Lapacho: Benefits, Dosage, Contraindications

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Lapacho, or Pau d'Arco, is a tropical tree belonging to the Bignoniaceae family, primarily originating from South America. This impressive tree, reaching 30 to 40 meters in height, is recognizable by its purple flowers and extremely insect and fungus-resistant wood. Lapacho is particularly valued for its inner bark, which contains its precious active ingredients. Used for centuries by indigenous populations, especially in traditional South American medicine, lapacho was used to treat various ailments, such as infections, fever, and inflammatory disorders. It was often prepared as a decoction. The main bioactive compounds in lapacho include naphthoquinones, such as lapachol, and anthraquinones, recognized for their antimicrobial and antitumor activities. Quercetin, an antioxidant flavonoid, is also present in its bark. These compounds potentially provide lapacho with beneficial properties for supporting the immune system, combating fungal and bacterial infections, and inhibiting certain tumor cells. Today, lapacho is being researched for its applications in oncology, particularly in the treatment of certain cancers, as well as its anti-inflammatory and antibacterial effects. Available in the form of decoction, powder, or extract, it is increasingly found in the dietary supplement aisles.

Other name(s) 

Pau d'arco

Scientific name(s)

Tabebuia impetiginosa

Family or group: 

Plants

Active ingredients:

Anthraquinones

Flavonoids

Lapachol


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


Dysmenorrhea
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A small open study in adults with dysmenorrhea showed that a daily intake of 1050 mg of Pau d'Arco combined with 75 mg of rutin for 8 weeks could reduce the intensity of pain by 41% from baseline. However, these results are limited by the absence of a comparator group and the frequent use of other pain medications, such as non-steroidal anti-inflammatory drugs.

Posologie

posologieOral: Bark

posologie1050 mg

formulationDry extract


Synergies


Cancer
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The anticancer effects of lapacho are primarily attributed to its active compounds, including lapachol and beta-lapachone. Research shows that these compounds can interfere with DNA replication and RNA synthesis, thus inhibiting the proliferation of cancer cells. In clinical settings, less toxic formulations, such as derivatives of lapachol, are being studied to harness these promising anticancer properties. However, to date, no clinical study has confirmed the efficacy of lapacho in the treatment of cancers.

Posologie

posologieOral: Bark

posologie1 g

formulationAqueous decoction, dry extract


Parasitic Infections, Mycoses
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The most popular use of Lapacho in the Amazon is its traditional use as a remedy against infections, notably parasitic and fungal infections. It is often used in the form of a decoction to treat candidiasis, and intestinal infections like amebiasis. This use is supported by its well-documented antimicrobial properties, attributed to naphthoquinones such as lapachol and beta-lapachone. Lapacho is also used in traditional medicine to treat skin fungal infections. Its extracts, particularly aqueous, dichloromethane and methanolic extracts, show significant antifungal activity.

Posologie

posologieTopical use, oral: Bark

posologie1 g

formulationAqueous decoction


Properties


Anticancer

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Lapacho, thanks to its active compounds like lapachol and beta-lapachone, inhibits the activity of topoisomerase I and interferes with DNA replication, thus slowing down the proliferation of cancer cells. These mechanisms have shown efficacy against cancers such as breast, lung, and prostate in preclinical studies, although human use is limited by its toxicity.

Usages associés

Cancer

Antibacterial

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The anthraquinones in lapacho, like anthraquinone-2-carboxylic acid, show strong activity against Helicobacter pylori and Clostridium paraputrificum. Beta-lapachone, more effective than lapachol, acts against pathogens such as Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), and various species of Streptococcus and Bacillus. Its mechanism includes interference with cellular respiratory mechanisms.

Usages associés

Parasitic Infections

Antifungal

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Lapachol acts by disrupting the cell membranes of fungi. Its effectiveness has been demonstrated against Candida albicans, Cryptococcus neoformans, and other pathogenic species, with activity comparable to amphotericin B.

Usages associés

Parasitic Infections

Anti-inflammatory

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Cyclopentene derivatives and compounds like beta-lapachone suppress inflammatory responses by blocking the production of prostaglandin E2 and NO via the inhibition of COX-2 enzymes and NO synthase expression. They also reduce pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) and macrophage-mediated responses. This action has been confirmed by animal studies on carrageenan-induced edema models.

Usages associés

Dysmenorrhea


Safety dosage

Adult: 1000 mg (dry extract)

For dysmenorrhea: 1050 mg of Pau d'Arco combined with 75 mg of rutin per day for 8 weeks was well-tolerated, with no serious side effects reported. High doses of lapachol (>1.5 g/day) may cause significant gastrointestinal toxicity and increase the risk of bleeding, especially in cancer patients. Available formulations: Capsules, tablets, liquid extracts, powder, and tea. Some products are standardized to 3% naphthoquinones, but these indications are not scientifically validated.


Interactions

Médicaments

Antiplatelet agents/Anticoagulant: moderate interaction

Lapacho could increase the risk of bleeding when combined with anticoagulant or antiplatelet medications or supplements. In vitro studies show it reduces platelet aggregation and could interfere with vitamin K, an essential factor in coagulation. These effects are primarily attributed to lapachol, its active compound. A clinical study indicates that at doses above 1.5 g per day, lapachol significantly increases the risk of bleeding.

Plantes ou autres actifs

Antiplatelet agents/Anticoagulant: moderate interaction

Lapacho might also interact with herbs and supplements that have anticoagulant or antiplatelet effects, such as ginkgo biloba, turmeric, or garlic, increasing the risk of bleeding.


Contraindications

Pregnant women: prohibited

Animal studies show teratogenic and abortive effects related to lapachol. Topical use is also discouraged due to a lack of reliable data.

Breastfeeding women: prohibited

No reliable information available, avoid use.