Quassia
OTHER NAME(S): Amargo, Bitter-Ash, Bitter Wood, Bitterwood, Bois Amer, Cayenne's quinquina, Écorce de Quassia, Jamaican Bitterwood Tree, Jamaican Quassia, Palo de Cuasia, Pao Tariri, Picrasma, Quassia Amer, Quassia Bark, Quassia de Jamaïque, Quassia de Surinam, Quassia excelsa, Quassia Wood, Ruda, Simaruba, Simarubabaum, Simaba, Surinam Quassia, Surinam Wood, Suriname Wood, Quassia amara, Picrasma excelsa, Bitterwood, Quassia Bark, Cuasia
Overview
Quassia is a plant. The wood and sometimes the leaf are used as medicine.
People use quassia for stomach and intestinal problems, diabetes, lice, skin conditions, and many other conditions, but there is no good scientific evidence to support most uses.
In manufacturing, quassia is used to flavor foods, beverages, lozenges, and laxatives. The bark and wood have been used as an insecticide.
Quassia contains chemicals that might prevent the parasite that causes malaria from growing and kill the mosquito larvae. These chemicals might also increase stomach acid and bile secretions, perhaps accounting for appetite stimulant and digestive effects.
Quassia contains chemicals that might prevent the parasite that causes malaria from growing and kill the mosquito larvae. These chemicals might also increase stomach acid and bile secretions, perhaps accounting for appetite stimulant and digestive effects.
Uses
Insufficient Evidence for
- Lice. Early research suggests that a single application of quassia tincture can kill head lice. But the lice might come back. Some research shows that two applications within one week might be more effective than a single application.
- A skin condition that causes redness on the face (rosacea). Applying a gel containing quassia to the skin might reduce redness and flushing in people with rosacea. But higher quality research is needed to confirm.
- Rough, scaly skin on the scalp and face (seborrheic dermatitis). Applying a gel containing quassia to the skin might help clear up seborrheic dermatitis in some people. But higher quality research is needed to confirm.
- Diabetes.
- Appetite loss.
- Indigestion.
- Constipation.
- Fever.
- Intestinal worms.
- Other conditions.
More evidence is needed to rate the effectiveness of quassia for these uses.
Side Effects
When taken by mouth: Quassia is LIKELY SAFE when taken by mouth in food amounts. But quassia is POSSIBLY UNSAFE when taken by mouth as medicine. It can cause side effects such as irritation of the mouth, throat, and digestive tract along with nausea and vomiting. In very large doses, it could cause abnormal heart function. But most people throw up before they get a high enough dose to cause heart problems. Long-term use can cause vision changes and blindness.
When applied to the skin: Quassia is POSSIBLY SAFE when applied to the skin.
When given as an enema (rectally): There isn't enough reliable information to know if quassia is safe or what the side effects might be.
Precautions
When taken by mouth: Quassia is LIKELY SAFE when taken by mouth in food amounts. But quassia is POSSIBLY UNSAFE when taken by mouth as medicine. It can cause side effects such as irritation of the mouth, throat, and digestive tract along with nausea and vomiting. In very large doses, it could cause abnormal heart function. But most people throw up before they get a high enough dose to cause heart problems. Long-term use can cause vision changes and blindness.
When applied to the skin: Quassia is POSSIBLY SAFE when applied to the skin.
When given as an enema (rectally): There isn't enough reliable information to know if quassia is safe or what the side effects might be.
Pregnancy and breast-feeding: Quassia is LIKELY UNSAFE when taken by mouth during pregnancy or breast-feeding. It can cause cell damage and nausea. Avoid using.
Diabetes: There is a concern that quassia might lower blood sugar levels. If you have diabetes and use quassia, be sure to monitor your blood sugar levels carefully. Check with your healthcare provider to see if the dose of diabetes medications you are taking needs to be lowered.
Digestive tract problems or diseases, such as stomach or intestinal ulcers, Crohn's disease, infections, and many other conditions: In large amounts quassia can irritate the digestive tract. Don't use it if you have one of these conditions.
Surgery: Quassia might lower blood sugar levels. There is some concern that it might interfere with blood sugar control during and after surgery. Stop using quassia at least 2 weeks before a scheduled surgery.
Interactions
Moderate Interaction
Be cautious with this combination
- Digoxin (Lanoxin) interacts with QuassiaQuassia is a type of laxative called a stimulant laxative. Stimulant laxatives can decrease potassium levels in the body. Low potassium levels can increase the risk of side effects of digoxin (Lanoxin).
- Water pills (Diuretic drugs) interacts with QuassiaQuassia is a laxative. Some laxatives can decrease potassium in the body. "Water pills" can also decrease potassium in the body. Taking quassia along with "water pills" might decrease potassium in the body too much. Some "water pills" that can decrease potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Microzide), and others.
- Medications changed by the liver (Cytochrome P450 1A1 (CYP1A1) substrates) interacts with QuassiaSome medications are changed and broken down by the liver. Quassia might decrease how quickly the liver breaks down some medications. Taking quassia along with some medications that are changed by the liver might decrease how quickly these medications are broken down by the liver. Before taking quassia talk to your healthcare provider if you take any medications that are changed by the liver. Some medications that are changed by the liver include chlorzoxazone, theophylline, bufuralol, and others.
- Medications for diabetes (Antidiabetes drugs) interacts with QuassiaQuassia might decrease blood sugar levels. Diabetes medications are also used to lower blood sugar. Taking quassia along with diabetes medications might cause your blood sugar to drop too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed. Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Minor Interaction
Be watchful with this combination
- Antacids interacts with QuassiaAntacids are used to decrease stomach acid. Quassia may increase stomach acid. By increasing stomach acid, quassia might decrease the effectiveness of antacids. Some antacids include calcium carbonate (Tums, others), dihydroxyaluminum sodium carbonate (Rolaids, others), magaldrate (Riopan), magnesium sulfate (Bilagog), aluminum hydroxide (Amphojel), and others.
- Medications that decrease stomach acid (H2-blockers) interacts with QuassiaQuassia might increase stomach acid. By increasing stomach acid, quassia might decrease the effectiveness of some medications that decrease stomach acid, called H2-blockers. Some medications that decrease stomach acid include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid).
- Medications that decrease stomach acid (Proton pump inhibitors) interacts with QuassiaQuassia might increase stomach acid. By increasing stomach acid, quassia might decrease the effectiveness of medications that are used to decrease stomach acid, called proton pump inhibitors. Some medications that decrease stomach acid include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium).
Dosing
The appropriate dose of quassia depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for quassia. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
References
- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Robbers JE, Speedie MK, Tyler VE. Pharmacognosy and Pharmacobiotechnology. Baltimore, MD: Williams & Wilkins, 1996.
- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Evans DA, Raj RK. Larvicidal efficacy of Quassin against Culex quinquefasciatus. Indian J Med Res 1991;93:324-7.
- Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
- Jensen O, Nielsen AO, Bjerregaard P. Pediculosis capitis treated with quassia tincture. Acta Derm Venereol 1978;58:557-9.
- Ajaiyeoba, E. O., Abalogu, U. I., Krebs, H. C., and Oduola, A. M. In vivo antimalarial activities of Quassia amara and Quassia undulata plant extracts in mice. J Ethnopharmacol. 11-30-1999;67(3):321-325.
- Toma, W., Gracioso, Jde S., de Andrade, F. D., Hiruma-Lima, C. A., Vilegas, W., and Souza Brito, A. R. Antiulcerogenic activity of four extracts obtained from the bark wood of Quassia amara L. (Simaroubaceae). Biol Pharm.Bull. 2002;25(9):1151-1155.
- Parveen, S., Das, S., Kundra, C. P., and Pereira, B. M. A comprehensive evaluation of the reproductive toxicity of Quassia amara in male rats. Reprod.Toxicol. 2003;17(1):45-50.
- Ninci, M. E. [Prophylaxis and treatment of pediculosis with Quassia amarga]. Rev Fac.Cien.Med Univ Nac.Cordoba 1991;49(2):27-31.
- Raji, Y. and Bolarinwa, A. F. Antifertility activity of Quassia amara in male rats - in vivo study. Life Sci 1997;61(11):1067-1074.
- Diehl C, Ferrari A. Efficacy of topical 4% Quassia amara gel in facial seborrheic dermatitis:a randomized, double-blind, comparative study. J Drugs Dermatol. 2013;12(3):312-5.
- Ferrari A, Diehl C. Evaluation of the efficacy and tolerance of a topical gel with 4% quassia extract in the treatment of rosacea. J Clin Pharmacol. 2012;52(1):84-8.
- Shields M, Niazi U, Badal S, Yee T, Sutcliffe MJ, Delgoda R. Inhibition of CYP1A1 by Quassinoids found in Picrasma excelsa. Planta Med. 2009;75(2):137-41.
- Bertani S, Houël E, Jullian V, et al. New findings on Simalikalactone D, an antimalarial compound from Quassia amara L. (Simaroubaceae). Exp Parasitol. 2012;130(4):341-7.
- Husain GM, Singh PN, Singh RK, Kumar V. Antidiabetic activity of standardized extract of Quassia amara in nicotinamide-streptozotocin-induced diabetic rats. Phytother Res. 2011;25(12):1806-12.