yohimbine

Yohimbine is a prescription medicine used to treat male impotence (erectile dysfunction) due to diabetes, vascular conditions or psychological origin. There are, however, limited data on its efficacy, and more effective drugs such as phosphodiesterase-5 inhibitors are available to treat erectile dysfunction.

Yohimbine has also been used as a street drug, promoted as an aphrodisiac, hallucinogen, for weight loss and many other purposes, but there is little scientific evidence to support any of these uses.

Yohimbine is a plant alkaloid isolated from the bark of Pausinystalia yohimbine, an evergreen tree native to central and western Africa. Yohimbine hydrochloride is a standardized form of yohimbine and is available as a prescription drug in the U.S.

Yohimbe is the P. yohimbine bark extract and is used in many herbal supplements sold over the counter. There is very little research on the safety and efficacy of yohimbe as a dietary supplement and currently, yohimbine is banned in many countries.

Yohimbine works by blocking alpha-2 adrenergic receptors, protein molecules on nerve cells that are stimulated by norepinephrine. This reduces sympathetic nervous system activity (adrenergic) and increases parasympathetic activity (cholinergic), resulting in increased blood flow into the penis and reduced outflow of blood, which help maintain erection.

• Do not use yohimbine in the following conditions:
  • Hypersensitivity to yohimbine
  • Panic disorder or schizophrenia
  • Heart, liver or kidney disease
  • Low blood pressure (hypotension)
• Yohimbine should not be used by women and children.
• Do not take yohimbine concurrently with foods rich in the amino acid tyramine, such as liver, cheese and red wine.
• Do not use yohimbine concurrently with other stimulant-like substances such as caffeine and ephedrine alkaloids. There have been reports of kidney failure, seizures, and death due to such combinations in dietary supplements.

Common side effects of yohimbine include:

• Dizziness
• Headache
• Flushing
• Sweating
• Nausea
• Vomiting
• Anxiety
• Irritability
• Drowsiness
• Disorientation
• Worsening of panic attacks
• Tremor
• Seizure (with high doses)
• Increase in blood pressure
• Rapid heart rate (tachycardia)
• Prolonged or painful erection (priapism)
• Rash
• Hives
• Hypersensitivity reactions
• Reduced urine output

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.

Tablets

• 5.4 mg

Adult:

Impotence, Aphrodisiac

• 0.5-1 tablet/caplet three times daily

The suggested treatment period is no more than 10 weeks.

Pediatric:

• Safety and efficacy not established

• Yohimbine overdose can cause anxiety, drowsiness, disorientation, tremors, and seizures with higher doses.
• Overdose is treated with symptomatic and supportive care. In case of overdose, immediately seek medical help 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.

• Severe interactions of yohimbine include:
• isocarboxazid
• linezolid
• phenelzine
• selegiline transdermal
• tranylcypromine
• Yohimbine has serious interactions with at least 30 different drugs.
• Yohimbine has moderate interactions with at least 168 different drugs.
• Mild interactions of yohimbine include:
• American ginseng
• desmopressin
• eucalyptus
• guarana
• sage
• yerba mate

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.

• Yohimbine is not for use in women and pregnant or nursing women certainly should not take it.

• Take yohimbine in the standardized form of tablets, only if prescribed by your physician and exactly as instructed.
• Store safely out of reach of children.
• Avoid taking yohimbine/yohimbe extract that is available as herbal supplement, natural products are not necessarily safe.
• Herbal supplements do not undergo rigorous evaluation by the FDA for safety and efficacy. There may very often be discrepancy between the labeling and the actual yohimbine content in herbal supplements. A study that analyzed 49 supplements with yohimbine found that only three of them contained the amount of yohimbine advertised on the label.