorinantein, aymalicin, alloyohimbine, corynantein and corynanthin. Can accumulate aluminum, calcium oxalate needle crystals.
INDICATIONS:
Yohimbe mainly used:
- as a vasodilator in erectile tissues, to increase libido and potency
- for chronic fatigue
- with low blood pressure (hypotension), especially associated with the use of certain antidepressants
- for the treatment of chronic constipation
- with deep depression
- for chest pain (angina pectoris)
- to stimulate muscle growth and improve performance, as well as to reduce weight, as it enhances thermogenesis (fat burning)
- is effective in treating narcolepsy.
Yet the main action of the cortex is to improve sexual performance. The beneficial effect of Yohimbe on male potency has been scientifically proven, doctors recommend drugs based on it for the treatment of organic impotence. Preparations based on Yohimbe (Yohimbine) are used not only for sexual problems in men, but also for women.
The effect of Yohimbe is very effective, since it does not depend on the physical and mental state of a person (fatigue, stress, depression).
Yohimbine activates blood flow to peripheral vessels, causing an erection, helps control ejaculation and helps to prolong sexual intercourse in men, enhances libido by stimulating testosterone production, and is a harmless means of stimulating sexual activity in both men and women.
Yohimbe enriches sexual sensations, enhances orgasm, helps to control ejaculation, has a tonic effect on the central nervous system, stimulates the centers of the lumbar spinal cord that control erection; increases energy and endurance, improves overall well-being.
CONSUMPTION:
In a mixture with ascorbic acid, yohimbine-ascorbic acid is formed, the effect of which is stronger than pure yohimbine, therefore vitamin C enhances and prolongs the effect on average up to 4-5 hours.
Method 1 Stir half a teaspoon of ground Yohimbe bark in a cup of boiling water, add 3-4 mint and coriander leaves. Insist for 5 minutes, add honey to taste to the cooled drink and drink in small sips.
Method 2 Using a French press, boil a tablespoon of Yohimbe bark and a spoonful of Guarana with boiling water, leave for 5-10 minutes, then drink, adding sugar or honey to taste.
3 way The simplest recipe available to everyone: just stir the ground bark in a mug of boiling water and drink, slowly adding new water. The effect occurs in 20-30 minutes.
Method 4 Preparation of Yohimbe cocktail for two: Add 2-3 teaspoons (about 6g.) To 0.5L. boiling water. Simmer for 15 minutes over low heat. Add 1g. vitamin C (ascorbic acid). Add honey to taste. Consume in small sips.
CONTRAINDICATIONS:
Before use, it is recommended to consult a doctor, since side effects are possible (increased blood pressure, fast or irregular heartbeat and anxiety, sweating, nausea, vomiting, etc.) Do not exceed the recommended dose!
ATTENTION! High doses can cause drooling, increased breathing, a drop in blood pressure, and increased heart rate. These side effects will subside within 20-30 minutes.
Yohimbe bark extract x10 (Yohimbe Bark, ext.x10)
Yohimbe (Pausinystalia yohimbe, Love tree) – evergreen tropical tall tree up to 30 m. Tall. Straight branching trunk, oval leaves, pointed up to 10 cm long; the seeds are small, winged, very thin.Originally from Nigeria, Cameroon and Congo.
Valued as a medicinal plant, has medicinal properties, in particular vasodilator, and also exhibits strengthening, tonic, restorative effects. Since ancient times, African tribes have used bark in various forms: smoked, rubbed into the body, added to food, smelled. The main component in the bark is the alkaloid Yohimbine.
COMPOSITION
Yohimbine is an indole alkaloid, an antagonist of alpha-2-adrenergic receptors that regulate the content of norepinephrine, its content in the bark of a tree is in the range of 2-15%.In small doses, less than 10 mg. It is used therapeutically to treat impotence. Recent studies have shown promising potential for yohimbine to combat fatigue in AIDS patients without any noticeable side effects.
The action of this alkaloid on the human body is multifaceted. Yohimbine activates blood flow to the peripheral vessels, causing an erection, helps control ejaculation and helps prolong sexual intercourse in men. Yohimbine also enhances sex drive by stimulating testosterone production and is a harmless means of stimulating sexual activity in both men and women.
READING
Yohimbe stimulates potency, enriches sexual sensations, enhances orgasm, helps control ejaculation and significantly prolongs sexual intercourse, has a tonic effect on the central nervous system, stimulates the centers of the lumbar spinal cord that control erection; increases energy and endurance, improves overall well-being.
Yohimbe is recommended for men seeking to achieve new levels of satisfaction in their sexual life or suffering from various forms of secondary sexual disorders, as well as people engaged in vigorous physical activity.
It is used for chronic fatigue syndrome, increases endurance during physical exertion.
The effect of Yohimbe is very effective, since it does not depend on the physical and mental state of a person (fatigue, stress, depression).
Large doses of 10-50 mg are used to support tantric sex rituals. Yohimbine causes the blood vessels in the lower abdomen to dilate, which contributes to long lasting and strong erections in men. Doses of 50-100 mg – cause hallucinations and very great stimulation.Doses over 50 mg and especially 100 mg can be very unpleasant and even dangerous. Yohimbine lowers blood pressure and is used to treat hypertension. This effect can have serious consequences for people with already low blood pressure. On the other hand, it can be used as a stimulant by people who usually cannot take most of these substances due to high blood pressure.
CONSUMPTION for a pair
In a mixture with ascorbic acid, yohimbine-ascorbic acid is formed, the action of which is stronger than pure yohimbine, therefore vitamin C enhances the effect, the effects will last on average 4-5 hours.
Take each extract at the end of a teaspoon, increase in subsequent times to 1/4 tsp. extract and wash down with juice or sweet tea. It is advisable to choose your comfortable dosage, so it is better to start small to avoid side effects.
High doses can cause drooling, increased breathing, drop in blood pressure, heart palpitations.
90,000 Achieve with Yohimbe
Stimulation of sexual activity
AchievewithYohimbe (Achieve with Yohimbe) is intended to stimulate and enhance sexual activity in men, as well as to enhance male reproductive function.This product is a verified combination of various drugs that increase libido, energy balance, increase sexual stamina, and have a general strengthening effect on men’s health.
The key active component of the complex (yohimbe bark extract) is the alkaloid yohimbine. While taking products containing yohimbine, there is a rush of blood flow to the small pelvis, due to which male sexual activity is noticeably enhanced. Simultaneously with this, there is an activation of the work of the nerve nodes of the spinal cord; they are responsible for erectile function.
Increased libido
As part of the AchievewithYohimbe complex (Achiv with Yohimbe), there are fruits of a dwarf palm tree, which stimulate the activity of the entire hormonal system (in particular the gonads). Dwarf palm (or creeping Saw Palmetto) has the ability to increase libido, increase semen secretion, and have a powerful anti-inflammatory effect during infections of the genitourinary system. The fruits of this plant inhibit prostate enlargement, and are also able to strengthen the body during and after illness.
Siberian Ginseng (or Eleutherococcus) is an excellent stimulant as well as an adaptogen. For more than one century, this culture has been used to preserve masculinity, improve hormonal balance, strengthen both the heart and nervous systems, and increase the overall resistance of the body. It is ginseng that is actively used in cases of impotence.
Increased libido
Smilax (or sarsaparil) is recommended for decreased potency. This plant has an excellent regenerative effect, maintains the overall organic balance, and also increases the material metabolism in the body.
AchievewithYohimbe (Achieve with Yohimbe) includes a sprawling turner (or damiana), which has long been known for relieving tension, feelings of nervousness. This herb is very useful for depression, exhaustion, feelings of weakness associated with sexual or emotional stress. Regularly taking the extract of this culture, a man experiences increased libido.
Garlic and cayenne pepper are known to increase male potency. It does this by stimulating blood flow to the pelvic organs.
An excellent remedy during fluid retention in the male body, at the same time serving as a diuretic, is stellate. Horsetail is available for the same purpose in the AchievewithYohimbe complex.
Medicinal complex for men from NSP
The Commonwealth of Plants included in this dietary supplement is also a colossal source of vitamin A, which is extremely useful for mucous membranes. In addition, the drug contains zinc, which is necessary for the harmonious activity of the prostate gland.
It should be added that all medicinal crops contain iron, magnesium, chromium, manganese, silicon, selenium. All these minerals are actively involved in metabolic processes.
Thus Achieve with Yohimbe is an excellent natural remedy to help you harmonize your sex life.
Composition – 1 capsule:
- Cayenne Pepper (Capsicum annuum) 15.7 mg
- Medium stellaria (Stellaria media) 9.7 mg
- Damiana (Turnera diffusa) 38.8 mg
- Garlic (Allium sativum) 15.7 mg
- Eleutherococcus senticosus 98.0 mg
- Gotu kola (Hydrocotyle asiatica) 43.6 mg
- Horsetail (Equisetum arvense) 1.6 mg
- Sassaparilla (Smilax spp.) 24.2 mg
- Dwarf palm (Serenoa repens) 53.4 mg
- Yohimbe Bark Extract (Pausinystalia yohimbe) 100 mg
- Niacin 11.0 mg
APPLICATION:
as a dietary supplement for adults take 1 capsule 1 time per day with meals with a glass of water.
Store at temperatures from 0 to 30 ° C.
CONTRAINDICATIONS: It is not recommended to take
in case of increased nervous excitability, insomnia, high blood pressure, cardiac disorders, severe atherosclerosis, liver and kidney diseases, and individual intolerance to the components of the product.It is recommended to consult a doctor before use.
.

3.2 Properties of the locally available formulation
PHARMACOLOGY AND TOXICOLOGY
1.2.3 Arterial blood gas analysis
3 Biomedical investigations and their interpretation
4 Systematic description of clinical effects
6 Summary
(WHO, 1992)
1.3 Synonyms
Aphrodine HydrochlorideChlorhydrate de QubrachineCorynine HydrochlorideYo Yo
(Reynolds, 1993)
1.4 Identification numbers
1.4.1 CAS number
Yohimbine 146-48-5
Yohimbine Hydrochloride 65-19-01.4.2 Other numbers
RTECS
Yohimbine ZG10000001.5 Brand names, Trade names
Monocomponent products
Actibine, Aphrodyne, Dayto Himbin, Revervyl, Reverzine,
Yobine, Yocon, Yohimex, Yohydrol
Combination products
Afrodex, Ictho-Himbin, Pasuma, Pluriviron, Potensan, Potensan
Forte, Prowess, Vikonon
(To be completed by each Centre using local data)
1.6 Manufacturers, Importers
To be completed by each Centre using local data
1.7 Presentation, Formulation
Tablets, either as single ingredient or in combination with
other ingredients, for human use.
Sterile injectable solution for veterinary use.
Street drug (as a powder)
(To be completed by each Centre using local data)
2. SUMMARY
2.1 Main risks and target organs
Yohimbine is a centrally acting alpha-2-adrenoceptor blocking
agent. It may also interact with alpha-1-adrenoceptors and,
in high concentrations, serotonin and dopamine receptors.
Yohimbine is a monoamine oxidase inhibitor, and has the
potential to interact with tyramine-containing foods and
stimulants such as phenylephrine and phenylpropanolamine.
Yohimbine affects the gastrointestinal, genito-urinary,
respiratory, cardiovascular and central nervous systems.
2.2 Summary of clinical effects
Yohimbine produces cardiovascular effects, including
increases in heart rate and blood pressure.
Bronchospasm and increased mucous secretion has been
reported.
CNS effects include anxiety, hallucinations and manic
reactions.
Gastrointestinal effects include nausea, anorexia and
diarrhoea.
Dysuria, and back and genital pain have occurred.
Yohimbine has been used for its alleged aphrodisiac
properties but evidence of such an effect is lacking.
2.3 Diagnosis
There are no significant signs or symptoms which are a key to
clinical diagnosis.
Qualitative tests are available, and include Thin Layer
Chromatography and Gas Chromatography.
Although yohimbine may be quantified in the plasma by HPLC,
toxic levels have not yet been established.
2.4 First aid measures and management principles
Support respiratory and cardiovascular function. Emesis may
be indicated for substantial ingestions, especially if
initiated within 30 minutes of ingestion. Activated charcoal
may also be administered. Diazepam may be useful in reducing
anxiety.
3. PHYSICO-CHEMICAL PROPERTIES
3.1 Origin of the substance
Yohimbine is the principal indole alkaloid derived from the
bark of the Yohimbe Tree (Pausinystalia yohimbe = Corynanthe
yohimbi) (Rubiaceae).
It is also found in the Rauwolfia root
and the dried bark of Aspidosperma quebracho.
(Reynolds, 1993)
3.2 Chemical structure
Structural formula
Molecular formula
Yohimbine C21H26N2O3
Yohimbine C21H26N2O3,HCl
Hydrochloride
Molecular weight
Yohimbine 354.4
Yohimbine 390.9
Hydrochloride
Structural Chemical names
Methyl 17alpha-hydroxy-yohimban-16alpha-carboxylate
hydrochloride.
(16alpha, 17alpha)-17-Hydroxyyohimban-16-carboxylic acid
methyl ester.
(Reynolds, 1993; Budavari, 1989)
3.3 Physical properties
3.3.1 Properties of the substance
3.3.1.1 Colour
No data available
3.3.1.2 State/Form
Yohimbine Hydrochloride
Orthorhombic plates
Prisms from alcohol
Yohimbine
Orthorhombic needles
3.3.1.3 Description
Yohimbine Hydrochloride
Decomposes at 302 C
Soluble 1 in 120 of water and 1 in 400 of
alcohol
Aqueous solution pH approximately neutral
Yohimbine
Melting point 234 C
Very slightly soluble in water
Soluble in ethanol and chloroform
Sparingly soluble in ether
3.
3.2 Properties of the locally available formulation
To be completed by each Centre using local data.
3.4 Other characteristics
Store in a cool place. Do not freeze. Protect from light.
3.4.1 Shelf-life of the substance
No data available.
3.4.2 Shelf-life of the locally available formulation(s)
To be completed by each Centre using local data.
3.4.3 Storage conditions
Store in a cool place. Do not freeze. Protect from
light.
3.4.4 Bioavailability
To be completed by each Centre using local data.
3.4.5 Specific properties and composition
To be completed by each Centre using local data.
4. USES
4.1 Indications
4.1.1 Indications
In humans, yohimbine has been used for the treatment of
impotence.
In street use, Yohimbine has been misused as a mild
hallucinogen, and as an aphrodisiac.
As a veterinary preparation, yohimbine is used to
reverse xylazine-induced anaesthesia in animals
including deer, steers, dogs, cats and horses.
4.1.2 Description
Not relevant
4.2 Therapeutic dosage
4.2.1 Adults
Oral
0.1 mg/kg may produce stimulant effects.
6 mg three times daily has been used to treat
impotence.
Yohimbine has been given in doses up to 30 mg daily
(Moffat, 1986) and the German Pharmacopoeia states a
human dose of up to 100 mg/day (Dukes, 1988).
4.2.2 Children
No data available.
4.3 Contraindications
Yohimbine should not be used in cardiac, hepatic and renal
disease. It is a monoamine oxidase inhibitor, therefore
tyramine-containing foods and stimulants such as
phenylephrine and phenylpropanolamine should be avoided.
5. ROUTES OF ENTRY
5.1 Oral
Most common in humans.
5.2 Inhalation
The powdered street drug may be smoked.
5.3 Dermal
No data available.
5.4 Eye
No data available.
5.5 Parenteral
Yohimbine has been administered intravenously in clinical
research.
Accidental injection may occur, especially inveterinary
practice.
5.6 Other
No data available.
6. KINETICS
6.1 Absorption by route of exposure
The kinetic disposition of yohimbine was examined in 8 young
male subjects following a single oral dose of 10 mg yohimbine
hydrochloride. Oral absorption was rapid, with an oral
absorption half-life of 0.17 +/- 0.11 hours (approximately 11
minutes)(Owen et al, 1987). In a similar study the absorption
half-life was approximately 7 minutes (Guthrie et al., 1990).
Absorption is complete and peak plasma levels occur at 45 to
60 minutes after 10 mg orally (Owen et al, 1987; Guthrie et
al., 1990). The bioavailability showed a great variability,
ranging from 7 to 87% (Guthrie et al., 1990).
6.2 Distribution by route of exposure
Oral
Studies on the volume of distribution showed a very wide
range (mean 2.
4 +/- 1.25 L/kg (Owen et al., 1987).
Parenteral
Rapid distribution phase after intravenous injection of 10
mg, alpha half-life approximately 6 minutes. Volume of
distribution was small (mean 0.26 L/kg) (Guthrie et al.,
1990).
6.3 Biological half-life by route of exposure
Yohimbine was rapidly eliminated from the plasma in 8 young
male patients receiving a single 10 mg dose of yohimbine
(half-life was 0.60 +/- 0.26 hours) (Owen et al., 1987).
After 10 mg yohimbine intravenously, half-life (beta) was
0.68 +/- 0.2 hours (Guthrie et al., 1990).
6.4 Metabolism
Since yohimbine is stable in blood, the rapid clearance of
yohimbine from human plasma suggests metabolism of the drug
by an organ with high blood flow, such as liver or kidney,
and a high extraction efficiency (Owen et al., 1987).
Ho et al. (1971) suggest that in mice the rapid metabolism of
yohimbine is primarily due to the hydrolysis of the 16-alpha
carboxylic acid methyl ester bond to yield yohimbinic acid.
However, the hydrolysis of yohimbine to yohimbinic acid is
unlikely to be a major metabolic route in humans. This is
based on data obtained from pharmacokinetic studies on
reserpine and raubasine, two indole alkaloids structurally
related to yohimbine.
Although both reserpine and raubasine contain a 16-alpha
carboxylic acid methyl ester moiety, de-esterification of
this group does not appear to be a significant metabolic
route for reserpine, and is not a rapid route for elimination
for raubasine in humans (Owen et al.
, 1987).
6.5 Elimination by route of exposure
Oral
Clearance after 10 mg yohimbine
Range 2.81 to 200 mL/min/kg
Mean 55.9 mL/min/kg
Less than 1% of unchanged drug was recovered in the urine in
24 hours.
(Owen et al., 1987).
Parenteral
Clearance after 10 mg yohimbine intravenously
Range 2.44 to 15.8 mL/min/kg
Mean 9.77 mL/min/kg
7. PHARMACOLOGY AND TOXICOLOGY
7.1 Mode of action
Yohimbine is a competitive antagonist selective for alpha
2-andrenoceptors, which are thought to be located on nerve
terminals and receptors and to mediate inhibition of
transmitter release. The presynaptic release of noradrenaline
is increased by an alpha-2-antagonist resulting in increased
sympathetic outflow. Yohimbine may also interact with alpha-
1-adrenoceptors and, in high concentrations, serotonin and
dopamine receptors (Dukes, 1988). Yohimbine has monoamine
oxidase inhibitory effects (Bhattacharya et al., 1991).
7.1.1 Toxicodynamics
It has been suggested that a central beta-origin
toxicity exists, since only beta blockers which cross
the blood-brain barrier are capable of antagonizing
this activity (Bourin et al., 1988).
7.1.2 Pharmacodynamics
Yohimbine is an alpha-2-adrenergic antagonist. It
increases the heart rate and blood pressure and causes
CNS stimulation and anti-diuresis (Reynolds et al.
,
1989).
7.2 Toxicity
7.2.1 Human data
7.2.1.1 Adults
An ingested dose of 1.8 g (100 times the
average daily dose) resulted in unconsciousness
for some hours, with priapism. The patient
recovered fully within a few days (Roth et al.,
1984; as cited in Dukes, 1988).
7.2.1.2 Children
No data available.
7.2.2 Relevant animal data
LD50 Oral (mouse) 43 mg/kg
LDLO Intravenous (mouse) 16 mg/kg
LDLO Intravenous (rabbit) 11 mg/kg
LD50 Subcutaneous (mouse) 20 mg/kg
LDLO Subcutaneous (rabbit) 50 mg/kg
(RTECS,1987)
7.2.3 Relevant in vitro data
No data available.
7.3 Carcinogenicity
No data available.
7.4 Teratogenicity
No data available.
7.5 Mutagenicity
No data available.
7.6 Interactions
Yohimbine has monoamine oxidase inhibitory effects, and
thus has the potential to interact with tyramine-containing
foods and stimulants such as phenylephrine and
phenylpropanolamine (Bhattacharya et al., 1991).
7.7 Main adverse effects
Principal adverse effects to be expected in humans with the
use of moderate doses are emotional arousal and a rise in
blood pressure and heart rate. An oral dose of 6 mg three
times per day resulted in only minimal adverse effects such
as dizziness and nervousness (Dukes, 1988).
8. TOXICOLOGICAL AND BIOMEDICAL INVESTIGATIONS
8.1 Material sampling plan
8.1.1 Sampling and specimen collection
8.1.1.1 Toxicological analyses
8.1.1.2 Biomedical analyses
8.1.1.3 Arterial blood gas analysis
8.1.1.4 Haematological analyses
8.1.1.5 Other (unspecified) analyses
8.1.2 Storage of laboratory samples and specimens
8.1.2.1 Toxicological analyses
8.1.2.2 Biomedical analyses
8.1.2.3 Arterial blood gas analysis
8.1.2.4 Haematological analyses
8.1.2.5 Other (unspecified) analyses
8.1.3 Transport of laboratory samples and specimens
8.1.3.1 Toxicological analyses
8.1.3.2 Biomedical analyses
8.1.3.3 Arterial blood gas analysis
8.1.3.4 Haematological analyses
8.1.3.5 Other (unspecified) analyses
8.2 Toxicological analyses and their interpretation
8.2.1 Tests on toxic ingredient(s) of material
8.2.1.1 Simple qualitative test(s)
Colour tests: Liebermann's Test - blue
Mandelin's Test - blue > green
8.2.1.2 Advanced qualitative confirmation test(s)
Thin-Layer Chromatography: system TA-Rf 63;
system TB-Rf 05; system TC-Rf 38 (Dragendorff
spray, positive; acidified iodoplatinate
solution, positive; Marquis Reagent, grey).
Gas Chromatography: system GA-RI 3296.
8.
2.1.3 Simple quantitative method(s)
8.2.1.4 Advanced quantitative method(s)
High Pressure Liquid Chromatography. In plasma:
sensitivity 10 ng/mL, electrochemical
detection.
8.2.2 Tests for biological specimens
8.2.2.1 Simple qualitative test(s)
8.2.2.2 Advanced qualitative confirmation test(s)
8.2.2.3 Simple quantitative method(s)
8.2.2.4 Advanced quantitative method(s)
8.2.2.5 Other dedicated method(s)
8.2.3 Interpretation of toxicological
8.3 Biomedical investigations and their interpretation
No specific laboratory test are necessary unless clinically
indicated.
8.3.1 Biochemical analysis
8.3.1.1 Blood, plasma or serum
"Basic analyses"
"Dedicated analyses"
"Optional analyses"
8.3.1.2 Urine
"Basic analyses"
"Dedicated analyses"
"Optional analyses"
8.3.1.3 Other fluids
8.3.2 Arterial blood gas analyses
8.3.3 Haematological analyses
"Basic analyses"
"Dedicated analyses"
"Optional analyses"
8.4 Other biomedical (diagnostic) investigations and their
interpretation
8.5 Overall interpretation of all toxicological analyses and
toxicological investigations
8.6 References
Goldberg MR et al. (1984) J Liq Chromat, 7: 1003-1004.
9. CLINICAL EFFECTS
9.1 Acute poisoning
9.1.1 Ingestion
Fatalities resulting from acute overdosage of yohimbine
have not been reported. Signs of overdosage include CNS
depression, ranging from drowsiness to coma.
Respiratory depression, hypothermia, diarrhoea,
vomiting, mental depression, flushing of the skin,
hypertension, cardiac arrhythmias, tachycardia and
short-term reversible paraesthesias of the legs and
feet may occur.
9.1.2 Inhalation
Mild hallucinations, including a disassociative state,
can occur when yohimbine is smoked (Linden et al.,
Siegel, 1976).
9.1.3 Skin exposure
Not relevant.
9.1.4 Eye contact
No data available.
9.1.5 Parenteral exposure
Symptoms would be as for those listed in Section 9.1.1
(Ingestion).
9.1.6 Other
No data available.
9.2 Chronic poisoning
9.2.1 Ingestion
No data available.
9.2.2 Inhalation
No data available.
9.2.3 Skin exposure
No data available.
9.2.4 Eye contact
No data available.
9.2.5 Parenteral exposure
No data available.
9.2.6 Other
No data available.
9.3 Course, prognosis, cause of death
Fatalities resulting from acute overdosage of yohimbine have
not been reported.
Large overdoses may impair cardiac
function and cause CNS depression, including coma.
9.4 Systematic description of clinical effects
9.4.1 Cardiovascular
Tachycardia, atrial fibrillation and hypertension are
features of yohimbine toxicity. Systolic blood pressure
increased significantly in subjects given oral doses of
yohimbine. The differences for diastolic pressure were
not significant (Henauer et al., 1984).
Patients with orthostatic hypotension appear to be very
sensitive to the effects of yohimbine. A 5 mg dose may
increase blood pressure, while greater than 20 mg is
needed in a healthy volunteer (to raise the blood
pressure 40 mmHg systolic)(Brosse et al., 1983).
9.4.2 Respiratory
Bronchospasm and increased mucous secretion have been
reported (Landis & Shore, 1989).
9.4.3 Neurological
9.4.3.1 Central nervous system (CNS)
Dizziness, insomnia, headache and irritability
have been reported (Goldberg & Robertson,
1983).
Yohimbine produced manic reactions in bipolar
psychiatric patients. Symptoms included
tremulousness, restlessness, giddiness, rapid
speech, laughing, increased energy and euphoria
(Price et al., 1984).
Mild hallucinations, including a disassociative
state, can occur when yohimbine is smoked or
used in a tea (Linden et al, 1985; Siegel,
1976).
Inco-ordination was observed following abuse of
yohimbine (Linden et al., 1985). It is commonly
reported to cause anxiety (Charney et al.,
1983).
9.4.3.2 Peripheral nervous system
Short-term reversible paraesthesias of the legs
and feet were reported in diabetics being
treated for impotency and in overdoses (Morales
et al., 1982; Linden et al., 1985).
9.4.3.3 Autonomic nervous system
Not relevant
9.4.3.4 Skeletal and smooth muscle
Not relevant
9.4.4 Gastrointestinal
Nausea, vomiting, diarrhoea and anorexia have been
reported (Goldberg & Robertson, 1983).
9.4.5 Hepatic
No data available.
9.4.6 Urinary
9.4.6.1 Renal
Dysuria has been reported (Goldberg &
Robertson, 1983).
9.4.6.2 Others
Genital pain has been reported (Goldberg &
Robertson, 1983).
9.4.7 Endocrine and reproductive systems
Studies have shown yohimbine to be 3 to 3.4 times as
effective as placebo in relieving male impotency
(Sobotka, 1969).
9.4.8 Dermatological
Not relevant
9.4.9 Eye, ears, nose, throat: local effects
No data available.
9.4.10 Haematological
No data available.
9.4.11 Immunological
No data available.
9.4.12 Metabolic
9.4.12.1 Acid-base disturbances
No data available.
9.4.12.2 Fluid and electrolyte disturbances
No data available.
9.4.12.3 Others
Yohimbine is a monoamine oxidase inhibitor,
and thus has the potential for reacting with
tyramine-containing foods.
9.4.13 Allergic reactions
No data available.
9.4.14 Other clinical effects
No data available.
9.4.15 Special risks
No data available.
9.5 Other
No data available.
9.6 Summary
Not relevant
10. MANAGEMENT
10.1 General principles
Treatment is symptomatic and supportive, including
maintaining respiratory and cardiovascular function.
10.2 Relevant laboratory analyses
10.2.1 Sample collection
Not relevant
10.2.2 Biomedical analysis
No specific analyses unless clinically indicated.
10.2.3 Toxicological analysis
Qualitative tests are available, and include Thin
Layer Chromatography and Gas Chromatography.
Although yohimbine may be quantified in the plasma
by HPLC, toxic levels have not yet been established.
10.3 Life supportive procedures and symptomatic/specific
treatment
Support respiratory and cardiovascular function.
Diazepam has been shown to be useful in treating yohimbine-
induced anxiety. Dose is given either orally or by slow
intravenous injection:
Adult 5 to 10 mg
Child 0.1 - 0.3 mg/kg bodyweight
If priapism is prolonged (more than 4 hours) then specific
treatment may be required, e.g. aspiration of the corpus
may be required.
10.4 Decontamination
Emesis should be considered following recent ingestion of
amounts exceeding the maximum therapeutic dose or if there
is evidence of any overdose, if the patient is not
comatose, is not convulsing, and has not lost the gag
reflex.
Where emesis is contraindicated, gastric lavage should be
considered.
Administer activated charcoal orally (adults 50 g; children
1 g/kg).
10.5 Elimination
No data available.
10.6 Antidote treatment
10.6.1 Adults
Clonidine has been used experimentally as an
antidote in normal volunteers to eliminate
yohimbine-induced anxiety (see Section 10.7).
10.6.2 Children
No data available
10.7 Management discussions
Clonidine 5 micrograms/kg bodyweight was found to eliminate
not only yohimbine-induced anxiety but also the increases
in blood pressure, plasma MHPG, and other autonomic
symptoms in a study using normal volunteers who ingested
30 mg yohimbine.
However, before clonidine can be
recommended as a routine antidote for yohimbine toxicity,
further clinical evaluation is required (Charney et al.,
1983).
11. ILLUSTRATIVE CASES
11.1 Case reports from literature
Case 1
An ingested dose of 1.8 g yohimbine (100 times the average
daily rate) resulted in unconsciousness for some hours with
priapism. The patient recovered fully within a few days
(Roth et al., 1984; as cited in Dukes, 1988).
Case 2
A 38-year-old man with insulin dependent diabetes was
admitted two hours after taking 350 mg yohimbine. The drug
had been prescribed by a consultant psychiatrist for
erectile impotence complicated by depression.
On admission to hospital he was alert and oriented. His
blood pressure was 130/80 mmHg and his pulse was regular at
88 beats/minute. Six hours after admission he discharged
himself, but was readmitted 17 hours later in a drowsy and
confused state. He was having rigors and complained of
retrosternal pain. He did not appear to have taken any
other drug. His rectal temperature as 35.5C and his blood
pressure was 135/85 mmHg. His hands and feet were warm and
well-perfused. Blood urea was 12.8 mmol/L, serum creatine
175 umol/L, and blood glucose 16.7 mmol/L. An electro-
cardiogram showed atrial fibrillation with a ventricular
rate of 150 beats/minute. The day after admission an
electrocardiogram showed sinus rhythm, and retrograde
amnesia for the preceding 24 hours persisted for four days.
Case 3
A 16-year-old female took an estimated 250 mg of a white
powder alleged to be yohimbine. Within 20 minutes she was
weak, had generalized paraesthesia, loss of coordination,
and was disassociative. She had a severe headache, was
dizzy, and had no tremors. A severe pressure-like
substernal chest pain was noted 4 hours post-ingestion, and
remained for 2 hours before subsiding spontaneously. The
next day, the patient remained weak and dizzy, with nausea,
sweating, severe headache and intermittent palpitations. On
examination more than 30 hours after ingestion, she had a
blood pressure of 150/80, pulse of 116 and respiration rate
of 24. She was anxious, with a blotchy erythematous rash on
her back and submucosal haemorrhage in the right tympanic
membrane. Symptoms resolved spontaneously but had lasted 36
hours (Linden et al., 1985).
11.2 Internally extracted data on cases
No data available.
11.3 Internal cases
To be completed by each Centre using local data.
12. ADDITIONAL INFORMATION
12.1 Availability of antidotes
No specific antidote is available (see Section 10.7).
12.2 Specific preventive measures
Store in a cool place out of direct sunlight. Keep out of
reach of children.
12.3 Other
Not relevant.
13. REFERENCES
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in rat brain.
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1034.
Bourin M, Malinge M, Colombel MC, & Larousse C (1988) Influence
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14. AUTHOR(S), REVIEWER(S), DATE(S) (INCLUDING UPDATES), COMPLETE
ADDRESS(ES)
Authors Dr Wayne A. Temple
National Toxicology Group
University of Otago Medical School
Dr Nerida A. Smith
Pharmacy School
University of Otago
PO Box 913
Dunedin
New Zealand
Tel: 64-3-4797244
Fax: 64-3-4770509
Date July 1992
Reviewer Poisons Unit
New Cross Hospital
Avonley Road
London SE14 5ER
United Kingdom
Tel: 44-71-9555095
Fax: 44-71-6392101
Date July 1992
Peer Review Drs Deng, Ferner, Landoni, Maramba, Shintani,
Wickstrom. London, July, 1992.