yohimbine

General

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

Pronunciation:
yoh-him-been


Trade Name(s)

  • yohimbe bark
  • Pausinystalia yohimbe
  • Corynanthe johimbi

Ther. Class.
erectile dysfunction agents

Common Uses

Sexual dysfunction.

Action

Yohimbine causes genital blood vessel dilation, nerve impulse transmission to genital tissue, and increased reflex excitability in the sacral region of the spinal cord. It works primarily through alpha 2–adrenergic receptor blockade and also has monoamine oxidase inhibiting, calcium channel blocking, and serotonin receptor blocking effects.

Therapeutic Effect(s):

Improved sexual function.

Pharmacokinetics

Absorption: Unknown

Distribution: Unknown

Metabolism and Excretion: Unknown

Half-life: Unknown

TIME/ACTION PROFILE

ROUTEONSETPEAKDURATION
POunknownunknownunknown

Contraindication/Precautions

Contraindicated in:

  • Hypersensitivity.
  • Angina.
  • Anxiety and depression.
  • Hypotension.
  • Heart disease.
  • Kidney disease.
  • Liver disease.
  • Pregnancy and lactation.
  • Children.

Use Cautiously in:

  • Benign prostatic hyperplasia.
  • Diabetes.
  • Hypertension.
  • Post-traumatic stress disorder.
  • Schizophrenia.
  • Concomitant use with consumption of tyramine-containing foods can lead to hypertensive crisis.
  • Excessive doses without medical supervision can cause significant toxicity.

Adverse Reactions/Side Effects

CV: hypertension, tachycardia, cardiac failure (high doses)

CNS: excitation, headache, tremor, anxiety, dizziness, insomnia

Derm: rash

F and E: fluid retention

GI: nausea, vomiting

GU: urinary frequency

MS: paralysis (high doses)

Misc: hypersensitivity reactions

Resp: respiratory depression (high doses)

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Natural Drug Interaction

  • Additive effects with monoamine oxidase inhibitors..
  • Antagonistic effects with clonidine and other antihypertensives.
  • Increased risk of alpha 2–adrenergic antagonism with phenothiazines..Increased risk of hypertensive crisis with stimulants..
  • May increase or decrease BP withtricyclic antidepressants..

Natural-Natural:

Concomitant use with caffeine-containing herbsand ephedracan cause hypertensive crisis.

Route/Dosage

PO: (Adults) 15–30 mg/daily. Doses up to 100 mg/day have been used but with significantly more side effects.

Availability

Capsules: 2.5 mg, 3 mg

Assessment

  • Assess frequency and severity of erectile dysfunction.

Potential Diagnoses

  • Sexual dysfunction (Indications)

Implementation

  • PO: May increase bioavailability by taking on an empty stomach.

Patient/Family Teaching

  • Instruct patient to take as recommended.
  • Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications, especially stimulants.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

Male erection sufficient to allow intercourse.

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