Description

Simple

Clinical

Overview

Rauwolfia (Rauwolfia serpentina), also spelled _ravolphia_, is a medicinal plant in the milkweed family. The root of the plant is ground into a powder or sold in tablets or capsules. It is a compound commonly used in Asian medicine, which includes traditional Ayurvedic medicine native to India. The active ingredients in this drug are alkaloids and about 50 have been identified through various studies, although the primary psychoactive components appear to be reserpine, rescinnamine, and deserpidine [10].

This product was approved prior to Jan 1, 1982, but since, has been discontinued due to its propensity for leading to depression [8, 20]. Reserpine is derived from Rauwolfia serpentina, and was commonly used as an antihypertensive agent in the 1950s [12]. Rauwolfia serpentina is also commonly referred to as _Sarpaghanda_ [Read more

Pharmacology

Indication

Rauwolfia alkaloids are indicated in the treatment of hypertension [6]. Rauwolfia alkaloids have been used for relief of symptoms in agitated psychotic states such as schizophrenia; however, use as antipsychotics and s... Read more

Pharmacodynamic

Reserpine is used to treat high blood pressure. It also is used to treat severe agitation in patients with mental disorders. Reserpine is in a class of medications called rauwolfia alkaloids. It works by slowing the activity of the nervous system, causing the heart rate to slow and the blood vessels... Read more

Mechanism of action


Reserpine is an adrenergic blocking agent used to treat mild to moderate hypertension via the disruption of norepinephrine vesicular storage. The antihypertensive actions of Reserpine are a result of its ability to deplete catecholamines from peripheral sympathetic nerve endings. These substances... Read more

Absorption

Mean maximum plasma levels of plasma concentrations after 0.5 mg of Reserpine, administered as two 0.25 mg tablets or as an aqueous solution, peaked after 2.5 hours. The mean peak level was approximately 1.1 ng/ml. Bioavailability of Reserpine, has been reported to be approximately 50% [ Read more

Protein binding

Reserpine is extensively bound (95%) to plasma proteins [15].

Volume of distribution

Information currently not available.

Clearance

Hepatically and renally [18].

Half life

After oral ingestion, an initial half-life of approximately 5 hours is followed by a terminal half-life of approximately 200 hours [16].

Route of elimination

The elimination of reserpine and its metabolites in the feces ranges from 30% after intramuscular administration to
about 60% after oral ingestion, primarily as unmetabolized reserpine, over a 4 day period after the
ingestionof 0.25 mg to 0.50 mg doses. Over the same time period, about 8% of the... Read more

Toxicity

Ld50: 390 mg/kg oral mouse [19].

Reserpine may increase gastric acid secretion and should be used with caution in patients with a history of gastroesophageal reflux disease (GERD) and peptic ulcer. It should also not be administere... Read more

Adverse Effects

Contraindications

Information currently not available.

Food Interactions

    Information currently not available.

Interactions

Type in a drug name to check for interaction with Rauwolfia serpentina root
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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
1-benzylimidazole
1-benzylimidazole may decrease the antihypertensive activities of Rauwolfia serpentina root.
2,5-Dimethoxy-4-ethylamphetamine
2,5-Dimethoxy-4-ethylamphetamine may decrease the antihypertensive activities of Rauwolfia serpentina root.
2,5-Dimethoxy-4-ethylthioamphetamine
2,5-Dimethoxy-4-ethylthioamphetamine may decrease the antihypertensive activities of Rauwolfia serpentina root.
4-Bromo-2,5-dimethoxyamphetamine
4-Bromo-2,5-dimethoxyamphetamine may decrease the antihypertensive activities of Rauwolfia serpentina root.
4-Methoxyamphetamine
4-Methoxyamphetamine may decrease the antihypertensive activities of Rauwolfia serpentina root.
5-methoxy-N,N-dimethyltryptamine
5-methoxy-N,N-dimethyltryptamine may decrease the antihypertensive activities of Rauwolfia serpentina root.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the hypotensive activities of Rauwolfia serpentina root.
Abediterol
Abediterol may decrease the antihypertensive activities of Rauwolfia serpentina root.
Acebutolol
The therapeutic efficacy of Rauwolfia serpentina root can be increased when used in combination with Acebutolol.
Aceclofenac
The therapeutic efficacy of Rauwolfia serpentina root can be decreased when used in combination with Aceclofenac.
Acemetacin
The therapeutic efficacy of Rauwolfia serpentina root can be decreased when used in combination with Acemetacin.
Acepromazine
Acepromazine may decrease the antihypertensive activities of Rauwolfia serpentina root.
Acetylsalicylic acid
The therapeutic efficacy of Rauwolfia serpentina root can be decreased when used in combination with Acetylsalicylic acid.
Adrafinil
Adrafinil may decrease the antihypertensive activities of Rauwolfia serpentina root.
Alclofenac
The therapeutic efficacy of Rauwolfia serpentina root can be decreased when used in combination with Alclofenac.
Aldesleukin
The therapeutic efficacy of Rauwolfia serpentina root can be increased when used in combination with Aldesleukin.
Alfentanil
Alfentanil may decrease the antihypertensive activities of Rauwolfia serpentina root.
Alfuzosin
Alfuzosin may increase the hypotensive activities of Rauwolfia serpentina root.
Aliskiren
The therapeutic efficacy of Rauwolfia serpentina root can be increased when used in combination with Aliskiren.
Alminoprofen
The therapeutic efficacy of Rauwolfia serpentina root can be decreased when used in combination with Alminoprofen.
21 References
  1. 1 . Mehrotra S, Goel MK, Srivastava V, Rahman LU: Hairy root biotechnology of Rauwolfia serpentina: a potent approach for the production of pharmaceutically important terpenoid indole alkaloids. Biotechnol Lett. 2015 Feb;37(2):253-63. doi: 10.1007/s10529-014-1695-y. Epub 2014 Oct 18.PubMed: 25326172
  2. 2 . Madhusudanan KP, Banerjee S, Khanuja SP, Chattopadhyay SK: Analysis of hairy root culture of Rauvolfia serpentina using direct analysis in real time mass spectrometric technique. Biomed Chromatogr. 2008 Jun;22(6):596-600. doi: 10.1002/bmc.974.PubMed: 18205139
  3. 3 . Mehrotra S, Srivastava V, Goel MK, Kukreja AK: Scale-Up of Agrobacterium rhizogenes-Mediated Hairy Root Cultures of Rauwolfia serpentina: A Persuasive Approach for Stable Reserpine Production. Methods Mol Biol. 2016;1391:241-57. doi: 10.1007/978-1-4939-3332-7_17.PubMed: 27108322
  4. 4 . Rauwolfia in the Treatment of Hypertension Link
  5. 5 . Rauwolfia Link
  6. 6 . Rauwolfia serpentina Link
  7. 7 . Human kidney proximal tubule cells are vulnerable to the effects of Rauwolfia serpentina. Link
  8. 8 . Hyserpin/rauwolfia Link
  9. 9 . Reserpine Link
  10. 10 . Review of Rauwolfia Link
  11. 11 . Prospecting for Novel Plant-Derived Molecules of Rauvolfia serpentina as Inhibitors of Aldose Reductase, a Potent Drug Target for Diabetes and Its Complications Link
  12. 12 . Rauwolfia Serpentina in the Treatment of High Blood Pressure A Review of the Literature Link
  13. 13 . Reserpine, Pub chem Link
  14. 14 . Sympatholytic therapy in primary hypertension: a user friendly role for the future Link
  15. 15 . Reserpine Link
  16. 16 . Reserpine, Drugs.com Link
  17. 17 . Differential Network Analysis Reveals Evolutionary Complexity in Secondary Metabolism of Rauvolfia serpentina over Catharanthus roseus Link
  18. 18 . Reserpine Link
  19. 19 . MSDS Link
  20. 20 . Severe depression caused by reserpine Link
  21. 21 . Reserpine-induced Reduction in Norepinephrine Transporter Function Requires Catecholamine Storage Vesicles Link