CAM PoliticsErectile DysfunctionYohimbine

Increasing prevalence of side effects with yohimbine

Yohimbine (yo HIM bean) increases the amount of blood flowing into the penis and prevents blood from flowing out, resulting in an erection. It’s sold under many brand names.

Here’s a report on side effect reported to the California Poison Control System.

First, the details.

  • A retrospective review of patients collected over 7 years (2000-2006) was conducted.
  • These adults were symptomatic following exposure to a yohimbine-containing product.
  • Reports with a causality rating of possible or better on the Naranjo scale were included.
    • The Naranjo scale is questionnaire designed to determine the likelihood of an adverse drug reaction being due to the drug or other factors.

And, the results.

  • 238 cases were identified.
  • There was a substantial increase in the annual prevalence of yohimbine-associated side effects.
    • Per 10,000 total adult exposures, there was an increased from 2 cases in 2000 to 8 cases in 2006.
  • Most (99%) of cases involved herbal (vs prescription) yohimbine products.
  • Common reasons for using yohimbine:
    • Sexual enhancement (28%)
    • Weight loss (9%)
    • Stimulant effects (8%)
  • Common side effects reported:
    • Gastrointestinal distress (46%)
    • Rapid heart rate (43%)
    • Anxiety/agitation (33%)
    • High blood pressure (25%)
  • Exposure to yohimbine was associated with a significantly greater proportion of severe outcomes, and was more likely to require management at a health-care facility compared to the average substance exposure reported to the poison control center.

The bottom line?

Side effects with yohimbine are becoming more common and are more serious than with other supplements.

The authors concluded, “A reexamination of whether yohimbine should be considered a ‘safe’ dietary supplement under the Dietary Supplement Health and Education Act (DSHEA) is warranted.”

Most interesting is that practically all (99%) of the reports involved readily available over-the-counter and Internet sales of yohimbine-containing products, while only 1% was associated with yohimbine by prescription.

5/5/10 15:53 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.