Pao pereira

Purported Benefits, Side Effects & More

Pao pereira

Purported Benefits, Side Effects & More
Pao pereira

Common Names

  • Pereiroá
  • Ubá-açú
  • Triguaaba
  • Camará-de-bilro
  • Pinguaciba

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?

Animal studies suggest pao pereira has antimalarial and anticancer effects, but human studies have not been conducted.

Pao pereira is a tree native to the northern part of South America. Preparations made from the stem bark are used in folk medicine as sexual stimulants and to treat malaria, digestive disorders, constipation, fever, liver pain, and cancer. Preclinical studies suggest the bark extracts have antimalarial and pain-relieving properties, may help improve cognition, and may also have anticancer effects, but studies in humans are lacking.

Pao pereira is also marketed in supplemental form as an alternative anticancer treatment. However, its safety and effectiveness has not been determined in humans.

What are the potential uses and benefits?
  • Malaria

    Lab experiments and animal studies suggest antimalarial activity.
  • Fever

    Although used for this purpose in folk medicine, scientific evidence is lacking.
  • Liver pain

    Pao pereira extracts appeared to relieve pain in animal models. Studies in humans are lacking.
  • Stomach disorders

    Although used for this purpose in folk medicine, scientific research has not been conducted.
  • Cancer treatment

    Although preclinical studies suggest anticancer activity, these extracts have not been studied in humans.
What are the side effects?

Studies in humans are lacking.

What else do I need to know?

Do Not Take if:

As studies have not been conducted in humans, there are no reports of drug interactions with pao pereira.

For Healthcare Professionals

Scientific Name
Geissospermum vellosii Fr., Geissospermum leave, Tabernaemontana laevis
Clinical Summary

Pao pereira is a tree native to the northern part of South America. It belongs to the family Apocyanaceae. Both aqueous and alcoholic decoctions prepared from the stem bark are used in folk medicine as sexual stimulants and to treat a variety of ailments including malaria, digestive disorders, constipation, fever, liver pain, and cancer.

Studies in vitro and in animal models using the bark extracts indicate antimalarial (1), antinociceptive (2) (11), and anti-inflammatory (11) effects, as well as anticholinesterase activity resulting in reversal of cognitive defects (3). This property is being explored as a potential treatment for Alzheimer’s disease (4). Flavopereirine derived from pao pereira demonstrated activity against leishmaniasis in vitro (13).

The anticancer potential of pao pereira has also been investigated. In preclinical studies, the bark extracts demonstrated antitumor activity and enhanced carboplatin effects in ovarian cancer cells (5). It also suppressed the growth of prostate cancer (6) (7) and pancreatic cancer cells along with potentiating gemcitabine effects (8), and inhibited pancreatic cancer stem-like cells (12). However, clinical trials have not yet been conducted.

Pao pereira is marketed in supplemental form as an alternative anticancer treatment, but safety and efficacy has not been determined.

Purported Uses and Benefits
  • Malaria
  • Fever
  • Liver Pain
  • Stomach disorders
  • Cancer
Mechanism of Action

Bioactive compounds in pao pereira known as indole alkaloids showed antiplasmodial activity against a chloroquine-sensitive strain of Plasmodium falciparum, the causative agent of malaria. Of five alkaloids tested, geissolosimine demonstrated the highest activity (1). In a murine model, the crude extract and dichloromethane fraction exerted antinociceptive effects against acetic acid and formalin-induced-nociception via stimulation of the 5-HT 1A receptor, which is involved in neuromodulation (2). In another animal study, geissospermine, the most abundant alkaloid, inhibited acetylcholinesterase, resulting in increased levels of acetylcholine and reduced amnesia induced by scopolamine (3).

Anticancer effects are attributed to various mechanisms. Preclinical studies suggest pao pereira induces apoptosis via cleavage of caspases 3 and 8 and PARP, associated with DNA damage and cell cycle inhibition (8). Reduced tumor cell growth and apoptosis in prostate cancer cells may occur via beta-carboline alkaloids that upregulate DNA repair response genes as well as genes involved in the apoptotic pathway (6). Another study suggests the extract induces cell growth arrest and apoptosis partially via inhibition of NFκB activation (7).

Adverse Reactions
  • Studies in humans are lacking.
Dosage (OneMSK Only)
  1. Mbeunkui F, Grace MH, Lategan C, et al. In vitro antiplasmodial activity of indole alkaloids from the stem bark of Geissospermum vellosii. J Ethnopharmacol. Jan 31 2012;139(2):471-477.
  2. Werner JA, Oliveira SM, Martins DF, et al. Evidence for a role of 5-HT(1A) receptor on antinociceptive action from Geissospermum vellosii. J Ethnopharmacol. Aug 17 2009;125(1):163-169.
  3. Lima JA, Costa RS, Epifanio RA, et al. Geissospermum vellosii stembark: anticholinesterase activity and improvement of scopolamine-induced memory deficits. Pharmacol Biochem Behav. May 2009;92(3):508-513.
  4. Araujo JQ, Lima JA, Pinto Ada C, de Alencastro RB, Albuquerque MG. Docking of the alkaloid geissospermine into acetylcholinesterase: a natural scaffold targeting the treatment of Alzheimer’s disease. J Mol Model. Jun 2011;17(6):1401-1412.
  5. Yu J, Chen Q. The plant extract of Pao pereira potentiates carboplatin effects against ovarian cancer. Pharm Biol. Jan 2014;52(1):36-43.
  6. Bemis DL, Capodice JL, Desai M, Katz AE, Buttyan R. Beta-carboline alkaloid-enriched extract from the amazonian rain forest tree pao pereira suppresses prostate cancer cells. J Soc Integr Oncol. Spring 2009;7(2):59-65.
  7. Chang C, Zhao W, Xie B, et al. Pao Pereira Extract Suppresses Castration-Resistant Prostate Cancer Cell Growth, Survival, and Invasion Through Inhibition of NFkappaB Signaling. Integr Cancer Ther. Nov 27 2013;13(3):249-258.
  8. Yu J, Drisko J, Chen Q. Inhibition of pancreatic cancer and potentiation of gemcitabine effects by the extract of Pao Pereira. Oncol Rep. Jul 2013;30(1):149-156.
  9. Mbeunkui F, Grace MH, Lila MA. Isolation and structural elucidation of indole alkaloids from Geissospermum vellosii by mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. Feb 15 2012;885-886:83-89.
  10. Hughes NA, Rapaport H. Flavopereirine, an Alkaloid from Geissospevrnurn oellosii. JACS. 1957;80:1604-1609.
  11. Lima JA, Costa TW, Silva LL, et al. Antinociceptive and anti-inflammatory effects of a Geissospermum vellosii stem bark fraction. An Acad Bras Cienc. Mar 2016;88(1):237-248.
  12. Dong R, Chen P, Chen Q. Extract of the Medicinal Plant Pao Pereira Inhibits Pancreatic Cancer Stem-Like Cell In Vitro and In Vivo. Integr Cancer Ther. Dec 2018;17(4):1204-1215.
  13. da Silva ESJV, Cordovil Brigido HP, Oliveira de Albuquerque KC, et al. Flavopereirine-An Alkaloid Derived from Geissospermum vellosii-Presents Leishmanicidal Activity In Vitro. Molecules. 2019 Feb 21;24(4):785.
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