Guarana

Purported Benefits, Side Effects & More
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Guarana

Purported Benefits, Side Effects & More
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Guarana

Common Names

  • Guarana gum
  • Guarana seed
  • Zoom cocoa
  • Brazilian cocoa

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For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.

What is it?

Guarana comes from the seeds of the guarana plant. It is used in traditional medicine for many issues. The seeds have caffeine and other chemicals that are like caffeine in them.

Guarana supplements come as tablets, capsules, and powders.

What are the potential uses and benefits?

Guarana is used to:

  • Make you less hungry
  • Manage fatigue (feeling very tired or having less energy than usual)
  • Increase sexual performance
  • Increase your energy

Guarana also has other uses, but doctors have not studied them to see if they work.

It’s generally safe to take small amounts of guarana. Talk with your healthcare provider before taking guarana supplements. Herbal supplements are stronger than the herbs you would use in cooking.

Supplements can also interact with some medications and affect how they work. For more information, read the “What else do I need to know?” section below.

What are the side effects?

Side effects of guarana may include:

  • Nausea (feeling like you’re going to throw up)
  • Insomnia (trouble falling asleep, staying asleep, or waking up too early)

Side effects of taking high amounts of guarana supplements may include:

  • Vomiting (throwing up)
  • Changes to your heartbeat
  • High blood pressure
  • Seizures (uncontrollable shaking)
What else do I need to know?
  • Talk with your healthcare provider if you’re taking stimulants. Guarana is also a stimulant so taking both at the same time may not be safe.
  • Talk with your healthcare provider if you’re taking blood thinners such as warfarin (Coumadin®, Jantoven®). Guarana may increase your risk of bleeding.
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For Healthcare Professionals

Scientific Name
Paullinia cupana
Clinical Summary

A bushy plant prevalent in the Amazon Basin, guarana is used in traditional medicine to treat fevers, headaches, and dysentery. The plant’s physiological actions are attributed to the caffeine found in its seeds (2) (3). Guarana is promoted as an appetite suppressant, stimulant, as an aphrodisiac, and to alleviate fatigue.

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), and guarana supplementation led to improvements in cognitive performance and mental fatigue in healthy adults (16).

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). A meta-analysis also concluded that guarana was not superior to placebo for cancer-related fatigue and that evidence was of low quality (30). Further research is needed.

Purported Uses and Benefits
  • Appetite suppression
  • Fatigue
  • Sexual performance
  • CNS Stimulant
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: Lab studies indicate guarana has antiplatelet activity and may therefore have additive effects (20) (21). Clinical relevance has yet to be determined.
Amiodarone: A study in rats showed that guarana extract decreases 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
  1. McGuffin M. A Botanical Safety Handbook. Boca Raton (FL): CRC Press; 1997.
  2. Gruenwald J, et al. PDR for Herbal medicines, 2nd ed. Montvale (NJ): Medical Economics Company; 1998.
  3. Schulz V, et al. Rational Phytotherapy: A Physicians Guide to the Use of Herbs and Related Remedies, 3rd ed. Berlin (Germany): Springer; 1998.
  4. Fetrow CW, et al. Professional’s Handbook of Complementary and Alternative Medicines. Philadelphia: Springhouse; 1999.
  5. McEvoy GK, et al. AHFS Drug Information. Bethesda (MD): ASHP; 1998.
  6. Brinker F. Herb Contraindications and Drug Interactions, 2nd ed. Sandy (OR): Eclectic; 1998.
  7. Cannon ME, Cooke CT, McCarthy JS. Caffeine-induced cardiac arrhythmia: an unrecognized danger of healthfood products. Med J Aust 2001;174:520-1.
  8. Robbers JE. Tyler’s Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York: Haworth Herbal Press; 1999.
  9. Wallach J. Interpretation of Diagnostic Tests: A synopsis of laboratory medicine. Boston: Little, Brown, & Company; 1992.
  10. Boozer CN, et al. An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Int J Obes Related Metab Disord 2001;25:316-24.
  11. Fukumasu H, Cristina da Silva T, Avanzo JL, et al. Chempreventive effects of Puallinia cupana Mart var. sorbilis, the guarana, on mouse hepatocarcinogenesis. Cancer Lett 2006 20;233(1):158-64.
  12. Fukumasu H, Latorre AO, Zaidan-Dagli ML. Paullinia cupana Mart. var. sorbilis, guarana, increases survival of Ehrlich ascites carcinoma (EAC) bearing mice by decreasing cyclin-D1 expression and inducing a G0/G1 cell cycle arrest in EAC cells. Phytother Res. 2011 Jan;25(1):11-6.
  13. de Oliveira DM, Barreto G, Galeano P, et al. Paullinia cupana Mart. var. Sorbilis protects human dopaminergic neuroblastoma SH-SY5Y cell line against rotenone-induced cytotoxicity. Hum Exp Toxicol. 2011 Sep;30(9):1382-91.
  14. Roncon CM, Biesdorf de Almeida C, Klein T, Palazzo de Mello JC, Audi EA. Anxiolytic effects of a semipurified constituent of guaraná seeds on rats in the elevated T-maze test. Planta Med. 2011 Feb;77(3):236-41.
  15. Costa Krewer C, Ribeiro EE, Ribeiro EA, et al. Habitual Intake of Guaraná and Metabolic Morbidities: An Epidemiological Study of an Elderly Amazonian Population. Phytother Res. 2011 Sep;25(9):1367-74.
  16. Kennedy DO, Haskell CF, Robertson B, et al. Improved cognitive performance and mental fatigue following a multi-vitamin and mineral supplement with added guaraná (Paullinia cupana). Appetite. Mar-May 2008;50(2-3):506-13.
  17. da Costa Miranda V, Trufelli DC, Santos J, et al. Effectiveness of guaraná (Paullinia cupana) for postradiation fatigue and depression: results of a pilot double-blind randomized study. J Altern Complement Med. 2009 Apr;15(4):431-3.
  18. Iyadurai SJ, Chung SS. New-onset seizures in adults: possible association with consumption of popular energy drinks. Epilepsy Behav. 2007 May;10(3):504-8.
  19. Mattei R, Dias RF, Espínola EB, Carlini EA, Barros SB. Guarana (Paullinia cupana): toxic behavioral effects in laboratory animals and antioxidants activity in vitro. J Ethnopharmacol. 1998 Mar;60(2):111-6.
  20. Bydlowski SP, Yunker RL, Subbiah MT. A novel property of an aqueous guaraná extract (Paullinia cupana): inhibition of platelet aggregation in vitro and in vivo. Braz J Med Biol Res. 1988;21(3):535-8.
  21. Bydlowski SP, D’Amico EA, Chamone DA. An aqueous extract of guaraná (Paullinia cupana) decreases platelet thromboxane synthesis. Braz J Med Biol Res. 1991;24(4):421-4.
  22. 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.
  23. Yamaguti-Sasaki E, Ito LA, Canteli VC, et al. Antioxidant capacity and in vitro prevention of dental plaque formation by extracts and condensed tannins of Paullinia cupana. Molecules. 2007 Aug 20;12(8):1950-63.
  24. Rodrigues M, Alves G, Lourenço N, Falcão A. Herb-Drug Interaction of Paullinia cupana (Guarana) Seed Extract on the Pharmacokinetics of Amiodarone in Rats. Evid Based Complement Alternat Med. 2012;2012:428560.
  25. 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.
  26. 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.
  27. Martins SP, Ferreira CL, Del Giglio A. Placebo-Controlled, Double-Blind, Randomized Study of a Dry Guarana Extract in Patients with Head and Neck Tumors Undergoing Chemoradiotherapy: Effects on Fatigue and Quality of Life. J Diet Suppl. Jun 20 2016:1-10.
  28. Biggs JM, Morgan JA, Lardieri AB, et al. Abuse and Misuse of Selected Dietary Supplements Among Adolescents: a Look at Poison Center Data. J Pediatr Pharmacol Ther. Nov-Dec 2017;22(6):385-393.
  29. Restani P, Di Lorenzo C, Garcia-Alvarez A, et al. Adverse Effects of Plant Food Supplements Self-Reported by Consumers in the PlantLIBRA Survey Involving Six European Countries. PLoS One. 2016;11(2):e0150089.
  30. de Araujo DP, Pereira P, Fontes AJC, et al. The use of guarana (Paullinia cupana) as a dietary supplement for fatigue in cancer patients: a systematic review with a meta-analysis. Support Care Cancer. Dec 2021;29(12):7171-7182.
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