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Rauvolfia serpentina Benth.

Synonyms

Ophioxylon serpentinum

Vernacular Names:

Indonesia: Akar tikus[1]
English: Snake root, rauwolfia[2]
Indian:  Sarpagandha, Sovannamilbori (Tamil)[2]
Burmese: Bongmaiza[3]
Sanskrit:  Ahibhuka[3]

General Information

Description

This is a genus of small, upright, poisonous shrubs and evergreen trees in the family Apocynaceae and is found from the Himalayas to Sri Lanka, Thailand and Indonesia.[3]

Plant Part Used

Root[1]

Chemical Constituents

The root of R-.serpentina contains about 30 alkaloids (0.5-2.5%), mostly indole alkaloids, which can be classified into 3 groups: yohimbane, heteroyohimbane and dihydroindole. Among the yohimbane group, reserpine and rescinnamine are the most important therapeutically.[3] Among other bioactive chemicals are deserpidine, yohimbine, ajmaline, ajmalicine and serpentinine. 

Five new indole alkaloids, N(b)-methylajmaline, N(b)-methylisoajmaline, 3-hydoxysarpagine, yohimbinic acid, isorauhimbinic acid, a new iridoid glucoside, 7-epiloganin and a new sucrose derivative, 6’-O-(3,4,5-trimethoxybenzoyl) glomeratose A were isolated from the dried roots.[4

Five anhydronium bases were isolated by preparative HPLC from a methanolic extract of R.serpentina roots: 3,4,5,6-tetradehydrojohimbine, 3,4,5,6-tetradehydro-(Z)-geissoschizol, 3,4,5,6-tetradehydrogeissoschizol and 3,4,5,6-tetradehydrogeissschizine-17-O-β-D-glucopyranoside.[5

Other chemicals reported

11-Methoxy-d-yohimbine, 2,6-dimethoxybenzoquinone, 3,4,5-trimethoxybenzoic acid, 3-epi-α-yohimbine, ajmalexine, ajmalinine, alloyohimbine, Calcium, chandrine, corynanthine, d-yohimbine, eudesmic acid, g-yohimbine, isoajmaline, isorauhimbine, isoraunitidine, isosandwicine, isoyohimbine, methyl-reserpate, neoajmaline, papaverine, Phosphorus, raubasine, raugaulline, rauhimbine, raunatine, raunolinine, raupine, rauwolfinine, rauwolscine, renoxidine, resajmaline, rescidine, reserpiline, reserpoxidine, sandwicine, sandwicolidine, sarpagine, sandwicolidine, sarpagine, serpajmaline, serpakrine, serpentine, serpinine, serposterol, stigmasterol, tetraphyllicine, thebaine, vimilenine, vomalidine.[6]

Traditional Use:

The root of R.sepentina is used as an antidote for snake poisoning, insect poisoning, dysentery, cholera, colic, anorexia, hysteralgia, anthelmintic, enteritis, mental disease, venereal disease, dyspnoea, abnominalgia, fever, anti-emetic and headache.[2

From time immemorial, it has been reported that the roots of R.serpentina have been used in Ayurvedic to expel intestinal worms, for the treatment of ulcers, bowel discomfort such as colic, biliousness, cholera, dysentery and to counteract snake-poison. A decoction of the roots is used to increase uterine contraction in childbirth.[3]

Pre-Clinical Data

Pharmacology

Many indole and dihydroindole alkaloids from R.serpentina have served as lead compounds in developing novel drugs for the treatment of cardiovascular diseases. And also serpentine has been found to exhibit anticancer and antimalarial properties.[5]

Toxicities

No documentation

Clinical Data

Clinical Trials

Reserpine is still formally used to reduce blood pressure although it has been replaced with more manageable drugs.[3]

Adverse Effects in Human:

Women who are pregnant and planning to start a family should not ingest preparations of Rauwolfia plant.[7] Besides, when taken orally, it may also cause nasal congestion, abdominal cramps, diarrhoea, nausea, vomiting, anorexia, increased gastric acid secretion, drowsiness, fatigue, lethargy, slowed reflexes, sexual dysfunction, and bradycardia.[8]

Use in Certain Conditions

Rauwolfia plants contain reserpine which dilates the blood vessels and is often been used to treat Raynaud’s disease.[9]

Pregnancy / Breastfeeding

Expecting mothers should not ingest rauvolfia plants or preparations made from them because it is likely unsafe as the reserpine alkaloids cross the placenta and can be potentially teratogenic.[3][8]

Age Limitations

Neonates / Adolescents

No documentation

Geriatrics

No documentation

Chronic Disease Conditions

Rauvolfia plant preparations may also be harmful for people with any chronic disease of the gastrointestinal tract, such as stomach or duodenal ulcers, oesophageal reflux, ulcerative colitis and diverticulosis.[7]

Interactions

Interactions with drugs

Interaction with alcohol may increase the risk of additive CNS-depressant effects.

Concomitant use of neuroleptics and barbiturates with rauvolfia may potentiate the effects of these drugs and the rauvolfia alkaloids.

Concomitant use of digoxin with rauvolfia may cause bradycardia, angina-like symptoms and arrhythmias.

Concomitant use of diuretics with rauvolfia may potentiate the hypotensive effects of rauvolfia alkaloids.

Concomitant use of ephedrine with rauvolfia may reduce indirec-sympathomimetic drug activity.

Concomitant use of L-Dopa with rauvolfia may reduce drug effectiveness and increase extrapyramidal motor symptoms.

Overlapping and concomitant use of rauvolfia with monoamine oxidase inhibitors (MAOIs) shoul be avoided. Overlapping may increase the risk of excitation and hypertension.

Concomitant use of rauvolfia with propanolol (Inderal) may enhance beta-blockage due to the rauvolfia alkaloid catecholamine-depleting effects.

Concomitant use of rauvolfia with sympathomimetic drugs may cause an initial increase in blood pressure and enhance or prolong the pressor effects.

Concomitant use of tricyclic antidepressant drugs (TCAs) with rauvolfia may decrease the effectiveness of rauvolfia alkaloids.[8]

Interactions with Other Herbs / Herbal Constituents

Rauvolfia interacts with:

-cardioactive glycoside containing herbs such as heelbore, digitalis, lily of the valley and oleander leaf.[8]

-Ephedra may cause a decrease in ephedrine effect.[8]

Contraindications

Contraindications

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Case Reports

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  1)  Botanical Info

References

  1. Eisai Indonesia, P.T. Medicinal Herb Index in Indonesia (Second Edition), Jakarta. 1995; pp199.
  2. Herbal Medicine Research Centre, Institute for Medical Research, Kuala Lumpur. Compendium of Medicinal Plants Used in Malaysia. 2002; 2:297.
  3. Wiart, C. Medicinal Plants of the Asia-Pacific: Drugs for the Future? World Scientific Publishing Co. Pte. Ltd. Singapore. 2006; pp 468-470.
  4. Itoh, A. et. al. Indole alkaloids and other constituents of Rauwolfia serpentina. J. Nat. Prod. 2005; 68:848-852.
  5. Wachsmuth, O. and Matusch,R. Anhydronium bases from Rauvolfia serpentina. Phytochemistry 2002; 61:705-709.
  6. Dr. Duke’s Phytochemical and Ethnobotanical Databases. www.ars-grin.gov/duke/
  7. Lewis, W.H. and Elvin-Lewis, M.P.F. Medical Botany. Wiley, Hoboken, USA. 2003; pp 286
  8. Natural Medicines Comprehensive Database, http:// www.naturaldatabase.com/indian snakeroot.html/
  9. Duke, J.A.. The Green Pharmacy. Rodale Press, Emmaus, Pennsylvania, USA. 1997; pp 379.