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Periwinkle

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

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, there is not enough reliable information to recommend the plant for these uses.

Dosing

There is no recent clinical evidence to support specific doses of periwinkle for medicinal use. 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. Therapeutic doses for preparations of the pure alkaloids vincristine and vinblastine are available.

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 the use of the alkaloids vincristine and vinblastine.

Botany

The plant was first described in Madagascar.1, 2 Periwinkle 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., V. rosea L., and Ammocallis rosea Small. The related plant Vinca minor (common periwinkle, myrtle) is used as a ground cover.1, 2, 3, 4

History

The plant was introduced in Europe during the mid-1700s and was cultivated as an ornamental. Today it grows throughout the world, and 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, hemorrhages, insect stings, and cancers.2, 4, 5, 6, 7

Chemistry

Descriptions of the chemical constituents of the plant are available.8 Approximately 130 terpenoid indole alkaloids are found in the plant.2, 9 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 now widely used antineoplastic agents. Identification of other alkaloids with cytotoxic potential is ongoing.10, 11

The aqueous plant extract is rich in phenolic compounds, including caffeoylquinic acid and flavonoids with antioxidant potential. The leaves also contain a complex volatile oil.12, 13 Identification and quantification techniques include high-pressure liquid chromatography and ion trap mass spectrometry.14, 15

Uses and Pharmacology

Antimicrobial/Antiprotozoal

Animal data

In vitro studies suggest C. roseus’ extracts possess antimicrobial effects.9, 16 Activity has not been attributed to particular chemical constituents; however, various extract techniques have resulted in differing antimicrobial properties.9 Some antiviral activity has been reported for yohimbine.9 Hexane and ethylacetate extracts were active against all tested bacteria except Salmonella typhi.16, 17 Antifungal activity has also been documented.18 Anthelminthic activity has been described in vitro,19 and activity against the malarial vector anopheles has been documented.20, 21

Clinical data

Research reveals no clinical studies using periwinkle for antimicrobial or antiprotozoal infections.

Cancer

Animal data

Animal studies have been described.22

Clinical data

Vincristine and vinblastine derived from periwinkle are recognized pharmacological agents in chemotherapy. Extensive documentation exists on the clinical uses of other purified alkaloids of C. roseus.2 Clinical studies using the whole plant to treat cancers are lacking.

Dermatological

Animal data

In limited studies in rats, researchers found increased healing rates with topical and oral ethanolic flower extracts.16, 23 An in vitro study showed limited effects of C. roseus extract on markers of psoriasis.24

Clinical data

Research reveals no clinical data for the use of periwinkle in wound healing or other dermatological applications.

Diabetes and hyperlipidemia

Animal data

Older screening studies suggested potential applications for C. roseus in diabetes.2, 9 Experiments using rodents showed that periwinkle’s crude leaf extract elucidated a mechanism of action for a hypoglycemic effect.25, 26, 27, 28, 29, 30, 31 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.30, 31, 32 A recent study found glucose and lipid effects similar to those of glibenclamide.33

Clinical data

Research reveals no clinical data for the use of periwinkle in diabetes or hyperlipidemia.

Other uses

Acetylcholinesterase inhibitory activity has been demonstrated by the root plant and aqueous extract (primarily arginine),13, 34 suggesting potential application in dementia.35

The presence of yohimbine in the plant extract has led to its use in erectile dysfunction; however, clinical studies to support this use are lacking.9

The plant has been used in the biosynthesis of silver nanoparticles.36

Dosing

There is no recent clinical evidence to support specific doses of periwinkle for medicinal use. 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.4

Therapeutic doses for preparations such as vincristine and vinblastine are available.

Pregnancy / Lactation

Avoid use. Abortifacient effects have been documented.37

Interactions

Case reports are lacking for C. roseus. An in vitro study evaluated the effect of periwinkle alkaloids on the cytochrome (CYP) P450 enzyme system, and some isolated alkaloids showed potent inhibition of CYP2D6, but weak activity against CYP3A4.38

Adverse Reactions

Clinical information is lacking. Adverse reactions are documented for vinca alkaloids related to doses used in chemotherapy.39

Toxicology

Severe, systemic adverse events are associated with the use of the alkaloids vincristine and vinblastine.39 The related species, V. minor, has been declared unsafe for human consumption by the US Food and Drug Administration.40

References

1. Loh K. Know the Medicinal Herb: Catharanthus roseus (Vinca rosea). Malays Fam Physician. 2008;3(2):12325606134
2. van Der Heijden R, Jacobs DI, Snoeijer W, Hallard D, Verpoorte R. The Catharanthus alkaloids: pharmacognosy and biotechnology. Curr Med Chem. 2004;11(5):607-628.15032608
3. Catharanthus roseus. USDA. NRCS. 2015 The PLANTS Database (http://plants.usda.gov, 30 November 2015). National Plant Data Center, Greensboro, NC 27401-4901 USA.
4. Duke J, Bogenschutz-Godwin M, duCellier J, Duke P. Handbook of Medicinal Herbs. 2nd ed. Boca Raton, FL: CRC Press; 2002.
5. Ochwang'i DO, Kimwele CN, Oduma JA, Gathumbi PK, Mbaria JM, Kiama SG. Medicinal plants used in treatment and management of cancer in Kakamega County, Kenya. J Ethnopharmacol. 2014;151(3):1040-1055.2436207810.1016/j.jep.2013.11.051
6. Lans CA. Ethnomedicines used in Trinidad and Tobago for urinary problems and diabetes mellitus. J Ethnobiol Ethnomed. 2006;2:45.17040567
7. Semenya SS, Potgieter MJ, Erasmus LJ. Exotic and indigenous problem plants species used, by the Bapedi, to treat sexually transmitted infections in Limpopo Province, South Africa. Afr Health Sci. 2013;13(2):320-326.2423593010.4314/ahs.v13i2.17
8. Duke J. Handbook of Biologically Active Phytochemicals and Their Activities. Boca Raton, FL: CRC Press; 1992.
9. Almagro L, Fernández-Pérez F, Pedreño MA. Indole alkaloids from Catharanthus roseus: bioproduction and their effect on human health. Molecules. 2015;20(2):2973-3000.2568590710.3390/molecules20022973
10. Zhang WK, Xu JK, Tian HY, et al. Two new vinblastine-type N-oxide alkaloids from Catharanthus roseus. Nat Prod Res. 2013;27(20):1911-1916.2362152310.1080/14786419.2013.790029
11. Wang CH, Wang GC, Wang Y, et al. Cytotoxic dimeric indole alkaloids from Catharanthus roseus. Fitoterapia. 2012;83(4):765-769.2244555210.1016/j.fitote.2012.03.007
12. Ferreres F, Pereira DM, Valentão P, Andrade PB, Seabra RM, Sottomayor M. New phenolic compounds and antioxidant potential of Catharanthus roseus. J Agric Food Chem. 2008;56(21):9967-9974.1885071410.1021/jf8022723
13. Pereira DM, Ferreres F, Oliveira J, Valentão P, Andrade PB, Sottomayor M. Targeted metabolite analysis of Catharanthus roseus and its biological potential. Food Chem Toxicol. 2009;47(6):1349-1354.1929884010.1016/j.fct.2009.03.012
14. Gupta MM, Singh DV, Tripathi AK, et al. Simultaneous determination of vincristine, vinblastine, catharanthine, and vindoline in leaves of Catharanthus roseus by high-performance liquid chromatography. J Chromatogr Sci. 2005;43(9):450-453.16212789
15. Chen Q, Zhang W, Zhang Y, Chen J, Chen Z. Identification and quantification of active alkaloids in Catharanthus roseus by liquid chromatography-ion trap mass spectrometry. Food Chem. 2013;139(1-4):845-852.2356118010.1016/j.foodchem.2013.01.088
16. Nayak BS, Anderson M, Pinto Pereira LM. Evaluation of wound-healing potential of Catharanthus roseus leaf extract in rats. Fitoterapia. 2007;78(7-8):540-544.17683880
17. Bakht J, Syed F, Shafi M. Antimicrobial potentials of Catharanthus roseus by disc diffusion assay. Pak J Pharm Sci. 2015;28(3):833-840.26004715
18. Naz S, Haq R, Aslam F, Ilyas S. Evaluation of antimicrobial activity of extracts of in vivo and in vitro grown Vinca rosea L. (Catharanthus roseus) against pathogens. Pak J Pharm Sci. 2015;28(3):849-853.26004716
19. Kamaraj C, Rahuman AA. Efficacy of anthelmintic properties of medicinal plant extracts against Haemonchus contortus. Res Vet Sci. 2011;91(3):400-404.2098003410.1016/j.rvsc.2010.09.018
20. Subarani S, Sabhanayakam S, Kamaraj C, Elango G, Kadir MA. Efficacy of larvicidal and pupicidal activity of Catharanthus roseus aqueous and solvent extracts against Anopheles stephensi Liston and Culex quinquefasciatus Say (Diptera: Culicidae). Asian Pac J Trop Med. 2013;6(8):625-630.2379033310.1016/S1995-7645(13)60107-8
21. Panneerselvam C, Murugan K, Kovendan K, et al. Larvicidal efficacy of Catharanthus roseus Linn. (Family: Apocynaceae) leaf extract and bacterial insecticide Bacillus thuringiensis against Anopheles stephensi Liston. Asian Pac J Trop Med. 2013;6(11):847-853.2408357810.1016/S1995-7645(13)60151-0
22. Noble RL. The discovery of the vinca alkaloids--chemotherapeutic agents against cancer. Biochem Cell Biol. 1990;68(12):1344-1351.2085431
23. Nayak BS, Pinto Pereira LM. Catharanthus roseus flower extract has wound-healing activity in Sprague Dawley rats. BMC Complement Altern Med. 2006;6:41.17184528
24. Pattarachotanant N, Rakkhitawatthana V, Tencomnao T. Effect of Gloriosa superba and Catharanthus roseus extracts on IFN-γ-induced keratin 17 expression in HaCaT human keratinocytes. Evid Based Complement Alternat Med. 2014;2014:249367.2543588810.1155/2014/249367
25. Ahmed AU, Ferdous AH, Saha SK, Nahar S, Awal MA, Parvin F. Hypoglycemic effect of Catharanthus roseus in normal and streptozotocin-induced diabetic rats. Mymensingh Med J. 2007;16(2):143-148.17703149
26. Nammi S, Boini MK, Lodagala SD, Behara RB. The juice of fresh leaves of Catharanthus roseus Linn. reduces blood glucose in normal and alloxan diabetic rabbits. BMC Complement Altern Med. 2003;3:4.12950994
27. Singh SN, Vats P, Suri S, et al. Effect of an antidiabetic extract of Catharanthus roseus on enzymic activities in streptozotocin induced diabetic rats. J Ethnopharmacol. 2001;76(3):269-277.11448549
28. Tiong SH, Looi CY, Hazni H, et al. Antidiabetic and antioxidant properties of alkaloids from Catharanthus roseus (L.) G. Don. Molecules. 2013;18(8):9770-9784.2395532210.3390/molecules18089770
29. Vega-Ávila E, Cano-Velasco JL, Alarcón-Aguilar FJ, Fajardo Ortíz Mdel C, Almanza-Pérez JC, Román-Ramos R. Hypoglycemic Activity of Aqueous Extracts from Catharanthus roseus. Evid Based Complement Alternat Med. 2012;2012:934258.2305614410.1155/2012/934258
30. Rasineni K, Bellamkonda R, Singareddy SR, Desireddy S. Antihyperglycemic activity of Catharanthus roseus leaf powder in streptozotocin-induced diabetic rats. Pharmacognosy Res. 2010;2(3):195-201.2180856610.4103/0974-8490.65523
31. Rasineni K, Bellamkonda R, Singareddy SR, Desireddy S. Abnormalities in carbohydrate and lipid metabolisms in high-fructose dietfed insulin-resistant rats: amelioration by Catharanthus roseus treatments. J Physiol Biochem. 2013;69(3):459-466.2333485710.1007/s13105-013-0233-z
32. Patel Y, Vadgama V, Baxi S, Chandrabhanu, Tripathi B. Evaluation of hypolipidemic activity of leaf juice of Catharanthus roseus (Linn.) G. Donn. in guinea pigs. Acta Pol Pharm. 2011;68(6):927-935.22125959
33. Chandra Mohan S, Anand T, Priyadharshini GS, Balamurugan V. GC-MS analysis of phytochemicals and hypoglycemic effect of Catharanthus roseus in allosan-induced diabetic rates. Int J Pharm Sci Rev Res. 2015;31(1):123-128.
34. Pereira DM, Ferreres F, Oliveira JM, et al. Pharmacological effects of Catharanthus roseus root alkaloids in acetylcholinesterase inhibition and cholinergic neurotransmission. Phytomedicine. 2010;17(8-9):646-652.1996287010.1016/j.phymed.2009.10.008
35. Shakir T, Coulibaly AY, Kehoe PG. An exploration of the potential mechanisms and translational potential of five medicinal plants for applications in Alzheimer's disease. Am J Neurodegener Dis. 2013;2(2):70-88.23844333
36. Mukunthan KS, Elumalai EK, Patel TN, Murty VR. Catharanthus roseus: a natural source for the synthesis of silver nanoparticles. Asian Pac J Trop Biomed. 2011;1(4):270-274.2356977310.1016/S2221-1691(11)60041-5
37. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG. 2002;109(3):227-235.11950176
38. Usia T, Watabe T, Kadota S, Tezuka Y. Cytochrome P450 2D6 (CYP2D6) inhibitory constituents of Catharanthus roseus. Biol Pharm Bull. 2005;28(6):1021-1024.15930738
39. Miltenburg NC, Boogerd W. Chemotherapy-induced neuropathy: A comprehensive survey. Cancer Treat Rev. 2014;40(7):872-882.2483093910.1016/j.ctrv.2014.04.004
40. Periwinkle. US Food and Drug Administration. FDA Poisonous Plant Database. http://www.accessdata.fda.gov/scripts/Plantox/Detail.CFM?ID=25854. Accessed November 23, 2015.

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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