Guarana

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Common Names

Guarana gum
Guarana seed
Zoom cocoa
Brazilian cocoa

For Patients & Caregivers

How It Works

Guarana contains caffeine, and therefore has stimulant effects. Long-term effects of using guarana are not known.

Guarana is extracted from the seed and gum of a plant found in the Amazon Basin. It is commonly used in beverages for its flavor and because it contains high levels of caffeine. Scientists are very familiar with how caffeine affects the body: it prolongs the action of the sympathetic nervous system, responsible for our “fight or flight” response. This stimulates the brain, heart, and muscles, and increases blood pressure.

Guarana showed anticancer, neuroprotective, and anti-anxiety properties in lab studies. A population study suggests that guarana intake may protect elderly subjects against metabolic disorders. A few small studies in cancer patients suggest guarana may help reduce chemotherapy-related fatigue, stabilize weight, and increase appetite. However, it did not reduce fatigue after radiation therapy, or in patients with head and neck cancers, and some symptoms worsened compared with a placebo. Further research is needed.

Purported Uses

As an appetite suppressant
No scientific evidence supports this use.
As a stimulant
Guarana contains caffeine, which has known stimulant effects.
To treat fatigue
Results from studies of guarana to treat fatigue in cancer patients are mixed, and in one study of head and neck cancer patients, some symptoms worsened. Additional research is needed.
To improve sexual performance
No scientific evidence supports this use.

Do Not Take If

You are taking anticoagulant or antiplatelet medications: Lab studies suggest guarana has antiplatelet activity and may have additive effects. Clinical relevance has yet to be determined.

Side Effects

Increased water loss from the body as urine
Insomnia

Case Reports

Seizures: In 4 healthy young adults who consumed energy drinks that contained guarana along with other ingredients.
Vomiting, agitation, irregular heartbeat, high blood pressure, or nausea: With abuse or misuse of guarana-containing supplements.

For Healthcare Professionals

Scientific Name

Paullinia cupana

Clinical Summary

Guarana, a bushy plant prevalent in the Amazon Basin, has been used in traditional medicine to treat fevers, headaches, and dysentery. Actions of guarana are attributed primarily to the caffeine present in its seeds ⁽²⁾ ⁽³⁾. It is promoted as an appetite suppressant, stimulant, as an aphrodisiac, and to alleviate fatigue. There are extensive data regarding caffeine and its activity.

In vitro studies indicate that guarana has chemopreventive ⁽¹¹⁾ ⁽¹²⁾, neuroprotective, ⁽¹³⁾ and anxiolytic ⁽¹⁴⁾ properties. Epidemiologic data suggest protective effects against metabolic disorders in elderly populations ⁽¹⁵⁾. Improvements in cognitive performance and mental fatigue were also observed following supplementation with guarana in healthy adults ⁽¹⁶⁾.

A few small studies in cancer patients suggest guarana may help reduce chemotherapy-related fatigue, stabilize weight, and increase appetite ⁽²²⁾ ⁽²⁵⁾ ⁽²⁶⁾. However, it did not reduce fatigue post-radiation or in patients with head and neck cancers, and some symptoms worsened compared with a placebo ⁽¹⁷⁾ ⁽²⁷⁾. Further research is needed.

Purported Uses

Suppress appetite
CNS stimulation
Fatigue
Sexual performance

Mechanism of Action

Many of guarana’s effects are thought to be due to its high caffeine content. Caffeine’s effects include skeletal muscle, CNS, and cardiac stimulation, diuresis, increased blood pressure, inhibition of platelet aggregation, and hyperglycemia ⁽²⁾ ⁽³⁾. Guarana demonstrated antioxidant effects by inhibiting lipid peroxidation ⁽¹⁹⁾. Chronic exposure to guarana seed extract produced an anxiolytic effect involving dopaminergic and serotonergic neurotransmission systems ⁽¹⁴⁾.

Adverse Reactions

Case Reports

Vomiting, agitation, tachycardia, hypertension, or nausea: Pediatric cases with abuse or misuse of guarana-containing supplements (28).
Tachycardia: In 2 women consuming guarana-containing supplement/energy drinks (29).
Premature ventricular contractions: In a 25-year-old woman with pre-existing mitral valve prolapse following consumption of guarana (7).
Seizures: In 4 healthy young adults following consumption of an energy drink that contained guarana along with other ingredients (18).

Herb-Drug Interactions

Anticoagulant or antiplatelet drugs: Laboratory studies indicate guarana has antiplatelet activity and may therefore have additive effects ⁽²⁰⁾ ⁽²¹⁾. Clinical relevance has yet to be determined.
Amiodarone: A study done in rats showed that guarana extract decreases the bioavailability of amiodarone ⁽²⁴⁾. Clinical relevance has yet to be determined.

Herb Lab Interactions

May cause arrhythmia and elevate blood pressure ⁽⁷⁾.

Dosage (OneMSK Only)

References

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de Oliveira Campos MP, Riechelmann R, Martins LC, et al. Guarana (Paullinia cupana) improves fatigue in breast cancer patients undergoing systemic chemotherapy. J Altern Complement Med. 2011 Jun;17(6):505-12.
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del Giglio AB, Cubero Dde I, Lerner TG, et al. Purified dry extract of Paullinia cupana (guarana) (PC-18) for chemotherapy-related fatigue in patients with solid tumors: an early discontinuation study. J Diet Suppl. Dec 2013;10(4):325-334.
Palma CG, Lera AT, Lerner T, et al. Guarana (Paullinia cupana) Improves Anorexia in Patients with Advanced Cancer. J Diet Suppl. 2016;13(2):221-231.
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Last Updated

Wednesday, July 8, 2020