Graviola (Annona muricata)
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.
Acetogenins, Annona bonplandiana,Annona cearensis, Annona cherimola,Annona macrocarpa, Annonaceae, annonacin, anona (Tigrigna), anona de broquel (Spanish), anona de puntitas (Spanish), anona espinhosa (Portuguese), araticum do grande (Portuguese), araticu-ponhé (Portuguese), atti (Filipino), Brazilian cherimoya, Brazilian paw paw, cabeza de negro (Spanish), cachiman épineux (French), cachimantier (French), catoche (Spanish), catuche (Spanish), coraçao-de-rainha (Portuguese), coronin, corossel (French), corossol (French), corossol épineux (French), corossolier, curassol (Portuguese), custard apple, durian belanda (Malay), durian benggala (Malay), durian blanda, durian maki (Malay), durian makkah (Malay), goniothalamicin, grand corossol (French), guanaba (Spanish), guanábana (Spanish), guanabana seed, guanábano, Guanabanus muricatus, guanavana, guayabano (Filipino), huanaba (Spanish), isoannonacin, jaca de pobre (Portuguese), jaca do pará (Portuguese), khan thalot (Lao (Sino-Tibetan)), khièp thét (Lao (Sino-Tibetan)), kowól (Creole), llabanos (Filipino), mang câù xiêm (Vietnamese), mstafeli (Swahili), nangka belanda (Javanese), nangka blanda, nangka londa, nangka seberng (Indonesian), pinha azeda (Portuguese), rian-nam (Thai), sappadillo, saua sap (Creole), Sauersack (German), seri kaya belanda (Malayan), sinini, sirsak (Javanese), sorsaka (Dutch), soursap (Dutch), soursop, Stachelannone (German), Stachlinger (German), sweetsop, thu-rian-khack (Thai), thurian-thet (Thai), tiep banla (Cambodian or Khmer), tiep barang (Cambodian or Khmer), toge-banreisi (Japanese), tropical fruit, zapote agrio (Spanish), zapote de viejas (Spanish), zunrzak (Dutch), zuurzak (Dutch).
Graviola, or soursop, is a small, upright evergreen tree that is native to tropical South and North America. The tree produces a large, heart-shaped, edible fruit that is sold commercially.
All parts of the graviola tree, including the fruit, juice, crushed seeds, bark, leaves, and flowers, are used in herbal medicine systems in the tropics. Graviola is mainly used as an alternative treatment for parasitic infections and cancer. It has also been used as a sedative and as a treatment for spasms. Extracts of the leaf, root, stem, and bark of graviola may also be useful to control snail species that carry schistosomiasis (a parasite).
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.
No available studies qualify for inclusion in the evidence table.
*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.
Abscesses, alcohol-induced hangover, analgesic (pain reliever), antibiotic, antidote to poisons, antiparasitic (molluscicidal, antiprotozoal), arthritis, asthma, astringent, bronchitis, calming, cancer, cardiac conditions (asthenia), carminative, catarrh, cathartic (laxative), childbirth, cough, colitis, colic, convulsions, diabetes, diarrhea, diuretic, dysentery (intestinal infection), eczema, edema (swelling), emetic (causes vomiting), fever, galactagogue (breast milk stimulant), gall bladder disorders, hematuria (blood in the urine), herpes simplex, hypertension (high blood pressure), incision wounds, indigestion, infections, inflammation, influenza, insecticide, leprosy, lice, liver disorders, malaria, mouth sores, nervousness, neuralgia (nerve pain), palpitations, parasites and worms, rashes, rheumatism, ringworm, sedative, skin disorders, sleep aid, styptic, tonic, tranquilizer, tumor, ulcer, urethritis (inflammation of the urethra), vomiting, wound healing.
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 safe or effective dose for graviola.
Based on historical use, an infusion composed of 150 milliliters of boiling water poured over 2 grams of dried graviola leaf and stem steeped for 5-10 minutes has been taken three times daily between meals. Alternatively, 2-4 milliliters of a 1:2 tincture has been taken three times daily.
For wound healing, based on historical use, the flesh of a graviola fruit has been applied as a poultice unchanged for three days to draw out chiggers and to speed healing.
Children (under 18 years old)
There is no proven safe or effective dose for graviola 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 sensitivity to graviola.
Side Effects and Warnings
Based on historical use and available research, it appears that graviola is well tolerated in amounts normally consumed in the diet. High doses of graviola may cause gastrointestinal upset, low blood pressure, neuronal dysfunction leading to neurological disorders and myeloneuropathy (disease of the myelin sheath) of the optic nerve.
Avoid use in patients with low blood pressure due to possible blood pressure-lowering effects.
Use cautiously in patients with gastrointestinal disorders due to the risk of gastrointestinal upset.
Use cautiously in patients taking antidepressants, as graviola contains constituents which may also have antidepressant effects.
Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.
Use cautiously with antibiotics, antifungals, anticancer agents, antiparasitic agents, antivirals, vasodilators, and agents used to treat Parkinson's disease.
Pregnancy and Breastfeeding
Graviola is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.
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
Graviola may lower blood pressure. Caution is advised in patients taking medications that lower blood pressure.
Graviola may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
Graviola may have additive effects with antibiotics, antidepressants, antifungals, anticancer agents, antiparasitic agents, antivirals, and vasodilators.
Graviola may interfere with drugs used to treat Parkinson's disease.
Interactions with Herbs and Dietary Supplements
Graviola may lower blood pressure. Caution is advised in patients taking herbs or supplements that lower blood pressure.
Graviola may increase the amount of drowsiness caused by some herbs or supplements.
Graviola may have additive effects with antibacterials, antidepressants, antifungals, anticancer herbs, antiparasitic herbs, antivirals, and vasodilators.
Graviola may interfere with herbs and supplements used to treat Parkinson's disease.
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.
Caparros-Lefebvre, D and Elbaz, A. Possible relation of atypical parkinsonism in the French West Indies with consumption of tropical plants: a case-control study. Caribbean Parkinsonism Study Group. Lancet 7-24-1999;354(9175):281-286. View Abstract
Enweani, IB, Esebelahie, NO, Obroku, J, et al. Use of soursop and sweetsop juice in the management of diarrhoea in children. J Diarrhoeal Dis Res 1998;16(4):252-253. View Abstract
Lannuzel, A, Hoglinger, GU, Verhaeghe, S, et al. Atypical parkinsonism in Guadeloupe: a common risk factor for two closely related phenotypes? Brain 2007;130(Pt 3):816-827. View Abstract
N'Gouemo, P. et al. Effects of ethanol extract of Annona muricata on pentylenetetrazol-induced convulsive seizures in mice. Phytother Res 1997;11(3):243-245.
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