yohimbine

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.

REMS

Sexual dysfunction.

Contraind./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.

Adv. Reactions/Side Effects ⬆ ⬇

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

Derm: rash

F and E: fluid retention

GI: nausea, vomiting

GU: urinary frequency

MS: paralysis (high doses)

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

Resp: respiratory depression (high doses)

Misc: hypersensitivity reactions

Interactions ⬆ ⬇

Natural-Drug Products:

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 Products:

Concomitant use with caffeine-containing herbs can cause hypertensive crisis.

Availability ⬆ ⬇

Capsules: 2.5 mg, 3 mg

Route/Dosage ⬆ ⬇

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

US Brand Names ⬆ ⬇

yohimbe bark, Pausinystalia yohimbe, Corynanthe johimbi

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 effects:

Improved sexual function.

Classifications ⬆ ⬇

Therapeutic Classification: erectile dysfunction agents

Pharmacokinetics ⬆ ⬇

Absorption: Unknown

Distribution: Unknown

Metabolism/Excretion: Unknown

Half-Life: Unknown

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

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.

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Indications ⬇