TYLOPHORA INDICA

DESCRIPTION :

Taxonomic description: Perennial, small, slender, much branched pubescent twining or

climbing herbs or under shrubs; sap yellowish. Roots long, fleshy, with longitudinally

fissured light brown, corky bark. Leaves 6.0-

10.5 x 3.8-6.0 cm, ovate-oblong to elliptic-

oblong, acute to acuminate, cordate at base,

thick, pubescent beneath when young,

glabrous above; petioles up to 12 mm long.

Flowers minute, 1-1.5 cm across, in 2 to 3-

flowered fascicles in axillary umbellate

cymes. Calyx divided nearly to the base,

densely hairy outside; segments lanceolate,

acute. Corolla greenish-yellow or greenish-purple; lobes oblong, acute. Fruit a follicle, up

to 7 x 1 cm, ovoid-lanceolate, tapering at apex forming fine mucro, finally striate,

glabrous. Seeds 0.6-0.8 x 0.3-0.4 cm, broadly ovate or ovate-oblong, flat, brown, dark

coloured in centre; coma 2.0-2.5 cm long. Fl. & Fr.: August-December (Kirtikar & Basu,

1935; Chopra et al., 1956; Jagtap & Singh, 1999)

Habitat: Found in the plains, forests, and hilly slopes and outskirts of the forest

(Vitacost, 2004; Truestarhealth, 2005). Forms dense patches in the forest in moist and

humid conditions in open hill slopes and narrow valleys, also cultivated for its medicinal

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uses. The plant shows stunted growth in the area with low rainfall. According to

Nadkarni (1976), it prefers sandy localities.

Distribution: It is indigenous to India (Aurorahealthcare, 2005). The plant inhabits up to

an elevation of 1,260 m in the sub-Himalayan tract and in the central and peninsular

India. It also met within Eastern, North-East and Central India, Bengal and parts of South

India (Nadkarni, 1976). Except throughout plains of India, it also harbor in Ceylon,

Malay island and Borneo (Kirtikar & Basu, 1935).

PHYTOACTIVE :

The powdered leaves, stem and root contain 0.2 - 0.3 per cent (up to 0.42-0.46 %) of

alkaloids. The alkaloidal content is not affected by seasonal variations. The alkaloids

present are tylophorine (C24H27O4N; m.p. 286-87o decomp.) and tylophorine

(C23H25O4N; m.p. 248-49o). Both the alkaloids are pharmacologically active, and are

reported to have caused dermatitis, producing itching, redness, swelling and eruptions on

the skin. Tylophorine is toxic to Paramoecium caudatam in concentrations of 1 in 50,000

or more. The MLD for frogs is 0.4 mg./g. body-wt. Its toxicity for mice and guinea pigs

is very low. It has no irritant action locally or when injected subcutaneously or

intramuscularly. It has a marked stimulating effect on both the striped and unstriped

muscles, and a distinct depressing effect on the musculature of heart. The blood-pressure

is lowered when a dose is administered but is raised soon after and is maintained at a

level higher than the normal for a fairly long time (Ratnagiriswaran & Venkatachalam,

loc. Cit.; Chopra et al.,loc. Sit.; Govindachari et al., Tetrahedron, 1958, 4, 311 ; 1961, 14,

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284, 288;1965, 21,2573;Govindachari et al.,Chem. & Ind., 1959, 950;1960, 966; Chopra

et al.,I, 585).

Laboratory research has shown this isolated plant extract exerts a strong anti-

inflammatory action.[Indian J Med Res 1979;69: pp.513-20.] Test tube studies suggest

that tylophorine is able to interfere with the action of mast cells, which are key

components in the process of inflammation. [Ind J Med Res 1980;71: pp.940-8] These

actions seem to support tylophora’s traditional use as an antiasthmatic and antiallergic

medication by Ayurvedic practitioners.

The leaves and roots are used medicinally (Bhavan, 1992). It is said to have laxative,

expectorant, diaphoretic and purgative properties. It has also been used for the treatment

of allergies, cold, dysentery, hay fever and arthritis (CSIR, 1948-1976). It has reputation

as an alterative and as a blood purifier, often used in rheumatism and syphilitic

rheumatism. Root or leaf powder is used in diarrhoea, dysentery and intermittent fever. It

is an expectorant and administered in respiratory affections, bronchitis and whooping

cough (Nadkarni, 1976). Dried leaves are emetic diaphoretic and expectorant. It is

regarded as one of the best indigenous substitute for ipecacuanha (Kirtikar & Basu,

1935), so it was considered as Indian ipecacuahna in the latter half of the 19th century

(Food4less1, 2005).

The roots and leaves possess stimulant, emetic, cathartic and purgative properties

(Shah & Kapoor, 1976; Sharma & Sharma, 1977; Vasudevan Nair et al., 1982; Nair et

al., 1984). The roots and leaves are also reported to be used in hydrophobia. The leaves

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are employed to destroy vermin. The leaf extract acts as anti tumour (Chitnis et al., 1972;

Stephan & Vijayammal, 2000).

Other uses: The roots are suggested to be a good natural preservative of food.

Toxic effect: According to Gupta et al. (1979), it may produce some side effects like

drowsiness or giddiness. Loss of taste for salt, mouth pain, upset stomach, temporary

nausea and vomiting are some other side effects (Shivpuri et al., 1969, 1972; Bone,

1996). Tightness in throat or chest, chest pain, skin hives, rash, or itchy or swollen skin

may occur in some cases (Healthtouch, 2005).

Preliminary studies shows that extract of Tylophora is toxic only in extremely high doses;

these extracts were apparently safe in the far smaller doses needed to produce a

therapeutic effect (Dikshith et al., 1990).

Chemical Components: The major constituent in this plant is alkaloid Tylophorine that

is responsible for a strong anti-inflammatory action (Gopalakrishnan et al., 1979) and

Tylophorinine. The other alkaloids include Tylophorinidine, Septicine and

Isotylocrebrine.

Pharmacology: Test tube studies suggest that tylophorine is able to interfere with the

action of mast cells, which are key components in the process of inflammation action

(Gopalakrishnan et al., 1980). These actions seem to support its traditional use as an anti-

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asthmatic and anti-allergic medication by traditional healers. According to Bone (1996),

the dose should not exceed 200-400 mg dried leaf powder per day or 1 to 2 ml of tincture

per day for the treatment of asthma. The plant shows inhibitory effect on cellular immune

response (Ganguly & Sainis, 2001) and antiallergic activity (Nayampalli & Sheth, 1979).

Weak preliminary evidence hints that Tylophora might have anti-inflammatory,

antiallergic, and antispasmodic actions (Gopalakrishnan et al., 1980; Wagner, 1989;

Udupa et al., 1991; Nandi, 1999). In tests with Tylophora extract, both adrenal weight

and plasma steroid levels were found increased (Vitasentials, 2005).

These historical and laboratory findings have been supported by several human clinical

trials using differing preparations of Tylophora, including the crude leaf, tincture, and

capsule. Clinical trial against asthma shows that Tylophora leaf chewed and swallowed

daily in the early morning for six days reduces asthma symptoms (Shivpuri et al., 1969).

An alcoholic extract of crude Tylophora leaves in 1 gram of glucose had comparable

effects to that of chewing the crude leaf (Shivpuri et al., 1972). Another trial found

similar success in reducing asthma symptoms (Thiruvengadam et al., 1978). However,

the Tylophora was not as effective as a standard asthma drug combination. One double-

blind trial failed to show any effect on asthma for Tylophora (Gupta et al., 1979).

DIRECTION FOR USE :

Uses

This plant has been traditionally used as a folk remedy in certain regions of India for the

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treatment of bronchial asthma, bronchitis, rheumatism, and dermatitis.

Reactions

Patients using tylophora may experience temporary nausea and vomiting, soreness of the

mouth, and loss of taste for salt, particularly with the fresh leaf and tincture. The herb’s

safety for use during pregnancy and breast-feeding has not been established. At the time

of writing, there were no well-known drug interactions.

The roots and leaves possess emetic and purgative properties. They are reported to

contain an amorphous alkaloid. The roots have a sweetish taste turning acrid, pleasant

aromatic odour, and a brittle fracture. They possess stimulant, emetic, cathartic,

expectorant, stomachic and diaphoretic properties and are used for the treatment of

asthma,bronchitis,whooping cough, dysentary and diarrhoea; they are reported to be

given in rheumatic and gouty pains. The roots are said to possess bacteriostatic properties

and have been suggested to be a good natural preservative of food. The roots and leaves

are also reported to be used in hydorphobia. The leaves are employed to destroy vermin

(Datta & Mukerji , Bull. Pharmacogn. Lab., No. 1, 1950,93-94; Rao, proc. Indian Acad.

Sci., 1948, 28A, 173;Nadkarni, I, 252; II, 1252-53; Koman, 1920, III,9;Kirt. & Basu, III,

1632; Chopra & Chopra, Spec. Rep.,Indian Coun. med. Res.,No. 30, 1955, 108; Dastur,

Medicinal plants, 240; Cameron, 195;Dymock, Warden & Hooper, III, 439; Shivpuri et

al.,J. Ass. Physicians. India, 1968, 16(1),9;U.S.D., 1955, 1913;Hocking, 235; Agarwal &

Saha, J. Andhra Pradesh Akad. Sci.,1968, 2, 31;Kirt. & Basu, III, 1632. )

CONTRAINDICATION :

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The leaves and roots have often been employed as a substitute for ipecacanha ; the dried

leaves are reported to be more uniform and certain in their action than the roots. In large

doses, the dried leaves may cause fatal poisoning. The roots are generally exported from

South India, where it is one of the commonest plants in the fields and low sandy jungles

(Ratnagiriswaran & Venkatachalam, Indian J. Med. Res.,1935, 22,433;Chopra et al.,ibid.,

1935, 23, 263;Kirt. & Basu, !!!,1632; Chopra et al.,I,585;U.S.D.,1955, 1913; Datta &

Mukerji, loc. cit).

Tylophora is a perennial climbing plant native to the plains, forests, and hills of southern

and eastern India. The portions of the plant used medicinally are the leaves and root.

Please note that it is extremely important to obtain an accurate diagnosis before trying to

find a cure. Many diseases and conditions share common symptoms: if you treat

yourself for the wrong illness or a specific symptom of a complex disease, you may delay

legitimate treatment of a serious underlying problem. In other words, the greatest danger

in self-treatment may be self-diagnosis. If you do not know what you really have, you

cannot treat it!

Knowing how difficult it is to weed out misinformation and piece together countless

facts in order to see the "big picture", we now provide simple online access to The

Analyst. Used by doctors and patients alike, The Analyst is a computerized diagnostic

tool that sits on a vast accumulation of knowledge and research. By combining

thousands of connections between signs, symptoms, risk factors, conditions and

treatments, The Analyst™ will help to build an accurate picture of your current health

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status, the risks you are running and courses of action (including appropriate lab testing)

that should be considered.

Tylophora (Tylophora indica/asthmatica) can help with the following:

Respiratory-Asthma

One clinical trial with asthma sufferers found that tylophora leaf (150mg of the leaf by

weight) chewed and swallowed daily in the early morning for six days led to moderate to

complete relief of their asthma symptoms. [J Allergy 1969;43:145–50] In a follow-up

trial with asthma patients, an alcoholic extract of crude tylophora leaves in 1gm of

glucose had comparable effects to that of chewing the crude leaf. [Ann Allergy 1972;30:

pp.407-12]

Another trial found similar success in reducing asthma symptoms using a tylophora leaf

powder at 350mg per day. [J Indian Med Assoc 1978;71: pp.172-6] However, the

tylophora was not as effective as a standard asthma drug combination. One double-blind

trial failed to show any effect on asthma for tylophora. [Ind J Med Res 1979;69: pp.981-

9]

Tylophora leaf at 200-400mg of the dried leaf per day or 1-2ml of tincture per day can be

used to treat asthma.[Clinical Applications of Ayurvedic and Chinese Herbs. Warwick,

Queensland, Australia: Phytotherapy Press, 1996: pp.134–6]

Medicinal Importance: It is traditionally used as a folk remedy in certain regions of

India for the treatment of bronchial asthma (Bielory & Lupoli, 1999), inflammation

(Exoticnatural. 2005), bronchitis, allergies, rheumatism and dermatitis (Gupta & Bal,

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1956; Shivpuri et al.,1969; Dhananjayan et al., 1974; Mathew & Shivpuri, 1974;

Haranath & Shyamalakumari, 1975; Thiruvengadam, et al., 1978; Gupta et al., 1979;

Karnick & Jopat, 1979; Gore et al., 1980; Truestarhealth, 2005; Remedyfind, 2005).

Apart from the above, it also seems to be a good remedy in traditional medicine as anti-

psoriasis, seborrheic, anaphylactic, leucopenia and as an inhibitor of the Schultz-Dale

reaction (Sarma, 1978; Sarma & Misra, 1995).

Conclusion

With the discovery of herbal wealth of Patalkot's treasures, many people are attracted

towards the valley and herbs. The natives are generous with their knowledge and offer

their medicinal secrets with open hearts. This is how the people have always survived, by

sharing information and supplies with each other. People who came to the forest,

however, saw a way to profit from this. They brought in teams of harvesters to strip the

forest clean of valuable herbs. They sold these herbs outside the district for great profit.

Tylophora is believed as one of the most important herbs. The whole series of traditional

medicine plants, which have been in use for thousands of years, will be threatened if

plants like T. indica will not be saved from excessive collection. It is, therefore, need of

the hour is to come forward and save this important herb of Patalkot. Active contribution

from everyone is highly desired specially people from Chhindwara district.

What Is Tylophora Used for Today?

Tylophora has become an increasingly popular treatment for asthma, based on its

traditional use for this purpose, and several studies performed in the 1970s. However, the

studies that found it effective were poorly designed, and a better designed study found no

benefits.

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Tylophora is also still recommended for some of its other traditional uses, including hay

fever, bronchitis and the common cold.

What Is the Scientific Evidence for Tylophora?

Weak preliminary evidence hints that tylophora might have anti-inflammatory,

antiallergic, and antispasmodic actions.9–12 All these effects could make it useful for the

treatment of asthma. However, only double-blind, placebo-controlled studies can actually

show a treatment effective. For tylophora and asthma, the evidence from this type of

study is mixed at best.

In 1972, researchers reported the results of a a double-blind placebo-controlled crossover

trial of 195 individuals with asthma who were given either placebo or 40 mg of a

tylophora alcohol extract daily for 6 days.13 The results showed that people taking

tylophora had less asthma symptoms, and the benefits endured for months after use of the

herb was stopped. Similarly long-lasting results were seen in two double-blind placebo-

controlled studies involving over 200 individuals with asthma.14,15

Even the researchers involved in these trials expressed surprise that short term use of

tylophora could produce long lasting benefits; to outside observers, such findings make

the results difficult to believe at all. Furthermore, most of these studies suffered from

poor design and reporting. In 1979, researchers published the results of a double-blind

study designed to remedy these problems.16 A total of 135 people with asthma were given

either tylophora or placebo. No benefits were seen, and tylophora has not undergone

much study since then.

The bottom line: Better studies that show benefit will be necessary to before tylophora

can be considered a promising herb for asthma.

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Dosage

The typical dosage of tylophora leaf in dried or capsule form is 200 mg twice daily or

400 mg total in 2 doses.

Safety Issues

In the second study mentioned above, tylophora caused nausea, vomiting, mouth

soreness, and alterations in taste sensation in more than half of the participants. The other

two studies found similar side effects, but far less frequently. The difference may have

been because the second study had people chew the whole leaves from the plant, whereas

other studies have used dried leaves or powdered extract in capsule form.

Preliminary studies on animals have found tylophora extracts to be toxic only in

extremely high doses; these extracts were apparently safe in the far smaller doses needed

to produce a therapeutic effect.17

Due to the lack of comprehensive safety studies on tylophora, the herb should not be used

by children, pregnant or nursing women, or individuals with severe kidney or liver

disease. Whether tylophora interacts with any drugs is unknown.

Alternative Medicine

The following information is specific for alternative and complementary medicine. For

additional evidence-based information on diseases, conditions, symptoms, diagnosis,

treatment and wellness issues, continue searching the Healthwise Knowledgebase.

Common name:

• Indian ipecac

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Botanical names:

• Tylophora indica

• Tylophora asthmatica

Parts used and where grown

Tylophora is a perennial climbing plant native to the plains, forests, and hills of southern

and eastern India. The portions of the plant used medicinally are the leaves and root. 1

Health Concerns

Tylophora has been used in connection with the following conditions (refer to the

individual health concern for complete information):

Asthma

Diarrhea

Hay fever

Reliable and relatively consistent scientific data showing a substantial health benefit.

Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal

health benefit.

An herb is primarily supported by traditional use, or the herb or supplement has little

scientific support and/or minimal health benefit.

How much is usually taken?

Tylophora leaf-200 to 400 mg of the dried leaf per day or 1 to 2 ml of tincture per day-

can be used to treat asthma.

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Side Effects

Are there any side effects or interactions?

Patients using tylophora may experience temporary nausea and vomiting, soreness of the

mouth, and loss of taste for salt, particularly with the fresh leaf and tincture. 10, 11, 12 The

herb's safety for use during pregnancy and breast-feeding has not been established.

People with asthma should be closely monitored by a qualified healthcare professional.

At the time of writing, there were no well-known drug interactions with tylophora.

This extract is derived form the leaves of Indian ipecac botanically known as Tylophora

asthmatica (syn. Tylophora indica) belonging to family Asclepiadaceae. The ovate to

orbicular leaves of this branching climber have attracted attention in the treatment of

bronchial asthma. This plant has been traditionally utilized as a folk remedy in certain

regions of India, not only in the treatment of bronchial asthma, but for bronchitis,

rheumatism, and dermatitis. The therapeutically important phytoconstituents in

Tylophora asthmatica include alkaloids major being the alkaloid Tylophorine.

Scientific Evidence

Laboratory research has shown this plant extract exerts a strong anti-inflammatory action.

Moreover, scientists suspect that tylophorine is able to interfere with the action of mast

cells, which are key components in the process of inflammation. In human trials

Tylophora indica was given to 110 bronchial asthma patients in doses of 150 mg of the

leaf. After six days, 62% of the patients consuming tylophora reported experiencing

moderate to complete relief of their asthma symptoms compared to 28% in the placebo

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group. In a separate study one group of patients received either 350 mg of tylophora leaf

powder or placebo daily in the first week. A second group of asthmatics were given a

similar amount of the leaf for seven days followed by an anti-asthmatic drug

combination. Overall, results of the study showed the amount of oxygen in the lungs

(e.g., vital capacity) increased in those using the leaf, but decreased in those using the

placebo. Further Tylophora asthmatica is also shown exert immunomodulatroy,

anticancer activities and

Parts used and where grown

Tylophora is a perennial climbing plant native to the plains, forests, and hills of southern

and eastern India. The portions of the plant used medicinally are the leaves and root.1

Historical or traditional use (may or may not be supported by scientific studies)

This plant has been traditionally used as a folk remedy in certain regions of India for the

treatment of bronchial asthma, bronchitis, rheumatism, and dermatitis. In the latter half of

the 19th century, it was called Indian ipecacuahna, as the roots of the plant have often

been employed as an effective substitute for ipecac. The use to induce vomiting led to

tylophora’s inclusion in the Bengal Pharmacopoeia of 1884.2

How much is usually taken?

Tylophora leaf—200 to 400 mg of the dried leaf per day or 1 to 2 ml of tincture per

day—can be used to treat asthma.9

Are there any side effects or interactions?

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Patients using tylophora may experience temporary nausea and vomiting, soreness of the

mouth, and loss of taste for salt, particularly with the fresh leaf and tincture.10 11 12 The

herb’s safety for use during pregnancy and breast-feeding has not been established.

People with asthma should be closely monitored by a qualified healthcare professional.

At the time of writing, there were no well-known drug interactions with tylophora.

Dosage: Talk with your caregiver about how much Tylophora you should take. The

amount depends on the strength of the medicine and the reason you are taking Tylophora.

If you are using this medicine without instructions from your caregiver, follow the

directions on the medicine bottle. Do not take more medicine or take it more often than

the directions tell you to.

To store this medicine: Keep all medicine locked up and away from children. Store

medicine away from heat and direct light. Do not store your medicine in the bathroom,

near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine

to break down and not work the way it should work. Throw away medicine that is out of

date or that you do not need. Never share your medicine with others.

Drug and Food Interactions: Do not take Tylophora without talking to your doctor first

if you are taking:

• Medicine used for seizures or migraine headaches (examples: butalbital

(Fiorinal(R), Fioricet(R)), phenobarbital

• Morphine (Roxanol(R), MS Contin(R))

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 Side Effects: Stop taking your medicine right away and talk to your doctor if you

have any of the following side effects. Your medicine may be causing these

symptoms which may mean you are allergic to it.

• Breathing problems or tightness in your throat or chest

• Chest pain

• Skin hives, rash, or itchy or swollen skin

Other Possible Side Effects: You may have the following side effects, but this medicine

may also cause other side effects. Tell your doctor if you have side effects that you think

are caused by this medicine.

• Drowsiness (sleepiness) or giddiness (5)

• Decreased taste, mouth pain, upset stomach, or throwing up (6)

Tylophora has become an increasingly popular treatment for asthma, based on its

traditional use for this purpose, and several studies performed in the 1970s. However, the

studies that found it effective were poorly designed, and a better designed study found no

benefits.

Tylophora is also still recommended for some of its other traditional uses, including hay

fever, bronchitis and the common cold.

What Is the Scientific Evidence for Tylophora?

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Weak preliminary evidence hints that tylophora might have anti-inflammatory,

antiallergic, and antispasmodic actions.9–12 All these effects could make it useful for the

treatment of asthma. However, only double-blind, placebo-controlled studies can actually

show a treatment effective. For tylophora and asthma, the evidence from this type of

study is mixed at best.

In 1972, researchers reported the results of a a double-blind placebo-controlled crossover

trial of 195 individuals with asthma who were given either placebo or 40 mg of a

tylophora alcohol extract daily for 6 days.13 The results showed that people taking

tylophora had less asthma symptoms, and the benefits endured for months after use of the

herb was stopped. Similarly long-lasting results were seen in two double-blind placebo-

controlled studies involving over 200 individuals with asthma.14,15

Even the researchers involved in these trials expressed surprise that short term use of

tylophora could produce long lasting benefits; to outside observers, such findings make

the results difficult to believe at all. Furthermore, most of these studies suffered from

poor design and reporting. In 1979, researchers published the results of a double-blind

study designed to remedy these problems.16 A total of 135 people with asthma were given

either tylophora or placebo. No benefits were seen, and tylophora has not undergone

much study since then.

The bottom line: Better studies that show benefit will be necessary to before tylophora

can be considered a promising herb for asthma.

Safety Issues

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In the second study mentioned above, tylophora caused nausea, vomiting, mouth

soreness, and alterations in taste sensation in more than half of the participants. The other

two studies found similar side effects, but far less frequently. The difference may have

been because the second study had people chew the whole leaves from the plant, whereas

other studies have used dried leaves or powdered extract in capsule form.

Preliminary studies on animals have found tylophora extracts to be toxic only in

extremely high doses; these extracts were apparently safe in the far smaller doses needed

to produce a therapeutic effect.17

Due to the lack of comprehensive safety studies on tylophora, the herb should not be used

by children, pregnant or nursing women, or individuals with severe kidney or liver

disease. Whether tylophora interacts with any drugs is unknown.

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