Health Care Professional Information

Scientific Name
Phytolacca americana, Phytolacca decandra
Common Name

Poke Root, pocan, red plant

Clinical Summary

Derived from various parts of the plant, including root, leaf, and berry. Patients use this herb to treat rheumatoid arthritis, infections, and cancer (as part of the Hoxsey herbal tonic).
Pokeweed has not been studied extensively.
Few in vitro studies indicate that it has antioxidant and acetylcholinesterase inhibition properties (5). Pokeweed antiviral protein (PAP), an N-glycosidase ribosomal-inactivating protein isolated from the plant, demonstrated antiviral effects against encephalitis infection (6).
Pokeweed causes significant toxicity following oral or topical administration.

Purported Uses
  • Cancer treatment
  • Fungal infections
  • Induce vomiting
  • Infections
  • Mastitis
  • Rheumatoid arthritis
  • Tonsillitis
Constituents
  • Alkaloids: Betanidine, betanine, phytolaccine, prebetanine
  • Lectins: Pokeweed mitogen glycoproteins (Pa1-Pa5)
  • Saponins: Phytolaccosides (A1, D2, and O), jaligonic acid, phytolaccagenic acid, aesculentic acid
  • Other: Isoamericanin A, pokeweed antiviral protein (PAP), alpha-spinasterol, histamine, GABA
    (1) (4)
Mechanism of Action

Pokeweed mitogens and glycosidic saponins are known toxins that possess mitogenic and irritant properties (1). Pokeweed antiviral protein (PAP) shows broad antiviral activity in vitro. PAP inhibits replication of herpes simplex, influenza and poliovirus, possibly via inactivation of eukaryotic ribosomes (2). Saponin extracts from pokeweed, chiefly phytolaccagenin, exhibit antiinflammatory activity as demonstrated by carrageenan rat paw edema tests. Pokeweed's histamine and GABA content may have hypotensive effects. PAFP-s, an antifungal peptide extract from pokeweed, displays fungistatic effects against a variety of species in vitro (3).

Warnings

Significant toxicity results from oral and topical administration of pokeweed.

Adverse Reactions

Reported: Nausea, vomiting, stomach cramps, diarrhea, weakness, hematemesis, hypotension, tachycardia.
Toxicity: Prolonged vomiting, bloody diarrhea, dyspnea, muscle spasms, convulsions, death.
(1)

Literature Summary and Critique

No study supports the use of pokeweed for any proposed claim.

References
  1. Newall C, et al. Herbal Medicines: A Guide for Health-Care Professionals, 1st ed. London: Pharmaceutical Press; 1996.
  2. Irvin JD. Pokeweed antiviral protein. Pharmacol Ther 1983;21:371-87.
  3. Shao F, et al. A new antifungal peptide from the seeds of Phytolacca americana: characterization, amino acid sequence and cDNA cloning. Biochim Biophys Acta 1999;1430:262-8.
  4. Takahashi H, et al. Triterpene glycosides from the cultures of Phytolacca americana. Chem Pharm Bull 2001;49:246-8.
  5. Zheleva-Dimitrova DZh. Antioxidant and acetylcholinesterase inhibition properties of Amorpha fruticosa L. and Phytolacca americana L. Pharmacogn Mag. 2013 Apr;9(34):109-13.
  6. Ishag HZ, Li C, Huang L, et al. Inhibition of Japanese encephalitis virus infection in vitro and in vivo by pokeweed antiviral protein. Virus Res. 2013 Jan;171(1):89-96.

Consumer Information

How It Works

Bottom Line: Because pokeweed has toxic effects, it should not be used to treat cancer, infections, inflammation, or any other medical condition.

Pokeweed products are extracts from all parts of the plant: leaves, root, and berries. Pokeweed contains chemicals that are known toxins, but several of its other components have shown biological activity in laboratory experiments. For example, pokeweed antiviral protein (PAP) is able to stop replication of viruses such as herpes simplex, influenza and poliovirus in the test tube, while pokeweed anti-fungal protein (PAFP) does the same to fungi. Certain saponins from pokeweed also reduce inflammation in rats. None of these effects have been seen in the human body.

Purported Uses
  • To treat cancer
    There are no data to back this claim.
  • To treat fungal infections
    Pokeweed extracts stop fungal growth in the test tube, but human trials have not been conducted.
  • To induce vomiting
    Vomiting is a reported side effect of pokeweed.
  • To treat infections
    Pokeweed extracts stop growth of certain viruses in the test tube. Human data are lacking.
  • To reduce inflammation in conditions such as mastitis and rheumatoid arthritis
    Although pokeweed extracts reduce inflammation in one experiment in rats, clinical trials are lacking.
  • To treat tonsillitis
    There are no data to support this claim.
Patient Warnings
  • Significant toxicity results from taking pokeweed by mouth or applying topically.
Side Effects
  • Nausea and vomiting
  • Stomach cramps
  • Diarrhea
  • Weakness
  • Vomiting blood
  • Low blood pressure
  • Tachycardia (fast heart rate)
  • Toxicity from high doses or prolonged use of pokeweed can cause protracted vomiting, bloody diarrhea, dyspnea (difficulty breathing), muscle spasms, convulsions, and death.
E-mail your questions and comments to aboutherbs@mskcc.org.