Health Care Professional Information

Scientific Name
Pueraria mirifica, Pueraria thunbergiana, Pueraria lobata L., Pueraria montana var. thomsonii, Radix puerariae
Common Name

Pueraria, Pueraria root, Ge Gen, Kudsu, Japanese arrowroot

Clinical Summary

Kudzu is a botanical used in Chinese medicine to treat alcoholism, menopausal symptoms, diabetes mellitus, fever, common cold, and neck or eye pain. There are several species of Kudzu and both the flowers and root extract are used for their medicinal properties. Isoflavones, the major components of kudzu, are thought responsible for the beneficial effects.
Kudzu demonstrated antiproliferative (1), anti-inflammatory (3), and neuroprotective (16) (18) properties. It also has antiapoptotic effects against ethanol-induced apoptosis and suppresses alcohol intake (4).

Small studies indicate benefits of kudzu in reducing alcohol intake in heavy drinkers (9) (19) (23). Data also indicate that it does not affect the sleep cycle in moderate drinkers (20). Kudzu may improve symptoms such as hot flushes and night sweats in perimenopausal women (5) (10) (21); and cognitive function in postmenopausal women (6). It may also be effective in preventing the development of gray hair (24).
However, because it has estrogenic effects (11), individuals with hormone-sensitive cancers and those taking tamoxifen should avoid kudzu.

Purported Uses
  • Alcoholism
  • Common cold
  • Diabetes
  • Eye pain
  • Fever
  • Menopausal symptoms
  • Neck pain
Constituents
  • Isoflavones: Daidzin, Daidzein, Puerarin, Genistein, Genistin, Tectorigenin, Glycitin, Tectoridin, 6”-O-xylosyltectoridin, 6”-O-xyloglycitin
    (1) (2)
Mechanism of Action

Isoflavones present in Pueraria mirifica are thought to be involved in alleviating symptoms such as hot flashes and night sweats in perimenopausal women (5) and affect cognitive function in postmenopausal women (6). The isoflavones present in the root extract suppress alcohol intake and alcohol withdrawal symptoms in mice although the mechanism is unclear (4). The anti-inflammatory property of kudzu is attributed to its ability to decrease prostaglandin E2 and tumor necrosis factor (TNF)-alpha release, both of which are involved in inflammatory process (3). The flowers of Pueraria thunbergiana exhibit protective effects against ethanol-induced apoptosis in human neuroblastoma cells by inhibiting the expression of a protease, caspase-3 that is responsible for proteolytic cleavage of many proteins (7).
Peurarin may alleviate chronic alcoholic liver injury in rats via inhibition of endotoxin gut-leakage, activation of Kupffer cells, and expression of lipopolysaccharide (LPS) receptors (22).

Tectorigenin, an isoflavone present in kudzu, demonstrated antiproliferative activity against human cancer (HL-60) cells. The proposed mechanisms are induction of differentiation in the cells and a reduction in the expression of Bcl-2, an antiapoptotic protein (1).

Pharmacokinetics

The pharmacokinetics of puerarin, the major isoflavone present in kudzu were determined in healthy adults. Following repeated administration of kudzu extract, puerarin was found to be rapidly absorbed via the oral route, reaching peak levels at 2 hours. It had a half-life of approximately 4.3 hours. The elimination half-life was not significantly altered after repeated administration (12).

Contraindications
  • Hypersensitivity to kudzu
  • Patients with estrogen receptor-positive (ER+) breast cancer
Adverse Reactions
  • Hepatotoxicity was observed in rats exposed to high doses of Pueraria tuberosa extract over a long period (13).
Herb-Drug Interactions
  • Tamoxifen: Because it has estrogenic activity (11), Kudzu may antagonize the effects of tamoxifen.
  • Antidiabetic drugs: Kudzu can have additive effects when used with antidiabetic drugs (14).
  • Cytochrome P450 2D6: Puerarin inhibited activity of CYP2D6 in vitro and can alter the metabolism of drugs that are substrates of this enzyme (15).
  • Cytochrome P450 1A2: Puerarin was shown to induce CYP1A2 in vitro and may affect the metabolism of some drugs that are substrates of this enzyme (15).
  • Methotrexate: When coadministered, a root decoction of Kudzu reduces its elimination resulting in an increase in the level of methotrexate in rats (17).
Literature Summary and Critique

Woo J, et al. Comparison of Pueraria lobata with hormone replacement therapy in treating the adverse health consequences of menopause. Menopause 2003; 10(4):352-361.
In this study, 127 postmenopausal women were randomized to receive hormone replacement therapy, Pueraria lobata (equivalent of 100mg isoflavone), or no treatment for three months. Lipid profile, neuropsychological tests and the levels of luteinizing hormone and follicle-stimulating hormone were measured at baseline and after three months. Women who received Pueraria showed no changes in lipid profile compared to those in HRT group who showed a reduction in cholesterol and LDL cholesterol. There was no significant change in hormonal levels in the Pueraria group compared to controls. However, women in Peuraria group showed improvement in flexible thinking whereas those in the HRT group demonstrated improved delayed recall. Although the study did not establish any use of Pueraria for controlling menopausal symptoms, it seems to affect cognitive function. Further studies are warranted.

Dosage (Inside MSKCC Only)
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References
  1. Lee KT, et al. Tectorigenin, an isoflavone of Pueraria thunbergiana Benth., induces differentiation and apoptosis in human promyelocytic leukemia HL-60 cells. Biol Pharm Bull 2001; 24(10):1117-1121.
  2. Boue SM, et al. Evaluation of the estrogenic effects of legume extracts containing phytoestrogens. J Agric Food Chem 2003; 51(8):2193-2199.
  3. Kim IT, et al. Anti-inflammatory and anti-nociceptive effects of the extract from Kalopanax pictus, Pueraria thunbergiana and Rhus verniciflua. J Ethnopharmacol 2004; 94(1):165-173.
  4. Benlhabib E, et al. Kudzu root extract suppresses voluntary alcohol intake and alcohol withdrawal symptoms in P rats receiving free access to water and alcohol. J Med Food 2004; 7(2):168-179.
  5. Lamlertkittikul S and Chandeying V. Efficacy and safety of Pueraria mirifica (Kwao Kruea Khao) for the treatment of vasomotor symptoms in perimenopausal women: Phase II Study. J Med Assoc Thai 2004; 87(1):33-40.
  6. Woo J, et al. Comparison of Pueraria lobata with hormone replacement therapy in treating the adverse health consequences of menopause. Menopause 2003; 10(4):352-361.
  7. Jang MH, et al. Protective effects of puerariaeflos against ethanol-induced apoptosis on human neuroblastoma cell line SK-N-MC. Jpn J Pharmacol 2001; 87(4):338-342.
  8. MICROMEDEX(R) Healthcare Series. 120. 2004. Thomson MICROMEDEX.
  9. Lukas SE, et al. An Extract of the Chinese Herbal Root Kudzu Reduces Alcohol Drinking by Heavy Drinkers in a Naturalistic Setting. Alcohol Clin Exp Res. 2005;29(5):756-62.
  10. Chandeying V, Sangthawan M. Efficacy comparison of Pueraria mirifica (PM) against conjugated equine estrogen (CEE) with/without medroxyprogesterone acetate (MPA) in the treatment of climacteric symptoms in perimenopausal women: phase III study. J Med Assoc Thai. 2007 Sep;90(9):1720-6.
  11. Cherdshewasart W, Sriwatcharakul S, Malaivijitnond S. Variance of estrogenic activity of the phytoestrogen-rich plant. Maturitas. 2008 Dec 20;61(4):350-7.
  12. Penetar DM, Teter CJ, Ma Z, et al. Pharmacokinetic profile of the isoflavone puerarin after acute and repeated administration of a novel kudzu extract to human volunteers. J Altern Complement Med. 2006 Jul-Aug;12(6):543-8.
  13. Santosh N, Mohan K, Royana S, Yamini TB. Hepatotoxicity of tubers of Indian Kudzu (Pueraria tuberosa) in rats. Food Chem Toxicol. 2010 Apr;48(4):1066-71.
  14. Hsu FL, Liu IM, Kuo DH, et al. Antihyperglycemic effect of puerarin in streptozotocin-induced diabetic rats. J Nat Prod. 2003 Jun;66(6):788-92.
  15. Zheng J, Chen B, Jiang B, et al. The effects of puerarin on CYP2D6 and CYP1A2 activities in vivo. Arch Pharm Res. 2010 Feb;33(2):243-6.
  16. Zhu G, Wang X, Chen Y, et al. Puerarin protects dopaminergic neurons against 6-hydroxydopamine neurotoxicity via inhibiting apoptosis and upregulating glial cell line-derived neurotrophic factor in a rat model of Parkinson's disease. Planta Med. 2010 Nov;76(16):1820-6.
  17. Chiang HM, Fang SH, Wen KC, et al. Life-threatening interaction between the root extract of Pueraria lobata and methotrexate in rats. Toxicol Appl Pharmacol. 2005 Dec 15;209(3):263-8.
  18. Xing G, Dong M, Li X, et al. Neuroprotective effects of puerarin against beta-amyloid-induced neurotoxicity in PC12 cells via a PI3K-dependent signaling pathway. Brain Res Bull. 2011 May 30;85(3-4):212-8.

  19. Penetar DM, Toto LH, Farmer SL, et al. The isoflavone puerarin reduces alcohol intake in heavy drinkers: A pilot study. Drug Alcohol Depend. 2012 Nov 1;126(1-2):251-6.
  20. Bracken BK, Penetar DM, Maclean RR, Lukas SE. Kudzu root extract does not perturb the sleep/wake cycle of moderate drinkers. J Altern Complement Med. 2011 Oct;17(10):961-6.
  21. Virojchaiwong P, Suvithayasiri V, Itharat A. Comparison of Pueraria mirifica 25 and 50 mg for menopausal symptoms. Arch Gynecol Obstet. 2011 Aug;284(2):411-9.
  22. Peng J, Cui T, Huang F, et al. Puerarin Ameliorates Experimental Alcoholic Liver Injury by Inhibition of Endotoxin Gut-leakage, kupffer Cell Activation and Lipopolysaccharide Receptors Expression. J Pharmacol Exp Ther. 2013 Mar;344(3):646-54.
  23. Lukas SE, Penetar D, Su Z, et al. A standardized kudzu extract (NPI-031) reduces alcohol consumption in nontreatment-seeking male heavy drinkers. Psychopharmacology (Berl). 2013 Mar;226(1):65-73.
  24. Jo SJ, Shin H, Paik SH, et al. Efficacy and Safety of Pueraria lobata Extract in Gray Hair Prevention: A Randomized, Double-Blind, Placebo-Controlled Study. Ann Dermatol. 2013 May;25(2):218-22.

Consumer Information

How It Works

Bottom Line: Kudzu has not been shown to treat cancer in humans.

Kudzu is an herb used in Chinese medicine to treat alcoholism, menopausal symptoms, diabetes mellitus, fever, common cold, and neck or eye pain. In vitro studies have shown that kudzu has antiproliferative, anti-inflammatory properties. It also suppressed alcohol intake. One clinical trial showed that kudzu may affect cognitive function in postmenopausal women. Patients with estrogen receptor-positive breast cancers should discuss with their physicians before using kudzu as isoflavones can promote the growth of certain breast cancer cells.

Purported Uses
  • Menopausal symptoms
    Clinical studies show that kudzu may help reduce menopausal symptoms. It does not affect hormonal levels in postmenopausal women but it influences cognitive function.
  • Alcohol abuse
    Kudzu has been shown in small studies to be effective in suppressing symptoms of alcohol intake and withdrawal.
  • Diabetes mellitus
    Kudzu is used in traditional medicine to treat diabetes.
  • Fever
    Kudzu is used in traditional medicine to treat fever. Kudzu may reduce inflammation and pain in animals when used in combination with other herbs.
  • Common cold
    Kudzu is used in traditional medicine to treat common colds. Kudzu may reduce inflammation and pain in animals when used in combination with other herbs. However, clinical data are lacking.
  • Neck or Eye pain
    Kudzu may reduce inflammation and pain in animals when used in combination with other herbs.
Research Evidence

Menopause:
In this clinical trial 127 postmenopausal women were given hormone replacement therapy (HRT), Pueraria lobata (equivalent of 100mg isoflavone), or no treatment for three months. There were no changes in hormonal levels in any of the groups. Women who took HRT had lowered cholesterol and LDL cholesterol levels compared to those on Pueraria. But women in Pueraria group showed improvement in flexible thinking and those in HRT group demonstrated improved delayed recall. Pueraria may have an effect on cognitive function in postmenopausal women.

Do Not Take If
  • You have hypersensitive to kudzu.
  • You have hormonal-sensitive cancer because kudzu has estrogenic activity.
  • You are taking tamoxifen because the isoflavones in kudzu may antagonize the effects of tamoxifen used for estrogen-dependent breast cancer.
  • You are taking antidiabetic medication, as kudzu can increase its activity.
  • You are taking methotrexate. When given together, a root decoction of Kudzu reduces its elimination resulting in an increase in the level of methotrexate in rats.
Side Effects
  • Liver toxicity was observed in rats exposed to high doses of Pueraria tuberosa extract over a long period.
E-mail your questions and comments to aboutherbs@mskcc.org.