pau d’arco

Pau d’arco is the Portuguese name for Tabebuia impetiginosa, a tree native to the tropical forests of South America. The bark and central portion of the wood (heartwood) have been used as herbal medicine by indigenous people for thousands of years.

Pau d’arco is used in herbal medicinal systems in the U.S., South and Latin American countries, and Europe to treat many conditions including respiratory problems, gastrointestinal problems, colds, cough, flu, fungal infections, fever, arthritis and rheumatism, skin conditions, leukemia, and other cancers.

Pau d’arco is believed to have antifungal, antimicrobial, anti-inflammatory, antioxidant, analgesic, laxative and anti-cancer properties. The active chemicals in pau d’arco include quinoids, flavonoids and benzenoids. Limited studies on one of the quinoids known as lapachol produced mixed results on its antitumor activity. Lab tests show evidence of antimicrobial activity, including in many bacterial, viral, fungal, and candida yeast infections, however, there are no well-controlled studies on these uses of pau d’arco in humans.

Pau d’arco is mainly taken as a decoction or tincture made from the bark. Some of the suggested uses include:

• Candida, yeast, and other fungal infections, taken orally, applied topically, or as a douche
• Leukemia and cancer
• Cold, flu, and bacterial and viral upper respiratory infections
• Sexually transmitted infections such as syphilis and gonorrhea
• Psoriasis and dermatitis

• Avoid use of pau d’arco during pregnancy. Lapachol, one of the active chemicals in pau d’arco may cause loss of pregnancy.
• Stop use of pau d’arco at least 2 weeks before any scheduled surgery, may increase the risk of bleeding.
• Avoid concurrent use with blood-thinning medications such as warfarin.

Common side effects of pau d’arco include:

• Nausea
• Vomiting
• Diarrhea
• Dizziness
• Internal bleeding

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

There isn't enough reliable information to know what might be an appropriate dose of Pau d’arco. Follow directions on product labels and consult a healthcare professional before using.

Suggested dosage:

• 1-4 g/per day divided twice-three times per day, use no more than 7 days
• 1 tsp bark steeped in boiling water, 2-8 times per day
• Dose based on lapachol content; lapachol intake should be 1.5-2.0 g/day

• Overdose of pau d’arco can cause nausea, vomiting, gastrointestinal upset, and uncontrolled bleeding.
• In case of overdose, seek medical help immediately or contact Poison Control.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Pau d’arco has no known severe interactions with other drugs.
• Pau d’arco has no known serious interactions with other drugs.
• Pau d’arco has moderate interactions with 72 different drugs.
• Minor interactions of pau d’arco include:
  • anamu
  • danshen
  • devil's claw

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• There isn’t any reliable information on the safety of pau d’arco use during pregnancy and breastfeeding, avoid use.

• Natural products are not always necessarily safe, check with your healthcare provider before taking any herbal supplement including pau d’arco.
• Pau d’arco is marketed as an herbal supplement and not regulated by the FDA. There may be discrepancy between the labeling and the actual ingredients and their amounts.
• There is no quality control or standardization and some products may not even contain the medicinal components of pau d’arco. A chemical analysis of 12 commercially available pau d’arco products found that only one of them contained the main active chemical lapachol, and only in trace amounts.
• If you decide to take pau d’arco, learn about the available products and suppliers, and find a reliable source.