What is it?

Yohimbe is an herbal medicine used to treat male impotence (sexual dysfunction). Yohimbe is not recommended for women, children, elderly people, and those with mental illness.

Other names for yohimbe include: Johimbe and Yohimbine

Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.

Before Using:

Tell your doctor if you

• are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement)
• are pregnant or plan to become pregnant while using this medicine
• are breastfeeding
• have kidney or liver disease, ulcers, or prostatic enlargement
• have any other health problems, such as high blood pressure or heart or blood vessel disease

Dosage:

Talk with your caregiver about how much Yohimbe you should take. The amount depends on the strength of the medicine and the reason you are taking yohimbe. 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 Throw away medicine that is out of date or that you do not need.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 yohimbe without talking to your doctor first if you are taking:

• Alcohol (14)
• Medicine for depression (examples: clomipramine (Anafranil(R)), desipramine (Norpramin(R))) (6,15)
• Medicine for high blood pressure (examples: atenolol (Tenormin(R)); metoprolol (Toprol(R), Lopressor(R)); diltiazem (Cardizem(R), Dilacor(R)); losartan (Cozaar(R) Hyzaar(R)); methyldopa (Aldomet(R) Aldoril(R)); clonidine (Catapres(R)); prazosin (Minipress(R))) (19-21)
• Medicine for seizures, migraines, or mental disorders (examples: carbamazepine (Tegretol(R)), lithium (Eskalith(R)), valproic acid (Depakote(R), Depakene(R))) (15)
• Morphine (Astramorph(R), Duramorph(R), Kadian(R), MS Contin(R), Oramorph SR(R), Roxanol(R)) (16)
• Naloxone (Narcan(R))
• Naltrexone (ReVia(R)) (22)
• Sibutramine (Meridia(R))
• Water pills (diuretics, examples: furosemide (Lasix(R)); hydrochlorothiazide (Microzide(R), Dyazide(R)); spironolactone (Aldactone(R)), amiloride (Midamor(R)); triamterene) (19-21)

Warnings:

• Before taking yohimbe, tell your doctor if you are pregnant or breastfeeding
• If you have high blood pressure, you should not take yohimbe without the advice of a health care professional
• If you have kidney or liver disease, you should not take yohimbe
• If you have chronic swelling or redness of the sexual organs or prostate gland, you should not take yohimbe
• If you have a history of ulcers, you should not take yohimbe
• Long-term use of yohimbe is not advised
• Do not drink alcohol if you take yohimbe

Side Effects:

Call your doctor right away if you have any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hand, swelling or tingling in your mouth or throat, chest tightness, trouble breathing, or rash.
• Fast or irregular heartbeat (7)
• High blood pressure (6)

Other 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.

• Dizziness, irritability, nervousness (7,8,10,15,18)
• Headache or mild tremors (7,8,10,15,18)
• Nausea or vomiting (3,8)
• Skin flushing or sweating (7,8,10,18)

References:

1. Gean CJ & Meyers FH: Pocket Drug Guide, 2nd ed. Williams & Wilkins, Baltimore, MD; 1997.

2. Tyler VE: The New Honest Herbal. GF Stickley Co, Philadelphia, PA; 1987.

3. Fleming T (ed): PDR for Herbal Medicines. Medical Economics Company, Montvale, NJ; 1998.

4. Anon: Yohimbine hydrochloride. Mosby Inc; 1998. Available at: http://www.Rxlist.com (cited 1/6/00).

5. McGuffin M, Hobbs C, Upton R et al: Botanical Safety Handbook. CRC Press, Boca Raton, FL; 1997.

6. Lacomblez L, Bensimon G, Isnard F et al: Effect of yohimbine on blood pressure in patients with depression and orthostatic hypotension induced by clomipramine. Clin Pharmacol Ther 1989; 45(3):241-251.

7. Charney DS, Heninger GR, & Sternberg DE: Assessment of alpha-2 adrenergic autoreceptor function in humans: effect of oral yohimbine. Life Sci 1982; 30(23):2033-2041.

8. Tyler VE: Herbs of Choice: The Therapeutic use of phytomedicinals. Pharmaceutical Products Press, New York, NY; 1991.

9. Price J & Grunhaus LJ: Treatment of clomipramine-induced anorgasmia with yohimbine: a case report. J Clin Psychiatry 1990; 51(1):32-33.

10. Morales A, Surridge DH, & Marshall PG: Yohimbine for treatment of impotence in diabetes. N Engl J Med 1981; 305(20):1221.

11. Landis E & Shore E: Yohimbine-induced bronchospasm. Chest 1989; 96(6): 1424.

12. Fetrow CW & Avila JR: Professional's Handbook of Complementary and Alternative Medicines. Springhouse Corporation, Springhouse, PA; 1999:689-692.

13. Charney DS, Heninger GR & Redmond DE: Yohimbine induced anxiety and increased noradrenergic function in humans: effects of diazepam and clonidine. Life Sci 1983; 33(1):19-29.

14. McDougle CJ, Krystal JH, Price LH et al: Noradrenergic response to acute ethanol administration in healthy subjects: comparison with intravenous yohimbine. Psychopharmacology 1995; 118(2):127-135.

15. Price LH, Charney DS & Heninger GR: Three cases of manic symptoms following yohimbine administration. Am J Psychiatry 1984; 141(10):1267-1268.

16. Gear RW, Gordon NC, Heller PH et al: Enhancement of morphine analgesia by the alpha2-adrenergic antagonist yohimbine. Neuroscience 1995; 66(1):5-8.

17. Jordan J & Sharma AM: Potential for sibutramine-yohimbine interaction. Lancet 2003; 361(9371):1826.

18. Product Information: Yohimbine hydrochloride. PDR Generics, Medical Economics, MontvYohimbine hydrochloride. PDR Generics, Medical Economics, Montvale, NJ, 1997.

19. Goldberg MR & Robertson D: Yohimbine: a pharmacological probe for study of the alpha2-adrenoreceptor. Pharmacol Rev 1983; 35:143-180.

20. Goldstein DS, Grossman E, Listwak S et al: Sympathetic reactivity during a yohimbine challenge test in essential hypertension. Hypertension 1991; 18 (Suppl 3): 40-48.

21. Grossman E, Rosenthal T, Peleg E et al: Oral yohimbine increased blood pressure and sympathetic nervous outflow in hypertensive patients. J Cardiovasc Pharmacol 1993; 22:22-26.

22. Rosen MI, Kosten TR & Kreek MJ: The effects of naltrexone maintenance on the response to yohimbine in healthy volunteers. Biol Psychiatry 1999; 45(12):1636-1645.