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Known interactions

Acarbose, Acetohexamide, Actoplus Met, Actos, Amaryl, Apidra, Avandamet, Avandia, Chlorpropamide, Diabeta, Diabinese, Dymelor, Fortamet, Glimepiride, Glipizide, Glipizide and Metformin, Glipizide Extended-Release, Glucophage, Glucophage XR, Glucotrol, Glucotrol XL, Glucovance, Glyburide, Glyburide and Metformin, Glynase, Glyset, Humalog, Humalog Mix 75/25, Humulin, Humulin 50/50, Humulin 70/30, Iletin II, Iletin II Mixed, Insulin - Mixed, Insulin glulisine, Insulin injection, Insulin Lispro, Metaglip, Metformin, Metformin Extended-Release, Metformin Oral Solution, Micronase, Miglitol, NovoLog Mix, Novolin, Novolin 70/30, Orinase, Pioglitazone, Pioglitazone and Metformin, Prandin, Precose, Repaglinide, Riomet, Rosiglitazone, Rosiglitazone and Metformin, Tolazamide, Tolbutamide, Tolinase, Velosulin.

Application of Red Periwinkle

Scientific Name: Catharanthus roseus

Other Names: Cape Periwinkle, Catharanthus, Church Flower, Madagascar Periwinkle, Red Periwinkle, Rosy Periwinkle

Who is this for?

NOTE: Catharanthus roseus is not recommended for oral use due to the possibility of serious side effects.

Catharanthus roseus should not be confused with Vinca minor, another plant that is commonly called periwinkle.

Traditionally, Catharanthus roseus has been used in folk medicine to treat diabetes and high blood pressure. As an antidiabetic remedy, it was believed to promote insulin production or to increase the body's utilization of sugars from food. A few studies of injectable and oral Catharanthus roseus in laboratory animals have shown some antidiabetic effects, but no human studies have found significant reductions in blood sugar after Catharanthus roseus was taken by mouth. Catharanthus roseus has some diuretic action, meaning that it may promote the loss of urine from the body. This effect may help to relieve high blood pressure, but other diuretics are both safer and more effective to use. The high risk of serious side effects from Catharanthus roseus makes taking it inadvisable.

During the 1950s however, Catharanthus roseus was discovered to contain a number of chemicals in the alkaloid class. Alkaloids are bitter-tasting plant compounds that contain nitrogen. Many of them have pain-relieving or anticancer properties. At least two of the alkaloids in Catharanthus roseus (vinblastine and vincristine) have been isolated and developed into prescription anti-cancer drugs. These injectable drugs and their derivatives (such as vinorelbine) work in several ways that interfere with the division of cancer cells. Recently, a laboratory study showed that chemicals in Catharanthus roseus may also prevent the growth of new blood vessels that support tumor growth. These drugs should only be used by healthcare professionals; however, because they may cause severe side effects.

When should I be careful taking it?

Catharanthus roseus should not be self-administered due to the probability that it will cause serious side effects.

What side effects should I watch for?

Poisoning and deaths have occurred among animals that have ingested large amounts of Catharanthus roseus plants.

Although no cases of birth defects attributed to Catharanthus roseus have been reported, birth defects have been caused by using prescription drugs derived from Catharanthus roseus during pregnancy.

Neurotoxicity, nerve damage that may become permanent, has been seen frequently in individuals who take a prescription form of Catharanthus roseus to treat cancer. Symptoms of neurotoxicity may include muscle weakness or a burning, itching, or tingling sensation in the hands or feet.

Catharanthus roseus alkaloids may decrease the ability of bone marrow to produce new blood cells.

What interactions should I watch for?

Catharanthus roseus is not known to interact with prescription drugs, non-prescription drugs, other herbal supplements, or foods. However, because few reliable studies of Catharanthus roseus have been conducted, its possible interactions with drugs, foods, and other dietary supplements are not understood completely.

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals.

Should I take it?

A bushy perennial, Catharanthus roseus may be native to the islands of the West Indies or to Madagascar, a large island located off the southeastern coast of Africa. Historical records show that it was well-established in Europe during the 18th century — primarily as an ornamental flowering hedge. Because it is such an attractive plant, Catharanthus roseus is still often used as a decorative bush in gardens and landscaping. In warm climates, it generally grows to between 24 and 30 inches in height and it consists of a thick, trunk-like stem with many upright branches. Its small, dark, shiny leaves stay green all year in the tropics and its 5-petaled flowers range in color from white through many shades of pink and lavender to red. In cool climates, Catharanthus roseus usually stays smaller and loses its leaves in the fall. Catharanthus roseus fruits, which are about an inch long, produce multiple tiny seeds.

Catharanthus roseus now grows wild only in Madagascar, where it is endangered by the spread of agriculture and metropolitan areas. Because it provides the anticancer alkaloids vinblastine and vincristine, Catharanthus roseus is cultivated on plantations in tropical countries. It may even be grown under artificial conditions, such as in bioreactors, which are systems used to produce large amounts of natural materials in shorter times than growing the plants would take. The whole Catharanthus roseus plant, including the roots, may be used in medicine. In India, the juice of fresh Catharanthus roseus leaves has been applied topically to treat venomous insect bites. In the West Indies, its flowers were used in eye preparations. In various parts of the world, a solution made from the whole plant has been used to control bleeding and as a mouthwash to ease sore throats. However, using Catharanthus roseus in any form is strongly discouraged due to the side effects that it is likely to cause.

Dosage and Administration

All of the prescription versions of Catharanthus roseus are formulated to be given by intravenous injection.

Taking Catharanthus roseus orally is discouraged and injecting it should always be supervised closely by a trained healthcare provider. The side effects of Catharanthus roseus make its use dangerous.

Summary

Currently, the use of Catharanthus roseus is not recommended due to the risk of severe side effects from taking it. Chemicals derived from it are used in prescription-only anticancer drugs.

Risks

Using Catharanthus roseus may lead to severe side effects, so it is not recommended.

Side Effects

Catharanthus roseus and the drugs derived from it have been associated with causing:

  • Birth defects
  • Neurotoxicity
  • Bone marrow suppression
  • Sensitivity to sunlight

Taking it may also cause gastrointestinal complaints, headache, and muscle weakness.

Interactions

While no interactions have been associated with Catharanthus roseus, it has not been well studied. Potential interactions may not be known, yet.

Last Revised June 2, 2004

References

Anon: Periwinkle. In: DerMarderosian A, Beutler JA, eds. Facts and Comparisons: The Review of Natural Products. St. Louis, MO, Facts and Comparisons. July 1994.

British Medical Association and the Royal Pharmaceutical Society of Great Britain. Vinca alkaloids and etoposide. In: BNF. The British National Formulary. Available at: http://bnf.org/bnf/bnf/current/doc/4747.htm. Accessed November 17, 2003.

Carod-Artal FJ. Neurological syndromes linked with the intake of plants and fungi containing a toxic component (I). Neurotoxic syndromes caused by the ingestion of plants, seeds and fruits. [Article in Spanish] Review of Neurology. 2003;36(9):860-871.

Chattopadhyay RR. A comparative evaluation of some blood sugar lowering agents of plant origin. Journal of Ethnopharmacology. 1999;67(3):367-372.

Cyberbotanica. Pharmacology of vinblastine, vincristine, vindesine and vinorelbine. University of Texas at Austin. Last Updated November 6, 1997. Available at: http://biotech.icmb.utexas.edu/botany/vvv.html. Accessed November 17, 2003.

Elgorashi EE, Taylor JL, Maes A, van Staden J, De Kimpe N, Verschaeve L. Screening of medicinal plants used in South African traditional medicine for genotoxic effects. Toxicology Letters. 2003;143(2):195-207.

Filippini R, Caniato R, Piovan A, Cappelletti EM. Production of anthocyanins by Catharanthus roseus. Fitoterapia. 2003;74(1-2):62-67.

Floridata. Catharanthus roseus. No date given. Available at: http://www.floridata.com/main_fr.cfm?state=ref_search&viewsrc=lists/search.cfm. Accessed October 31, 2003.

Fulzele DP, Heble MR. Large-scale cultivation of Catharanthus roseus cells: production of ajmalicine in a 20-l airlift bioreactor. Journal of Biotechnology. 1994;35(1):1-7.

Herbs2000. Rosy periwinkle. Madagascar periwinkle. No date given. Available at: http://www.herbs2000.com/herbs/herbs_periwinkle.htm. Accessed November 17, 2003.

MedLine Plus. Vinblastine. Last revised January 1, 2003. Available at: http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682848.html. Accessed November 17, 2003.

MedLine Plus. Vincristine. Last revised January 1, 2003. Available at: http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682822.html. Accessed November 17, 2003.

Misra N, Luthra R, Kumar S. Enzymology of indole alkaloid biosynthesis in Catharanthus roseus. Indian Journal of Biochemistry and Biophysics. 1996;33(4):261-273.

Nammi S, Boini MK, Lodagala SD, Behara RB. The juice of fresh leaves of Catharanthus roseus Linn. reduces blood glucose in normal and alloxan diabetic rabbits. BMC Complementary and Alternative Medicine. 2003;3(1):4.

Ram VJ, Kumari S. Natural products of plant origin as anticancer agents. Drug News Perspectives. 2001(8):465-482.

Singh SN, Vats P, Suri S, Shyam R, Kumria MM, Ranganathan S, Sridharan K. Effect of an antidiabetic extract of Catharanthus roseus on enzymic activities in streptozotocin induced diabetic rats. Journal of Ethnopharmacology. 2001;76(3):269-277.

Sottomayor M, Ros Barcelo A. Peroxidase from Catharanthus roseus (L.) G. Don and the biosynthesis of alpha-3',4'-anhydrovinblastine: a specific role for a multifunctional enzyme. Protoplasma. 2003;222(1-2):97-105.

Swanston-Flatt SK, Day C, Flatt PR, Gould BJ, Bailey CJ. Glycaemic effects of traditional European plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetes Research. 1989;10(2):69-73.

van Der Heijden R, Jacobs DI, Snoeijer W, Hallard D, Verpoorte R. The Catharanthus alkaloids: pharmacognosy and biotechnology. Current Medicinal Chemistry. 2004;11(5):607-628.

Wang S, Zheng Z, Weng Y, et al. Angiogenesis and anti-angiogenesis activity of Chinese medicinal herbal extracts. Life Sciences. 2004;74(20):2467-2478.

Zheng W, Wang SY. Antioxidant activity and phenolic compounds in selected herbs. Journal of Agriculture and Food Chemistry. 2001;49(11):5165-5170.


(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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