Pau D'Arco Max-V [Discontinued] by Douglas Laboratories

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Cancer. Although there has been interest in using oral pau d'arco for cancer, there is insufficient reliable information about the clinical effects of pau d'arco for this purpose.
• Dysmenorrhea. Oral pau d'arco has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small open-label study in adults with dysmenorrhea shows that taking pau d'arco 1050 mg plus rutin 75 mg daily for up to 8 weeks may reduce pain intensity scores by 41% when compared to baseline (114012). The validity of this finding is limited by the lack of a comparator group and common use of other pain medications, such as NSAIDs.
• Peptic ulcers. Although there has been interest in using oral pau d'arco for peptic ulcers, there is insufficient reliable information about the clinical effects of pau d'arco for this purpose.
• Wound healing. Although there has been interest in using oral and topical pau d'arco for wound healing, there is insufficient reliable information about the clinical effects of pau d'arco for this purpose. More evidence is needed to rate pau d'arco for these uses.

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POSSIBLY UNSAFE ...when used orally. The safety of pau d'arco in typical doses is unclear. Serious toxicities have been found with high doses of the lapachol constituent (91939). In patients with cancer, doses of lapachol above 1.5 grams daily were associated with significant gastrointestinal toxicities and an increased risk of bleeding (91939). However, in patients with dysmenorrhea, doses of pau d'arco 1050 mg plus rutin 75 mg daily for up to 8 weeks did not lead to serious adverse effects (114012). There is insufficient reliable information available about the safety of pau d'arco when used topically.

PREGNANCY: POSSIBLY UNSAFE
when used orally in typical doses. Animal studies have found that lapachol, a constituent of pau d'arco, has teratogenic and abortifacient effects (68314,68315); avoid using. There is insufficient reliable information available about the safety of pau d'arco when used topically in pregnancy; avoid using.

LACTATION:
Insufficient reliable information available; avoid using.

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ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, pau d'arco might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.  Details In vitro research shows that pau d'arco reduces platelet aggregation and may interfere with vitamin K (18057,68319). One clinical study shows that taking the lapachol constituent of pau d'arco in doses above 1.5 grams daily increases the risk of bleeding (91939). The effects of whole pau d'arco or pau d'arco extract in humans are unclear.

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General ...A thorough evaluation of safety outcomes with pau d'arco has not been conducted. However, taking the lapachol constituent of pau d'arco in doses above 1.5 grams daily is regarded as unsafe.

Gastrointestinal ...Orally, the lapachol constituent of pau d'arco, taken in doses above 1. 5 grams daily, may cause severe nausea, vomiting, and diarrhea (91939).

Hematologic ...Orally, the lapachol constituent of pau d'arco, taken in doses above 1. 5 grams daily, may cause anemia and increased risk of bleeding (91939).

Immunologic ...Occupational exposure to sawdust from the pau d'arco tree and related species may cause asthma and dermatitis. The fresh sawdust can produce erythema and papules which progress to a severe weeping and crusting dermatitis (92184).

Neurologic/CNS ...Orally, the lapachol constituent of pau d'arco, taken in doses above 1. 5 grams daily, may cause dizziness (91939).

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