yohimbe bark


yohimbine

(yoh-him-been) yohimbine,

yohimbe bark

(trade name),

Pausinystalia yohimbe

(trade name),

Corynanthe johimbi

(trade name)

Classification

Therapeutic: erectile dysfunction agents
Sexual dysfunction.

Action

Yohimbine causes genital blood vessel dilation, nerve impulse transmission to genital tissue, and increased reflex excitability in the sacral region of the spinal cord. It works primarily through alpha 2–adrenergic receptor blockade and also has monoamine oxidase inhibiting, calcium channel blocking, and serotonin receptor blocking effects.

Therapeutic effects

Improved sexual function.

Pharmacokinetics

Absorption: UnknownDistribution: UnknownMetabolism and Excretion: UnknownHalf-life: Unknown

Time/action profile

ROUTEONSETPEAKDURATION
POunknownunknownunknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity.Angina.Anxiety and depression.Hypotension.Heart disease.Kidney disease.Liver disease.Pregnancy and lactation.Children.Use Cautiously in: Benign prostatic hyperplasia.Diabetes.Hypertension.Post-traumatic stress disorder.Schizophrenia.Concomitant use with consumption of tyramine-containing foods can lead to hypertensive crisis.Excessive doses without medical supervision can cause significant toxicity.

Adverse Reactions/Side Effects

Cardiovascular

  • hypertension
  • tachycardia
  • cardiac failure (high doses)

Central nervous system

  • excitation
  • headache
  • tremor
  • anxiety
  • dizziness
  • insomnia

Dermatologic

  • rash

Fluid and Electrolyte

  • fluid retention

Gastrointestinal

  • nausea
  • vomiting

Genitourinary

  • urinary frequency

Musculoskeletal

  • paralysis (high doses)

Miscellaneous

  • hypersensitivity reactions

Respiratory

  • respiratory depression (high doses)

Interactions

Additive effects with monoamine oxidase inhibitors. Antagonistic effects with clonidine, guanabenz, and other antihypertensives. Increased risk of alpha 2–adrenergic antagonism with phenothiazines. Increased risk of hypertensive crisis with stimulants. May increase or decrease blood pressure withtricyclic antidepressants. Concomitant use with caffeine-containing herbsand ephedracan cause hypertensive crisis.Oral (Adults) 15–30 mg/daily. Doses up to 100 mg/day have been used but with significantly more side effects.

Availability

Capsules: 2.5 mg, 3 mg

Nursing implications

Nursing assessment

  • Assess frequency and severity of erectile dysfunction.

Potential Nursing Diagnoses

Sexual dysfunction (Indications)

Implementation

  • Oral: May increase bioavailability by taking on an empty stomach.

Patient/Family Teaching

  • Instruct patient to take as recommended.
  • Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications, especially stimulants.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

  • Male erection sufficient to allow intercourse.