Cowhage (Mucuna pruriens)
Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
Dolichos pruriens, Fabaceae (family), kapikachu, kiwach, Mucuna birdwoodiana, Mucuna pruriens, Mucuna sempervirens, velvet bean.
Cowhage (Mucuna pruriens) seeds have been used in traditional Ayurvedic medicine to treat Parkinson's disease. This traditional use is supported by laboratory analysis that shows cowhage contains 3.6-4.2% levodopa, the same chemical used in several Parkinson's disease drugs that is a precursor to dopamine. In a few clinical trials in Parkinson's disease patients, three cowhage treatments yielded positive results. However, more research should be conducted to elucidate the treatment that is the most effective. In addition, cowhage seeds have nutritional quality comparable to soy beans and other conventional legumes, but several antinutritional/antiphysiological compounds prevent these seeds from being used as a food source.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Traditional Ayurvedic medicine and preliminary evidence suggests that cowhage contains 3.6-4.2% levodopa, the same chemical used in several Parkinson's disease drugs. Cowhage treatments have yielded positive results in early studies. However, more research should be conducted to determine the treatment that is the most effective.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Anticoagulant (blood thinner), diabetes, fracture healing, hyperprolactinemia (excessive prolactin in the blood).
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
There is no proven effective dose for cowhage in adults. For Parkinson's disease, 15 and 30 grams of a cowhage preparation has been taken by mouth for a week. Sachets containing a derivative of cowhage, called HP-200, have also been used.
Children (younger than 18 years)
There is no proven safe or effective dose for cowhage in children.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid in individuals with a known allergy or hypersensitivity to cowhage (Mucuna prurient) or its constituents. Hairs on cowhage flowers and pods can cause severe pruritus (itching).
Side Effects and Warnings
Few adverse effects have been reported for cowhage. In one study in Parkinson's disease patients, a derivative of Mucuna prurient caused mild adverse effects that were mainly gastrointestinal in nature. Cowhage has also caused acute toxic psychosis, which may be due to its levodopa content. Use cautiously in patients with Parkinson's disease and/or taking levodopa, dopamine, dopamine agonists, dopamine antagonists, or dopamine reuptake inhibitors as cowhage seeds contain the dopamine precursor levodopa.
Hairs on cowhage flowers and pods can cause severe pruritus (itching), and have also been used to artificially induce pruritus.
Use cautiously in patients taking monoamine oxidase inhibitors (MAOIs), as the levodopa in cowhage seeds may interact and cause high blood pressure.
Use cautiously in patients taking anticoagulants (blood thinners) or with diabetes or hypoglycemia, due to the potential for additive effects.
Avoid in patients with psychosis or schizophrenia, as cowhage has caused acute toxic psychosis.
Avoid in pregnant or breastfeeding patients as cowhage may inhibit prolactin secretion.
Pregnancy and Breastfeeding
Cowhage is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Two early studies indicate that cowhage may inhibit prolactin secretion.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
The leaves of Mucuna pruriens may dose-dependently prolong blood clotting. Caution is advised in patients taking drugs that also increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Use cautiously in patients taking diabetes medications as cowhage may alter blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely be a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Cowhage seeds contain levodopa, which may cause high blood pressure when taken with monoamine oxidase (MAO) inhibitors. Caution is advised in patients with hypertension (high blood pressure) or taking medication that alters blood pressure due to possible additive effects.
In a case report, cowhage caused an outbreak of acute toxic psychosis. Caution is advised in patients with mental illnesses.
Based on a clinical study in Parkinson's disease patients, cowhage may increase serum levodopa concentrations. Caution is advised in Parkinson's disease patients taking levodopa, dopamine, dopamine agonists, dopamine antagonists, anticholinergics and antiparkinsonian agents due to possible additive effects.
Interactions with Herbs and Dietary Supplements
The leaves of Mucuna pruriens may dose-dependently prolong blood clotting. Use cautiously in patients with bleeding disorders or taking other blood thinning herbs or supplements due to a possible increase in the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
In a case report, cowhage caused an outbreak of acute toxic psychosis. Use cautiously in patients with mental illnesses.
Ayahuasca (Banisteriopsiscaapi) is a known MAO inhibitor; cowhage seeds contain levodopa, which may cause high blood pressure when taken with MAO inhibitors. Use cautiously in patients with hypertension (high blood pressure) or taking other herbs or supplements, such as ayahuasca, that alter blood pressure.
Ergot (Claviceps purpura) has known dopamine agonist activity; cowhage seeds contain levodopa, which is a precursor to dopamine. Use cautiously in patients with mental illnesses, such as depression, as the combination of cowhage and ergot may result in additive effects.
Jimson weed (Datura stramonium) is a known anticholinergic; cowhage seeds contain levodopa, which may interact with anticholinergics. Use cautiously in patients with Parkinson's disease as the combination of cowhage and Jimson weed may result in additive effects.
Fava beans (Vicia faba) contain levodopa, as do cowhage seeds. Use cautiously with fava beans due to possible additive effects.
Cowhage may alter blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking herbs or supplements that affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Centers for Disease Control (CDC). Mucuna pruriens-associated pruritus--New Jersey. MMWR Morb.Mortal.Wkly.Rep. 12-6-1985;34(48):732-734. View Abstract
Grover JK, Yadav S, Vats V. Medicinal plants of India with anti-diabetic potential. J Ethnopharmacol 2002;81(1):81-100. View Abstract
Houghton PJ, Skari KP. The effect on blood clotting of some west African plants used against snakebite. J Ethnopharmacol 1994;44(2):99-108. View Abstract
Infante ME, Perez AM, Simao MR, et al. Outbreak of acute toxic psychosis attributed to Mucuna pruriens. Lancet 11-3-1990;336(8723):1129. View Abstract
Katzenschlager R, Evans A, Manson A, et al. Mucuna pruriens in Parkinson's disease: a double blind clinical and pharmacological study. J.Neurol.Neurosurg.Psychiatry 2004;75(12):1672-1677. View Abstract
Nagashayana N, Sankarankutty P, Nampoothiri MR, et al. Association of L-DOPA with recovery following Ayurveda medication in Parkinson's disease. J Neurol.Sci 6-15-2000;176(2):124-127. View Abstract
No Author. An alternative medicine treatment for Parkinson's disease: results of a multicenter clinical trial. HP-200 in Parkinson's Disease Study Group. J Altern Complement Med 1995;1(3):249-255. View Abstract
Prakash D, Niranjan A, Tewari SK. Some nutritional properties of the seeds of three Mucuna species. Int.J.Food Sci.Nutr. 2001;52(1):79-82. View Abstract
Pugalenthi M, Vadivel V, Siddhuraju P. Alternative food/feed perspectives of an underutilized legume Mucuna pruriens var. utilis--a review. Plant Foods Hum.Nutr 2005;60(4):201-218. View Abstract
Rajyalakshmi P, Geervani P. Nutritive value of the foods cultivated and consumed by the tribals of south India. Plant Foods Hum.Nutr 1994;46(1):53-61. View Abstract
Shuttleworth D, Hill S, Marks R, et al. Relief of experimentally induced pruritus with a novel eutectic mixture of local anaesthetic agents. Br J Dermatol 1988;119(4):535-540. View Abstract
Singhal B, Lalkaka J, Sankhla C. Epidemiology and treatment of Parkinson's disease in India. Parkinsonism.Relat Disord 2003;9 Suppl 2:S105-S109. View Abstract
Vadivel V, Janardhanan K. Nutritional and anti-nutritional composition of velvet bean: an under-utilized food legume in south India. Int.J.Food Sci.Nutr. 2000;51(4):279-287. View Abstract
Vadivel V, Janardhanan K. Nutritional and antinutritional characteristics of seven South Indian wild legumes. Plant Foods Hum.Nutr 2005;60(2):69-75. View Abstract
Yang HY. [L-dopa extracted from seeds of Mucuna sempervirens Hemsl as a promoter of fracture healing]. Zhong.Xi.Yi.Jie.He.Za Zhi. 1985;5(7):398-401, 386. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017