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Periwinkle

Scientific Name(s): Catharanthus roseus G. Don.
Common Name(s): Cape periwinkle, Church-flower, Madagascar periwinkle, Magdalena, Myrtle, Old maid, Periwinkle, Ram-goat rose, Red periwinkle, Rosy periwinkle, Vinca

Medically reviewed by Drugs.com. Last updated on Aug 22, 2023.

Clinical Overview

Use

Periwinkle alkaloids have been used to treat certain cancers; however, use of the plant for this purpose is not recommended without consulting a health care provider. Periwinkle has been studied for potential antimicrobial and antiprotozoal applications, as well as for use in diabetes and wound healing; however, clinical trial data are lacking to recommend use for these indications.

Dosing

There are no recent clinical data to support specific dosing recommendations for periwinkle. Traditional doses have included 10 leaves and 10 flowers boiled in water as a tea, or 9 pink flowers in 0.5 L of water for 3 hours ("solar tea") sipped throughout the day. Preparations of the pure alkaloids vincristine and vinblastine are available, with associated therapeutic dosing recommendations.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Avoid use. Abortifacient effects have been documented.

Interactions

None well documented.

Adverse Reactions

Clinical information is lacking.

Toxicology

Severe, systemic adverse events are associated with use of the periwinkle alkaloids vincristine and vinblastine.

Scientific Family

Botany

Periwinkle, first described in Madagascar, is a perennial herb that grows up to 1 m in height. It is highly branched and develops a woody base, with flowers that can bloom throughout the year depending on the climate. The flowers are often bred for their unique colors, ranging from white to green-yellow and lavender. The seed pod dries, splits, and releases numerous tiny seeds. The stem produces a milky sap that is rich in indole alkaloids. Synonyms include Lochnera rosea Reichb., Vinca rosea L., and Ammocallis rosea Small. The related plant Vinca minor (common periwinkle, myrtle) is used as a ground cover.Duke 2002, Loh 2008, USDA 2020, van Der Heijden 2004

History

The periwinkle plant was introduced in Europe during the mid-1700s and was cultivated as an ornamental. It grows throughout the world, and periwinkle plantations have been established on continents with warmer climates. The plant has been widely used in tropical folk medicine. Decoctions of the plant have been used to treat ocular inflammation, diabetes, hemorrhage, insect stings, and cancers.Duke 2002, Lans 2006, Ochwang'i 2014, Semenya 2013, van Der Heijden 2004

Chemistry

C. roseus synthesizes some of the most structurally, chemically, and biologically active phytomolecules. These monoterpenoid indole alkaloids have a wide range of pharmaceutical activities.Sharma 2020 Approximately 130 terpenoid indole alkaloids are found in the plant.Almagro 2015, van Der Heijden 2004 The concentration of alkaloids varies with the region of harvest and plant part. The most well-known of the vinca alkaloids derived from C. roseus are vinblastine and vincristine, which are widely used antineoplastic agents. Identification of other alkaloids with cytotoxic potential is ongoing.Wang 2012, Zhang 2013 The 2 alkaloids vindogentianine and vindoline have exhibited hypoglycemic activities.Goboza 2019, Tiong 2015

The aqueous plant extract is rich in phenolic compounds, including caffeoylquinic acid and flavonoids with antioxidant potential. The leaves also contain complex volatile oils.Ferreres 2008, Pereira 2009 Endophytic fungi (eg, Talaromyces radicus, Nigrospora sphaerica), which have been isolated from C. roseus, also produce vincristine and vinblastine.Munoz-Rojas 2017, Palem 2015

Uses and Pharmacology

Antimicrobial/Antifungal activity

Animal and in vitro data

In vitro studies suggest C. roseus extracts possess antimicrobial effects.Almagro 2015, Nayak 2007 When ethanolic extracts from different parts of C. roseus (eg, leaves, stems, roots, flowers) were tested for antibacterial activity, leaf extracts showed significantly higher activity, suggesting that bioactive compounds of C. roseus can potentially be exploited as antibacterial agents; activity has not been attributed to a single alkaloid.Almagro 2015 In other in vitro studies, hexane and ethyl acetate extracts were active against all tested bacteria except Salmonella typhi.Bakht 2015, Nayak 2007 Green ZnO nanoparticles from C. roseus have demonstrated antimicrobial activity.Gupta 2018 Antifungal activity of C. roseus has also been documented in vitro and in vivo.Naz 2015 The ethyl acetate extracts of C. roseus also showed concentration-dependent, broad-spectrum antimicrobial activity against various bacteria, yeast, and fungi, with minimum inhibitory concentrations ranging from 7.8 to 250 mcg/mL.Sudharshana 2018 The C. roseus plant has been used in the biosynthesis of silver nanoparticles (AgNPs)Mukunthan 2011; in a study in which biosynthesis of AgNPs from C. roseus leaf extracts was conducted, synthesized AgNPs exhibited strong in vitro antioxidant and antimicrobial activities against various pathogens.Al-Shmgani 2017

Antiparasitic activity

In vitro data

Anthelminthic activity of C. roseus has been described in vitro,Kamaraj 2011 and antimalarial properties have been highlighted, including activity against the malarial vector anopheles.Chan 2016, Panneerselvam 2013, Subarani 2013

Cancer

Animal and in vitro data

Numerous older animal studies using vinca alkaloids as chemotherapeutic agents have been described.Noble 1990 More recently, the unprecedented bisindole alkaloid cathachunine (lacking C-18 and C-19) was isolated from C. roseus. This lead compound exerted a potent antitumor effect on human leukemia cells through induction of apoptosis via an intrinsic pathway.Wang 2016

Photosynthesized gold nanoparticles from C. roseus have demonstrated the ability to induce caspase-mediated apoptosis in cervical cancer cells (HeLa cells).Ke 2019

Clinical data

Vincristine and vinblastine derived from periwinkle are recognized pharmacological agents in chemotherapy and are used to treat Hodgkin disease, lymphocytic leukemia, and other cancers.Chan 2016, van Wyk 2015 Extensive documentation exists regarding clinical uses of other C. roseus purified alkaloids.van Der Heijden 2004 Clinical studies using the whole plant to treat cancers are lacking.

Dementia

In vitro data

Acetylcholinesterase inhibitory activity has been demonstrated by the root of the plant and aqueous extracts (primarily arginine),Pereira 2009, Pereira 2010 suggesting potential application in dementia.Shakir 2013

Dermatological effects

Animal and in vitro data

In limited studies using rats, researchers found increased wound healing rates with topical and oral ethanolic flower extracts.Nayak 2006, Nayak 2007 An in vitro study showed limited effects of C. roseus extract on markers of psoriasis.Pattarachotanant 2014

In vivo assessment of wound healing in AgNPs-treated mice revealed effectiveness in closuring and reducing the size of wounds.Al-Shmgani 2017

Clinical data

An ethnopharmacological survey conducted in Palestine showed that C. roseus was one of the most frequently used medicinal plants (often as a paste) to treat psoriasis.Shawahna 2017

Diabetes and hyperlipidemia

Animal and in vitro data

Screening studies suggest potential applications for C. roseus in diabetes.Almagro 2015, van Der Heijden 2004 Experiments using rodents showed that periwinkle crude leaf extract elucidated a mechanism of action for a hypoglycemic effect.Ahmed 2007, Nammi 2003, Rasineni 2010, Rasineni 2013, Singh 2001, Tiong 2013, Vega-Ávila 2012 Studies have suggested activity similar to that of tolbutamide because of increased glucose metabolism and transport, as well as antioxidant effects on pancreatic tissue. Animal studies have also shown that periwinkle possesses a hypolipidemic effect.Patel 2011, Rasineni 2010, Rasineni 2013 In a study of rats with induced diabetes, high-density lipoprotein serum cholesterol levels were increased in those administered an ethanol leaf extract of C. roseus compared with the diabetic control group; this finding suggests that the hypoglycemic and hypolipidemic effects of C. roseus are similar to effects of the standard antidiabetic drug glibenclamide.Chandra Mohan 2015 A phenolic fraction of C. roseus containing gallic acid and chlorogenic acid had a hypoglycemic effect on mice that may be explained by an increase in insulin secretion.Espejel-Nava 2018

Erectile dysfunction

The presence of yohimbine in the C. roseus plant extract has led to its use in erectile dysfunction; however, clinical studies to support this use are lacking.Almagro 2015

Dosing

There are no recent clinical data to support specific dosing recommendations for periwinkle. Traditional doses have included 10 leaves and 10 flowers boiled in water as a tea, or 9 pink flowers in 0.5 L of water for 3 hours ("solar tea") sipped throughout the day.Duke 2002

Preparations of the pure alkaloids vincristine and vinblastine are available, with associated therapeutic dosing recommendations.

Pregnancy / Lactation

Avoid use. Abortifacient effects have been documented.Ernst 2002

Interactions

Case reports are lacking regarding drug interactions with C. roseus. An in vitro study evaluated the effect of periwinkle alkaloids on the CYP-450 enzyme system, and some isolated alkaloids showed potent inhibition of CYP2D6 but weak activity against CYP3A4.Usia 2005

Blood pressure-lowering agents: Monitor for excessive decreases in blood pressure if herbal products with hypotensive properties are used with blood pressure-lowering agents. Monitor therapy.Ernst 2003, Richard 2005

Herbs (hypotensive properties): Herbs (hypotensive properties) may enhance the adverse/toxic effect of other herbs (hypotensive properties). Excessive blood pressure-lowering may manifest. Monitor therapy.Ernst 2003, Richard 2005

Adverse Reactions

Clinical information is lacking. Adverse reactions are documented for vinca alkaloids related to doses used in chemotherapy.Miltenburg 2014

Toxicology

Severe, systemic adverse events are associated with use of the alkaloids vincristine and vinblastine.Miltenburg 2014 The related species, V. minor, has been declared unsafe for human consumption by the US Food and Drug Administration.FDA 2020

Index Terms

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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