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Podophyllum (Podophyllum hexandrum, Podophyllum peltatum)

Synonyms/Common Names/Related Substances:

  • American mandrake, Araceae (family), bajiaolian, Berberidaceae (family), beta-peltatin, Condylox®, CPH 82, CPH 86, devil's apple, diphyllin, duck's foot, Dysosma pleianthum, epipodophyllotoxin, etoposide 7a, etophos 7b, ground lemon, Hakkakuren, highly purified podophyllotoxin, Himalayan mayapple, hog apple, Indian apple, Indian podophyllum, kampherol, mandrake, mayapple, Podocon-25®, podofilox, Podofin®, podophylli pelati rhizome/resina, podophyllic acid, podophyllin, podophyllinic acid ethylhydrazide, podophyllotoxin, podophyllotoxin-beta-o-benzyliden-glucoside (SP-G), podophyllotoxin derivatives, Podophyllum emodi, Podophyllum hexandrum, Podophyllum hexandrum Royale, podophyllum lignan, Podophyllum peltatum, Podophyllum peltatum L., Podophyllum pleianthum, podophyllum resin, Podophyllum versipelle, Proresid®, quercetin, raccoon berry, RP-1, semisynthetic podophyllotoxin glycosides, Sinopodophyllum emodi, SP-1, Syngonium podophyllum, teniposide 7c, umbrella plant, vegetable mercury, VePesid®, wild lemon, wild mandrake.
  • Note: This monograph covers both American mayapple (Podophyllum peltatum) and Himalyan mayapple (Podophyllum hexandrum or Podophyllum emodi). Although more research has been conducted on the American species, the Himilayan species has a higher content of the active constituent podophyllotoxin.
  • Note: Podophyllum should not be confused with Mandragora officinarum, although both are commonly known as mandrake; podophyllum is potentially toxic when orally ingested.

Clinical Bottom Line/Effectiveness

Brief Background:

  • Podophyllum rhizomes have a long medicinal history among native North American tribes who used a rhizome powder as a laxative or an anthelmintic. A poultice of the powder was also used to treat warts and tumorous growths on the skin.
  • Podophyllotoxin is a plant-derived compound used to produce two cytostatic drugs, etoposide and teniposide. The substance has been primarily obtained from the American mayapple (Podophyllum peltatum). The Himalayan mayapple (Podophyllum hexandrum or Podophyllum emodi) contains this constituent in a much greater quantity, but is endangered in the wild. Podophyllotoxin is used in combination chemotherapy to treat lung cancer and a wide variety of tumors (1;2;3).
  • Currently, extracts of the podophyllum plant such as podophyllin are used in dermatological medicine as topical medications for genital warts, HIV-related oral hairy leukoplakia, and some skin cancers (4). Evidence from one well-designed randomized controlled trial has shown its effectiveness in the treatment of penile warts; however, evidence is lacking in the treatment of other types of warts. Podophyllum has also been successfully used in combination with carbon dioxide laser treatment to treat laryngeal papilloma and hairy leukoplakia; however, large controlled studies supporting efficacy are lacking.
  • Preliminary research also shows that CPH 82, an oral form of Podophyllum emodi composed of two purified semisynthetic lignan glycosides, may be useful in treating rheumatoid arthritis. However, when used orally, podophyllum can be lethal and should be avoided.

Dosing/Toxicology

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Precautions/Contraindications

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Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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Mechanism of Action

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History

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Evidence Table

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Evidence Discussion

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Products Studied

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Author Information

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References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.