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Piper betle Linn.


Piper siriboa L.

Vernacular Names:

Malaysia: Sirih, sirih melayu, sirih cina, sirih hudang, sirih carang, sirih kerakap
English: Betel, betel pepper, betel-vine
Tamil:  Vetrilai
Hindi:  Pan
Semang:  Serasa, be, cabe
Jakun:  Kerekap, kenayek
Sakai:  Jerak
Javanese: Sirih, suruh, bodeh
Thai:  Pelu

General Information


The betel plant is apparently a native of central and eastern part of peninsular Malaysia. In early times, it became a cultivated plant, spreading through tropical Asia and peninsular Malaysia. It grows in warm and humid climatic conditions, usually in lowlands and also in villages, and sometimes grows wild in forest undergrowths.[1]

Plant Part Used

Leaf, root.[1]

Chemical Constituents

Chemically the herb contains:

-arecoline, carvacrol, caryophyllene, piperitol, piperbetol, eugenol, isoeugenol, allyl pyrocatechol, chavicol, safrole, anethole[2]

-chavibetol, cadinene[3]


-β-sitosterol, β-sitosteryl palmitate, dotriacontanoic acid, tritriacontane, stearic acid, cepharadione, piperine, piperlonguminine[5]

-chavibetol acetate, allylpyrocatechol monoacetate[6]

-allyl diacetoxy benzene[7]

-estragole, methyl eugenol and hydroxycatechol[8]

-methylpiperbetol, piperol A and piperol B[9]

-cavacrol, eugenol acetate, and allyl pyrocatechol diacetate[10]

Traditional Use:

Betel pepper leaves, in which their lateral nerves make a complete loop rejoining the midrib, are believed to be more potent medicinally than the leaves in which these are not obvious. These leaves known as ‘sirih bertemu urat’ are used in the treatment of ailments which are difficult to cure. The Ayurvedics claim that the leaves are anthelminthic, aphrodisiac, carminative and laxative. They are also known to be stomachic and tonic. The Yunani regard the leaves as a styptic and a vulnerary. They prescribe it to improve the appetite and taste, to strengthen teeth and as tonic for the brain, heart and liver. In Vietnam, the leaves in the form of a collutory made of the extract are claimed to have antibacterial properties. Malays find the betel quid useful for administering medicine but beyond that, the sireh leaf is apparently selected as a vehicle for its own stimulant value.[1

The chewing of betel acts as a gentle stimulant and beyond all other uses, it sweetens the breath. The Ayurvedics prescribe it to treat halitosis, bronchitis and elephantiasis. The Indians add the extract of the leaves to medications to treat the mucous membrane lining of the mouth, nose and stomach. The leaves are used in various ways to relieve constipation in children. In the Philippine Islands, the heated leaves are applied to the abdomen, while in India the stalks of the leaves with oil are used in place of an enema. Malays usually eat the leaf with ‘gambir’ to treat diarrhoea. The extract is also prescribed in a mixture ingested to treat gonorrhoea. This plant is used for the treatment of dysentery, fever, gastritis, rheumatism and leucorrhoea. It is also used to eliminate body odour.[1

The leaves are used externally as poultice in various ways. The lowest branches of the vines produce relatively juiceless, deformed leaves. There may be more rubefacient action in these leaves compared to the more juicy ones. These are used in lotions and paste which are applied to ulcers, swellings and wounds. A poultice of the leaves as well as a wash with the decoction are used in treating burns, impetigo, furunculosis, eczema and lymphangitis. The leaves are used as lotion to treat nose ulcer and are also applied to the body during confinement. The extract of the leaves is further used as ear-drops and eye-drops. Malays apply the heated leaves to chests to relieve cough and asthma. Malays and Indians apply the leaves to the breast to arrest lactation.[1

The oil obtained from the leaves is used as an external application for treating catarrh and breast abscesses. The oil is used in Indonesia as pessary during confinement. The leaf and root, mixed in oil, are believed to have been used as a salve or ointment to treat hard tumours and scirrhi.[1]

Pre-Clinical Data


Platelet inhibition activity

Hydroxychavicol (HC) was tested for its inhibition effect on platelet aggregation. The results showed hydroxychavicol to be a potent inhibitor for cyclooxygenase activity, reactive oxygen scavenger and inhibits platelet calcium signalling, thromboxan B2 production and aggregation. HC could be a potential therapeutic agent for prevention and treatment of artherosclerosis and other cardiovascular diseases through its anti-inflammatory and antiplatelet effects, without effects on haemostatic functions.[4

Antibacterial activity

In a search for major active principles from natural resources which can prevent halitosis or act as “breath fresheners”, a methanol extract of fresh leaves of Piper betle was subjected to in vitro tests using plate and broth MIC assays, bio-film assay, saliva chip model and a conductometric method. The result outcome suggests that the active constituent, allylpyrocatechol might be responsible for the antimicrobial activity against various obligate oral anaerobes.[6

Antidiabetic activity

Both the aqueous and ethanolic extracts of P.betle leaves possess marked hypoglycaemic activity when tested in fasted normoglycaemic rats. In glucose tolerance test, the extracts showed antihyperglycaemic activity in the external glucose level. The ability of lowering blood glucose levels of streptozotocin (STZ)-induced diabetic rats gives a suggestion that the extracts have insulinomimetic activity.[7

Antioxidant activity

In a study, it was reported that aqueous extracts of three varieties of P.betle leaves showed antioxidant effects when evaluated by in vitro systems such as DPPH radical scavenging, superoxide radical scavenging, hydroxyl radical scavenging and prevention of lipid peroxidation.[11

Antifertility activity

A study to develop an orally effective male contraceptive agent was extensively carried out in male mice with various doses of the leaf-stalk extracts of Piper betle. The results show no toxicity in all metabolically active tissues of mice and interestingly, the contraceptive efficacy emphasised reversible fertility after withdrawal of treatment.[12]

Radioprotective activity

Mammalian systems if exposed to radiation can cause damaging effects leading to cell death and an increased risk of degenerative diseases. Recently the radioprotective property of ethanolic extract of P.betle leaves was studied as alternative low cost preventive medicine to synthetic radioprotectants which are reported to be toxic. The capacity of the extract in preventing g-ray induced lipid peroxidation and DNA damage in rat liver mitochondria were assessed and evaluated to establish the mechanism of its radioprotective action. The study revealed significant immunomodulatory and superior radical scavenging activities which may be due to the presence of phenolic bioactives such as chavibetol and allyl pyrocatechol. It suggests that the herb has a great potential not only it is cheap but also easily accessible natural radioprotectant to the common people.[10

Protective and healing activity

Most recently, a study was undertaken to evaluate the protective and healing effects of allylpyrocatechol against the indomethacin-induced stomach ulceration in rat model. Results showed that allylpyrocatechol can protect indomethacin-induced gastric ulceration due to its antioxidative and mucin protecting properties.[13]


No documentation

Clinical Data

Clinical Trials

No documentation

Adverse Effects in Human:

In 1997, in Taiwan following an advertisement in a local newspaper about a new facial ‘whitening’ by applying popular dressings with steamed betel leaves before bedtime,15 patients were treated at a clinic after contacting leukomelanosis induced by Piper betle leaves. Data collected revealed all the patients suffered from some degree of irritation such as redness, stinging or tingling in earlier stage. The cause could be due to the phenolic compounds present in the essential oils i.e. chavicol and eugenol.[14]

Use in Certain Conditions

Pregnancy / Breastfeeding

No documentation

Age Limitations

Neonates / Adolescents

No unacceptable side effects[7]


No unacceptable side effects[7]

Chronic Disease Conditions

No unacceptable side effects[7]


Interactions with drugs

No documentation

Interactions with Other Herbs / Herbal Constituents

Addictive chewing of betel leaves with arecanut and lime (calcium hydroxide), and occasionally with Uncaria gambier can cause oral submucous fibrosis and may be associated with squamous cell carcinoma.[15] Betel chewing may also affect the central and autonomic nervous systems.[16]



No documentation

Case Reports

No documentation

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  1) Botanical Info

  2) Cultivation

  1. Herbal Medicine Research Centre, Institute for Medical Research, Kuala Lumpur. Compendium of Medicinal Plants Used in Malaysia. 2002; 2:225.
  2. Samy, J., Sugumaran, M. & Lee, K.L.W. Herbs of Malaysia. Federal Publications Sdn Berhad, Malaysia. 2005; pp187.
  3. A Modern Herbal/ Betel-Herb Profile and Information, accessed on 1 October 2007.
  4. Chang, M.C. et al. Hydroxychavicol, a novel betel leaf component, inhibits platelet aggregation by suppression of cyclooxygenase, thromboxane production and calcium mobilization. Br. J. Pharmacol. 2007; 152: 73-82.
  5. Parmar, V.S. et al. Polyphenols and alkaloids from Piper species. Phytochemistry. 1998;49:1069-1078.
  6. Ramji, N., Ramji, N., Iyer, R. & Chandrasekaran, S. Phenolic antibacterials from     Piper betle in the prevention of halitosis. J. Ethnopharmacol. 2002; 83:149-152.
  7. Arambewela,L.S.R.,Arawwawala,L.D.A.M. & Ratnasooriya,W.D. Antidiabetic activities of aqueous and ethanolic extracts of Piper betle leaves in rats. J.Ethnopharmacol. 2005; 102:239-245.
  8. Wikipedia on Piper Betle Plant: accessed on 12 June 2007.
  9. Zeng,H.W.,Jiang,Y.Y.,Cai,D.G., Bian,J.,Long,K. & Chen, Z.L. Piperbetol, methylpiperbetol, piperol A and piperol B: a new series of highly specific PAF receptor antagonists from Piper betle.Planta Med. 1997; 63:296-8.
  10. Bhattacharya, S. et al. Radioprotective Property of the Ethanolic Extract of Piper betel Leaf. J. Radiat. Res.,2005; 46:165-171.
  11. Dasgupta, N.& De, B. Antioxidant activity of Piper betle L. leaf extract in vitro. Food Chemistry. 2004; 88:219-224.
  12. Sarkar,   M. et al. The reversible antifertility effect of Piper betle Linn. on Swiss albino male mice. Contraception 2000; 62:271-274.
  13. Bhattacharya, S. et. Healing property of the Piper betel phenol, allylpyrocatechol against Indomethacin-induced stomach ulceration and mechanism of action. World J Gastroenterol. 2007; 13: 3705-13.
  14. Liao, Y-L. et al. Contact leukomelanosis induced by the leaves of Piper betle L. (Piperaceae): A clinical and histopathologic survey. J. Amer. Academy Dermatology 1999; 40: 583-589.
  15. Norton, S.A. Betel: Consumption and consequences. J. Amer. Academy Dermatology 1997 ;37: 81-8.
  16. Chu, N-S. Effects of Betel Chewing on the Central and Autonomic Nervous Systems. J. Biomed. Sc. 2001; 8:229-36.

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