DRUGS AND SUPPLEMENTS

Periwinkle (Vinca spp.)

March 22, 2017

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Periwinkle (Vinca spp.)

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.

Related Terms

  • Apovincamine, Catharanthus alkaloids, Catharanthus roseus, Cavinton®, cezayirmeneksesi (Turkish), common periwinkle, creeping myrtle, cytokinin, deacetylvinblastine, deacetylvinblastine amide, Devincan™, ethyl apovincaminate, ethylene, evergreen, kavinton, lesser periwinkle, Madagascar periwinkle, myrtle, Oncovin®, pervincamine, Rgh-4405, rose periwinkle, small periwinkle, Tcv-3B, terpenoid indole alkaloids, vinblastine, vinca alkaloids, Vinca balcanica, Vinca difformis, Vinca heracea, Vinca major, Vinca minor, Vincae minoris herba, vincamine, vincapervinc, vincristine, vincristine-vinblastine, vindesine, vinorelbin, vinorelbine, vinpocetin, vinpocetine, vinRx, vintoperol, wintergreen.

  • Note: The use of periwinkle as a dietary supplement is not recommended, because it contains pharmacologically active vinca alkaloids, which may cause damage to the liver, kidneys, and nerves, as well as death.

Background

  • Periwinkle (Vinca spp.) and Madagascar periwinkle (Catharanthus spp.) are both members of the Apocynaceae family. Madagascar periwinkle was formerly classified as a Vinca species (Vinca rosa) but is now classified as a separate species. The two are similar in appearance and are both commonly referred to as "myrtle."

  • Lesser periwinkle is commonly cultivated for use as ornamental ground cover, though it is considered an invasive weed in some areas of North America and Australia. Madagascar periwinkle is also commonly used as an ornamental plant but thrives only in a subtropical environment where temperatures do not fall below 41ºF (5ºC).

  • Both species produce alkaloids that have been studied and used as a treatment for treatment of a wide variety of conditions, including diabetes, cancer, hypertension (high blood pressure), and stroke.

  • The use of periwinkle as a dietary supplement is not recommended, because it contains vinca alkaloids, which may cause damage to the liver, kidneys, and nerves, as well as death.

Scientific Evidence

Uses

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.

Grade*

Cancer

Although this has not been well studied in humans, the anticancer potential for Madagascar periwinkle (Catharanthusroseus) extract has been recognized, and several bioactive alkaloids have been identified and are currently under investigation for cancer treatment.

C

Dementia

Periwinkle and compounds found in periwinkle have been used to promote brain health and function. Further research is required.

C

Hodgkin's disease

Although this has not been well studied in humans, the anticancer potential for Madagascar periwinkle (Catharanthusroseus) extract has been recognized, and several bioactive alkaloids have been identified and are currently under investigation for treatment of Hodgkin's disease.

C

Idiopathic thrombocytopenic purpura

Compounds found in periwinkle have been found to be useful in patients with idiopathic thrombocytopenia (low platelet count). However, studies with the periwinkle plant are lacking. Additional research is needed.

C

Stroke

Compounds found in periwinkle have been found to dilate the blood vessels and decrease blood clotting. Thus, they may be of interest as potential treatments for stroke. Additional research is needed.

C

*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).

Tradition/Theory

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.

  • Alzheimer's disease, angina, antibacterial, antiplatelet, astringent, bile flow stimulant, blood circulation, blood disorders, blood purification, breast cancer (metastatic breast cancer), cardiac ischemia, cerebral ischemia, cognitive function, colitis, cough, dementia (prevention), diabetes mellitus, diarrhea, diuretic, edema, eye disorders, heart disease, hypertension, fever, immune function, infections, inflammation, insect bites and stings, intestinal disorders and inflammation, leukemia, liver disease, malaria, memory enhancement, menstrual pain, neuroprotection, non-Hodgkin's lymphoma, non-small cell lung cancer, ocular disorders (eye disorders), parasites (leishmaniasis), peripheral vascular disease, rheumatism, scurvy, sedative, sore throat, tonsillitis, toothache, vaginal discharge, venereal disease, wound healing.

Dosing

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)

  • For acute phase of stroke, 60 milligrams of pervincamine (a compound in periwinkle), infused in the vein, has been used daily for five days.

  • For dementia, 30 milligrams of vincamine (a compound in periwinkle) has been taken by mouth twice daily for 12 weeks.

Children (under 18 years old)

  • There is no proven safe or effective dose for periwinkle in children.

Safety

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.

Allergies

  • Avoid with known allergy/hypersensitivity to periwinkle (Vinca spp.), Madagascar periwinkle (Catharanthus spp.), their constituents, or members of the Apocynaceae family.

Side Effects and Warnings

  • Side effects of periwinkle, or compounds isolated from periwinkle, may include bacterial infections, bone marrow depression, cancer, gastrointestinal side effects (upset, vomiting, diarrhea, ulcer), kidney damage, liver damage, nerve damage, pancytopenia (decreased blood cells), peripheral neuropathy, rash, skin flushing, and urinary tract infections.

  • Periwinkle may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

  • Periwinkle may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be altered in the blood and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

  • Periwinkle may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.

  • Use compounds from lesser periwinkle cautiously in patients taking blood vessel dilating agents or those with blood disorders.

  • Avoid with known allergy/hypersensitivity to periwinkle (Vinca spp.), Madagascar periwinkle (Catharanthus spp.), their constituents, or members of the Apocynaceae family.

  • Avoid in pregnant women, as compounds found in periwinkle may increase the risk of abortion or birth defects.

Pregnancy and Breastfeeding

  • Avoid in pregnant women, as compounds found in periwinkle may increase the risk of abortion or birth defects.

Interactions

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

  • Periwinkle may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

  • Periwinkle may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be altered in the blood and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

  • Periwinkle may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.

  • Periwinkle may also interact with agents that suppress the immune system, anticancer agents, antidepressant agents, agents that are toxic to the liver, and blood vessel dilating agents.

Interactions with Herbs and Dietary Supplements

  • Periwinkle may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking herbs and supplements that may increase the risk of bleeding. Dosing adjustments may be necessary.

  • Periwinkle may interfere with the way the body processes certain herbs and supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of these agents may be altered in the blood and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

  • Periwinkle may cause low blood pressure. Caution is advised in patients taking herbs or supplements that lower blood pressure.

  • Periwinkle may also interact with herbs or supplements that suppress the immune system, anticancer agents, antidepressant agents, herbs and supplements that are toxic to the liver, and blood vessel dilating herbs and supplements.

Author Information

  • 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).

References

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.

  1. Csomor, K. and Karpati, E. Effect of vintoperol on platelet aggregation and experimental thrombosis. Arzneimittelforschung. 1994;44(1):36-40. View Abstract

  2. Filippini, R., Caniato, R., Piovan, A., et al. Production of anthocyanins by Catharanthus roseus. Fitoterapia 2003;74(1-2):62-67. View Abstract

  3. Foldi, M., Obal, F., and Szeghy, G. [On the effect of Devincan (Vinca minor alkaloid) on the EEG and the fundus oculi pattern in patients with cerebral sclerosis]. Med.Welt. 9-11-1965;37:2122-2124. View Abstract

  4. Ghosh, D., Roy, I., Chanda, S., et al. Allergy to periwinkle pollen (Catharanthus roseus G. Don.). Ann.Agric.Environ.Med. 2007;14(1):39-43. View Abstract

  5. Jordan, M. A. and Wilson, L. Microtubules as a target for anticancer drugs. Nat.Rev.Cancer 2004;4(4):253-265. View Abstract

  6. Kidd, P. M. A review of nutrients and botanicals in the integrative management of cognitive dysfunction. Altern.Med.Rev. 1999;4(3):144-161. View Abstract

  7. Krainer, M., Tomek, S., Elandt, K., et al. A prospective, open label, randomized phase II trial of weekly docetaxel versus weekly vinorelbine as first line chemotherapy in patients with androgen independent prostate cancer. J.Urol. 2007;177(6):2141-2145. View Abstract

  8. Leveque, D. and Jehl, F. Clinical pharmacokinetics of vinorelbine. Clin.Pharmacokinet. 1996;31(3):184-197. View Abstract

  9. Mans, D. R., da Rocha, A. B., Schwartsmann, G. Anti-cancer drug discovery and development in Brazil: targeted plant collection as a rational strategy to acquire candidate anti-cancer compounds. Oncologist. 2000;5(3):185-198. View Abstract

  10. Nakabayashi, M., Ling, J., Xie, W., et al. Response to vinorelbine with or without estramustine as second-line chemotherapy in patients with hormone-refractory prostate cancer. Cancer J. 2007;13(2):125-129. View Abstract

  11. Osujih, M. Exploration of the frontiers of tradomedical practices: basis for development of alternative medical healthcare services in developing countries. J.R.Soc.Health 1993;113(4):190-194. View Abstract

  12. Rosazza, J. P., Duffel, M. W., el-Marakby, S., et al. Metabolism of the Catharanthus alkaloids: from Streptomyces griseus to monoamine oxidase B. J.Nat.Prod. 1992;55(3):269-284. View Abstract

  13. Szatmari, S. Z., Whitehouse, P. J. Vinpocetine for cognitive impairment and dementia. Cochrane.Database.Syst.Rev. 2003;(1):CD003119. View Abstract

  14. Verma, S., Wong, N. S., Trudeau, M., et al. Survival differences observed in metastatic breast cancer patients treated with capecitabine when compared with vinorelbine after pretreatment with anthracycline and taxane. Am.J.Clin.Oncol. 2007;30(3):297-302. View Abstract

  15. Wu, M. L., Deng, J. F., Wu, J. C., et al. Severe bone marrow depression induced by an anticancer herb Cantharanthus roseus. J.Toxicol.Clin.Toxicol. 2004;42(5):667-671. 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.

Updated:  

March 22, 2017