Related Terms

• American nightshade, American spinach, bear's grape, branching phytolacca, cancer jalap, chongras, coakum, coakum-chorngras, cokan, crowberry, endod, fitolaca, garget, hierba carmine, inkberry, jalap, kermesbeere, mitogenic lectins, monodesmosidic serjanic acid saponin, monodesmosidic spergulagenic acid saponin, PAP, phytolacain (G, R) Phytolacca acinosa, Phytolacca acinosa Esculenta, Phytolacca americana, phytolacca berry, Phytolacca decandra, Phytolacca dioica, Phytolacca dodecandra (Endod), Phytolacca icosandra, Phytolacca octandra, Phytolacca rigida, Phytolaccaceae (family), phytolaccagenin, phytolaccatoxin, phytolaccosides, pigeonberry, pocan, poke, poke root, poke salad, pokeberry, pokeweed antiviral protein (PAP), pokeweed berry, proteinaceous mitogens, raisin d'amérique, red-ink plant, red plant, red weed, resin, saponin glycosides, scoke, skoke, tannin, teinturiére, TXU-PAP, Virginian poke.

Background

• In folk medicine, pokeweed leaves have been used for rheumatism, arthritis, emesis (vomiting) and purging. Unsubstantiated reports describe the toxicity of pokeweed root and berries, which may be due to the saponin content of the plant.

• One derivative of pokeweed, pokeweed antiviral protein (PAP) from the spring leaves of Phytolacca Americana, shows promising therapeutic effects. Interest in PAP is growing due to its use as a potential anti-HIV agent. However, the clinical use of native PAP is limited due to inherent difficulties in obtaining sufficient quantities of homogeneously pure active PAP without batch-to-batch variation from its natural resource.

• The United Kingdom allows pokeweed in medicinal products where toxic constituents are absent and the product adheres to mandated limits. Ongoing research is investigating the use of pokeweed for the flu, HSV-1, and polio.

Scientific Evidence

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.

• Abortifacient (induces abortion), abscesses (mammary), acne, anthrax, antimicrobial, antiviral, arthritis, cancer, contraception, dysmenorrhea (painful menstruation), earache, edema, emetic (induces vomiting), fatigue, fertility, food uses, gonorrhea, headache, HIV, inflammation (upper and lower respiratory tract), intestinal worms, laryngitis, laxative, leeches, leukemia, lymphadenitis (inflammation of lymph nodes), mastitis (inflammation of the breast), pruritus (severe itching), purgative (laxative), rabies, rheumatism, ringworm, scabies, schistosomiasis (tropical parasitic infection), skin disorders, stimulant (cardiac), skin ailments (sycosis), syphilis (STD), tonsillitis.

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)

• There is no proven safe or effective dose for pokeweed. Traditionally, 1 gram of dried pokeweed root has been used as an emetic (induces vomiting) or purgative (laxative). For immune stimulation or rheumatism, 60 to 100 milligrams daily of the root and berries has been used.

Children (under 18 years old)

• There is no proven safe or effective dose for pokeweed in children, and use in not recommended.

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 in individuals with a known allergy or hypersensitivity to pokeweed or its constituents.

Side Effects and Warnings

• All parts of the pokeweed plant are considered toxic. Pokeweed antiviral protein (PAP) appears to have fewer side effects, which include transient elevation of the liver enzyme alanine aminotransferase. Use PAP cautiously in patients with liver disorders. Use PAP cautiously and only under the guidance of a medical professional for HIV. Dosing and efficacy are unclear based on currently available literature.

• When taken by mouth, all parts of the pokeweed plant may cause nausea, vomiting, cramping, abdominal pain, diarrhea, hypotension (low blood pressure), blood abnormalities, burning sensations in the mouth and throat, weakness, bloody emesis (vomiting), bloody diarrhea, salivation, respiratory failure, difficulty breathing, tachycardia (fast heart rate), Mobitz type I heart block, transient blindness, urinary incontinence, spasm, convulsion, severe thirst, somnolence (sleepiness/drowsiness), or death.

• Protective gloves should be used to handle the plant because when the root comes in contact with broken skin or is ingested, pokeweed may cause changes in the blood. Use pokeweed cooked leaves cautiously in adult patients, as only cooked early spring leaves are considered nontoxic.

Pregnancy and Breastfeeding

• Pokeweed is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. The berry may have uterine stimulant and abortifacient (abortion inducing) effects.

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

• Pokeroot may lower blood pressure and thus increase the action of antihypertensive herbs and supplements. Patients taking blood pressure lowering herbs should consult with a qualified healthcare professional, including a pharmacist.

• Pokeweed root may have anti-inflammatory effects, and therefore may interact additively with anti-inflammatory drugs.

• Pokeweed may have antiviral effects, and therefore may interact with antiviral medications.

• Pokeweed may cause Mobitz type I heart block, and may therefore interact with cardiac glycosides, such as digoxin or digitoxin.

• Theoretically, pokeweed may have diuretic activity, and may interact additively with other diuretics. Caution is advised.

• Phytolaccosides from Phytolacca americana may increase the intestinal absorption of hydrophilic drugs, or heparin, having difficulty crossing the intestinal epithelium. Consult with a qualified healthcare professional, including a pharmacist, for a full list of interactions.

Interactions with Herbs and Dietary Supplements

• Pokeroot may lower blood pressure and thus increase the action of antihypertensive herbs and supplements. Patients taking blood pressure lowering herbs should consult with a qualified healthcare professional, including a pharmacist.

• Pokeweed root may have anti-inflammatory effects, and therefore may interact additively with herbs and supplements with anti-inflammatory effects.

• Pokeweed may have antiviral effects, and therefore may interact with antiviral herbs.

• Pokeweed may cause Mobitz type I heart block, and may therefore interact with cardiac glycoside herbs, such as foxglove.

• Theoretically, pokeweed may have diuretic activity, and may interact additively with other diuretics. Caution is advised.

• Phytolaccosides from Phytolacca americana may increase the intestinal absorption of hydrophilic herbs having difficulty crossing the intestinal epithelium. Consult with a qualified healthcare professional, including a pharmacist, for a full list of interactions.

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. Barkhordari A, Stoddart RW, McClure SF, McClure J. Lectin histochemistry of normal human lung. J Mol.Histol. 2004;35(2):147-156. View Abstract

2. Cho SY, Sim JS, Kang SS, et al. Enhancement of heparin and heparin disaccharide absorption by the Phytolacca americana saponins. Arch Pharm Res 2003;26(12):1102-1108. View Abstract

3. D'Cruz OJ, Uckun FM. Pokeweed antiviral protein: a potential nonspermicidal prophylactic antiviral agent. Fertil.Steril. 2001;75(1):106-114. View Abstract

4. D'Cruz OJ, Waurzyniak B, Uckun FM. Mucosal toxicity studies of a gel formulation of native pokeweed antiviral protein. Toxicol.Pathol. 2004;32(2):212-221. View Abstract

5. Erko B, Abebe F, Berhe N, et al. Control of Schistosoma mansoni by the soapberry Endod (Phytolacca dodecandra) in Wollo, northeastern Ethiopia: post-intervention prevalence. East Afr.Med J 2002;79(4):198-201. View Abstract

6. Esser KB, Semagn K, Wolde-Yohannes L. Medicinal use and social status of the soap berry endod (Phytolacca dodecandra) in Ethiopia. J Ethnopharmacol. 2003;85(2-3):269-277. View Abstract

7. Ndekha A, Hansen EH, Molgaard P, et al. Community participation as an interactive learning process: experiences from a schistosomiasis control project in Zimbabwe. Acta Trop. 2003;85(3):325-338. View Abstract

8. Rajamohan F, Doumbia SO, Engstrom CR, et al. Expression of biologically active recombinant pokeweed antiviral protein in methylotrophic yeast Pichia pastoris. Protein Expr.Purif. 2000;18(2):193-201. View Abstract

9. Rau E. Treatment of acute tonsillitis with a fixed-combination herbal preparation. Adv.Ther 2000;17(4):197-203. View Abstract

10. Schlick J, Dulieu P, Desvoyes B, et al. Cytotoxic activity of a recombinant GnRH-PAP fusion toxin on human tumor cell lines. FEBS Lett. 4-28-2000;472(2-3):241-246. View Abstract

11. Sussner U, Abel G, Schulte R, Kreis W. Isolation and characterisation of a cysteine protease (phytolacain G), from Phytolacca americana roots. Planta Med 2004;70(10):942-947. View Abstract

12. Tadeg H, Mohammed E, Asres K, et al. Antimicrobial activities of some selected traditional Ethiopian medicinal plants used in the treatment of skin disorders. J Ethnopharmacol. 8-22-2005;100(1-2):168-175. View Abstract

13. Treyvaud V, Marston A, Dyatmiko W, et al. Molluscicidal saponins from Phytolacca icosandra. Phytochemistry 2000;55(6):603-609. View Abstract

14. Woldeamanuel Y, Abate G, Chryssanthou E. In vitro activity of Phytolacca dodecandra (Endod) against dermatophytes. Ethiop.Med J 2005;43(1):31-34. View Abstract

15. Yang WH, Wieczorck M, Allen MC, et al. Cytotoxic activity of gonadotropin-releasing hormone (GnRH)-pokeweed antiviral protein conjugates in cell lines expressing GnRH receptors. Endocrinology 2003;144(4):1456-1463. View Abstract