Cowhage

Last Editorial Review: 6/11/2021
Other Name(s):

Atmagupta, Couhage, Cowitch, Cow-Itch Plant, Dolichos Pruriens, Feijao Macaco, HP 200, HP-200, Kapi Kacchu, Kapikachchhu, Kapikachhu, Kapikachu, Kaunch, Kawach, Kawanch, Kevanch, Kiwach, Macuna, Mucuna hirsuta, Mucuna pruriens, Mucuna Prurient, Mucuna Prurita, Nescafé, Ojo de Buey, Ojo de Venado, Pica-Pica, Pois à Gratter, Pois Mascate, Pois Velu, Stizolobium pruriens, Velvet Bean.

Overview

Cowhage is a bean-like plant. It grows wild in the tropics, including India and the Bahamas, and its range may extend to southern Florida. The bean, seed, and hair of the bean pod are used to make medicine.

Cowhage has been used since ancient times in Ayurvedic medicine for the treatment of Parkinson's disease. Today, cowhage is still used for treating Parkinson's disease, as well as for treating anxiety, arthritis, parasitic infections, and a condition called hyperprolactinemia. In hyperprolactinemia, the blood levels of a hormone called prolactin are too high. Cowhage is also used to relieve pain and fever, to induce vomiting, and to treat snakebite.

Some people apply cowhage directly to the skin for joint and muscle pain, to stimulate surface blood flow in conditions that involve paralysis, and to treat scorpion stings.

How does it work?

Cowhage contains levodopa (L-dopa), which is used to treat Parkinson's disease. L-dopa is changed to the chemical dopamine in the brain. Symptoms of Parkinson's disease occur in patients due to low levels of dopamine in the brain. Unfortunately, most L-dopa is broken down in the body before it ever reaches the brain unless special chemicals are used with levodopa. These chemicals are not present in cowhage.

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Next to red peppers, you can get the most vitamin C from ________________. See Answer

Uses & Effectiveness

Insufficient Evidence to Rate Effectiveness for...

  • High levels of a hormone called prolactin (hyperprolactinemia). There is some evidence that cowhage might be useful for treating hyperprolactinemia in men caused by the medication chlorpromazine. But cowhage does not appear to be effective for hyperprolactinemia of unknown cause in women.
  • Parkinson's disease. Developing research suggests that some cowhage preparations might help improve symptoms of Parkinson's disease when used in combination with prescription drugs such as amantadine, selegiline, and anticholinergic agents. Cowhage contains levodopa (L-dopa), a chemical used to treat Parkinson's disease.
  • Worm infestations.
  • Bone and joint conditions.
  • Muscle pain.
  • Stimulating surface blood flow in conditions that involve paralysis.
  • Other conditions.
More evidence is needed to rate the effectiveness of cowhage for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Side Effects

A powdered preparation of cowhage seed, called HP-200, is POSSIBLY SAFE for most people when taken by mouth for up to 20 weeks. The most common side effects include nausea and a sensation of abdominal bloating. Less common side effects include vomiting, abnormal body movements, and insomnia.

Side effects of other cowhage preparations include headache, pounding heartbeat, and symptoms of psychosis including confusion, agitation, hallucinations, and delusions.

The hair of the cowhage bean pod is POSSIBLY UNSAFE when taken by mouth or applied directly to the skin. It is a strong irritant and can cause severe itching, burning, and swelling.

Special Precautions & Warnings:

Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking cowhage if you are pregnant or breast-feeding. Stay on the safe side and avoid use.

Diseases of the heart and blood vessels (cardiovascular disease): Due to the levodopa (L-dopa) in cowhage, it should be avoided or used cautiously in people with cardiovascular disease. L-dopa can frequently cause low blood pressure on standing (orthostatic hypotension), dizziness, and fainting. Much less frequently, L-dopa can also cause pounding or irregular heartbeat.

Diabetes: There is some evidence that cowhage can lower blood sugar levels and might cause blood sugar to drop too low. If you have diabetes and use cowhage, be sure to monitor you blood sugar carefully. The doses of your diabetes medications might need to be adjusted.

Low blood sugar (hypoglycemia): There is some evidence that cowhage can lower blood sugar levels and might make low blood sugar worse.

Liver disease: Cowhage contains levodopa (L-dopa). L-dopa seems to raise the blood levels of chemicals that indicate liver damage. This may mean that the cowhage is making liver disease worse. If you have liver disease, don't use cowhage.

Skin cancer called melanoma: The body can use the levodopa (L-dopa) in cowhage to make to the skin pigment called melanin. There is some concern that this extra melanin might make melanoma worse. Don't use cowhage if you have a history of melanoma or a suspicious changes in the skin.

Stomach or intestinal ulcers (peptic ulcer disease): There have been reports that levodopa (L-dopa) can cause gastrointestinal (GI) bleeding in people with ulcers. Since cowhage contains L-dopa, there is some concern that it might cause gastrointestinal (GI) bleeding in patients with ulcers. However, this problem has not yet been reported with cowhage.

Mental illness: Due to the levodopa (L-dopa) content, cowhage might make mental illness disease worse.

Surgery: Since cowhage might affect blood sugar levels, there is some concern that it might interfere with blood sugar control during and after surgery. Stop taking cowhage at least 2 weeks before a scheduled surgery.

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Interactions


Medications for depression (MAOIs)Interaction Rating: Major Do not take this combination.

Cowhage contains chemicals that stimulate the body. Some medications used for depression can increase these chemicals. Taking cowhage along with these medications used for depression might cause serious side effects including fast heartbeat, high blood pressure, seizures, nervousness, and others.

Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.


Methyldopa (Aldomet)Interaction Rating: Major Do not take this combination.

Cowhage can lower blood pressure. Methyldopa (Aldomet) can also lower blood pressure. Taking cowhage and methyldopa together might lower blood pressure too much.


Guanethidine (Ismelin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Cowhage can decrease blood pressure. Guanethidine (Ismelin) can also decrease blood pressure. Taking cowhage and guanethidine together might cause blood pressure to go too low.


Medications for diabetes (Antidiabetes drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Cowhage might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking cowhage along with diabetes medications might cause your blood sugar to go 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.


Medications for mental conditions (Antipsychotic drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Cowhage seems to increase a chemical in the brain called dopamine. Some medications for mental conditions help to decrease dopamine. Taking cowhage along with some medications for mental conditions might decrease the effectiveness of some medications for mental conditions.

Some medications for mental conditions include chlorpromazine (Thorazine), clozapine (Clozaril), fluphenazine (Prolixin), haloperidol (Haldol), olanzapine (Zyprexa), perphenazine (Trilafon), prochlorperazine (Compazine), quetiapine (Seroquel), risperidone (Risperdal), thioridazine (Mellaril), thiothixene (Navane), and others.


Medications used during surgery (Anesthesia)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Cowhage contains a chemical called L-dopa (levodopa). Taking L-dopa along with medications used for surgery can cause heart problems. Be sure to tell your doctor what natural products you are taking before having surgery. You should stop taking cowhage at least two weeks before surgery.


Medications used for depression (Tricyclic antidepressants)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications used for depression can slow down the stomach and intestines. This might decrease how much cowhage is absorbed. Taking some medications used for depression might decrease the effects of cowhage.

Some of these medicines used for depression include amitriptyline (Elavil), imipramine (Tofranil), and others.

Dosing

The appropriate dose of cowhage 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 cowhage. 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.

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References

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HP-200 in Parkinson's Disease study group. An alternative medicine treatment for Parkinson's disease: Results of a multicenter clinical trial. J Alt Comp Med 1995;1:249-55.

Infante ME, Perez AM, Simao MR, et al. Outbreak of acute toxic psychosis attributed to Mucuna pruriens. Lancet 1990;336:1129.

Katzenschlager R, Evans A, Manson A, et al. Mucuna pruriens in Parkinson's disease: a double blind clinical and pharmacological study. J Neurol Neurosurg Psychiatry 2004;75:1672-77. View abstract.

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Vadivel V, Janardhanan K. Nutritional and anti-nutritional composition of velvet bean: an under-utilized food legume in south India. Int J Food Sci Nutr 2000;51:279-87. View abstract.

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