Pau D'Arco Bark Extract

Tabebuia avellanedae / Handroanthus impetiginosus
Evidence Level
Limited
2 Clinical Trials
4 Documented Benefits
2/5 Evidence Score

Pau D'Arco (also called Lapacho or Taheebo) is the inner bark of South American trees in the Tabebuia/Handroanthus genus, used in traditional Brazilian and indigenous medicine. Its major bioactives are naphthoquinones — most notably lapachol and beta-lapachone — which exhibit antimicrobial, antifungal, and cytotoxic activity in preclinical (cell and animal) studies. Lapachol itself was advanced into a National Cancer Institute Phase I anticancer trial in the 1970s but was withdrawn from further development because of unacceptable systemic toxicity, including prothrombin-time prolongation consistent with anti-vitamin-K effects. Modern supplement use is largely traditional; rigorous human evidence is sparse. Use bark-only commercial extracts at modest doses and avoid in pregnancy or when anticoagulated.

Studied Dose Traditional dose: 500-1000 mg of dried inner bark extract, 1-3 times daily, or 1-2 g brewed as a decoction. Limited modern dosing guidance; cycle short-term. AVOID in pregnancy and on anticoagulants.
Active Compound Naphthoquinones: lapachol, beta-lapachone, alpha-lapachone, and related quinones; also iridoid and benzoic acid derivatives.

Benefits

Traditional Immune Support

Pau D'Arco has been used in traditional South American medicine as a general immune tonic. Preclinical evidence shows naphthoquinones can inhibit growth of certain bacteria, yeasts, and parasites in vitro, which informs the supplement's marketed immune-support positioning.

Antifungal Tradition

Lapachol and related quinones display activity against Candida and other fungi in laboratory assays. Pau D'Arco is widely used in folk and integrative practice for yeast-balance protocols, though high-quality human trial data is limited.

Antioxidant Bark Compounds

The polyphenolic and quinone fraction of Pau D'Arco bark exhibits free-radical scavenging activity in vitro. This may contribute to its traditional reputation as a 'cleansing' or restorative tonic in indigenous and folk practice.

Inflammation-Modulating Activity

Naphthoquinones from the bark have shown anti-inflammatory effects in preclinical models, including suppression of NF-kB signaling and reduction of inflammatory cytokine production. Clinical translation to human supplement use remains preliminary.

Mechanism of action

1

Naphthoquinone Redox Cycling

Lapachol and beta-lapachone undergo enzymatic redox cycling, generating reactive oxygen species that can selectively damage microbial and tumor cells. This mechanism underlies the bark's traditional antimicrobial use but also contributes to systemic toxicity at higher doses.

2

Topoisomerase Inhibition

Beta-lapachone inhibits topoisomerase I, a DNA-processing enzyme upregulated in rapidly dividing cells. This action was the basis for early preclinical anticancer interest, though clinical development was limited by off-target toxicity.

3

Anti-Vitamin-K Activity

Lapachol's quinone structure resembles vitamin K and competes with K-dependent clotting factor activation, prolonging prothrombin time at higher doses. This pharmacologic effect was a documented dose-limiting toxicity in the historical NCI Phase I trial.

4

NQO1 Substrate

Beta-lapachone is a substrate for NAD(P)H quinone dehydrogenase 1 (NQO1), an enzyme often elevated in stressed or transformed cells. NQO1-mediated bioactivation generates oxidative stress preferentially in tissues expressing this enzyme.

Clinical trials

1
Lapachol Phase I Anticancer Trial — Historical

Phase I clinical trial conducted in the 1970s by the National Cancer Institute investigating lapachol (the major naphthoquinone from Pau D'Arco) for anticancer activity in patients with advanced malignancies.

Adults with advanced solid tumors in early-phase oncology testing.

Lapachol produced dose-limiting toxicity, including prothrombin-time prolongation consistent with anti-vitamin-K effects, anemia, and gastrointestinal symptoms. Development was discontinued. The trial establishes that the active naphthoquinone from Pau D'Arco produces measurable systemic effects at supratherapeutic doses and informs current safety framing — particularly the contraindication with anticoagulant therapy.

2
Preclinical Antimicrobial and Antifungal Activity

Series of in vitro and animal studies evaluating Pau D'Arco bark extract and isolated naphthoquinones against bacterial, fungal, and parasitic organisms.

Cell culture and rodent infection models.

Pau D'Arco extracts and isolated lapachol/beta-lapachone show measurable inhibitory activity against Candida albicans, Staphylococcus aureus, and select parasites in laboratory assays. Animal models suggest some in vivo efficacy. Translation to clinical antimicrobial dosing in humans has not been established by controlled trials.

Side effects and drug interactions

Common Potential side effects

Anti-vitamin-K bleeding risk: at high doses lapachol can prolong prothrombin time and increase bleeding susceptibility.
Gastrointestinal upset: nausea, vomiting, or diarrhea at higher doses or prolonged use.
Anemia has been reported in early clinical use of high-dose lapachol.
Avoid in pregnancy and breastfeeding due to historical reports of teratogenicity in animal studies.
Quality varies widely; some commercial products mix inner and outer bark — choose reputable suppliers.

Important Drug interactions

Warfarin and other anticoagulants — additive bleeding risk from anti-vitamin-K activity; avoid combination
Antiplatelet drugs (aspirin, clopidogrel) — increased bleeding risk; use only with prescriber oversight
Chemotherapy agents — quinone redox cycling may interact unpredictably; avoid during active cancer treatment without oncologist input
NSAIDs — additive gastrointestinal and bleeding risk at higher Pau D'Arco doses

Frequently asked questions about Pau D'Arco Bark Extract

What is the recommended dosage of Pau D'Arco Bark Extract?

The clinically studied dose for Pau D'Arco Bark Extract is Traditional dose: 500-1000 mg of dried inner bark extract, 1-3 times daily, or 1-2 g brewed as a decoction. Limited modern dosing guidance; cycle short-term. AVOID in pregnancy and on anticoagulants.. Always follow product labeling and consult a healthcare provider for personalized dosing recommendations.

What is Pau D'Arco Bark Extract used for?

Pau D'Arco Bark Extract is studied for traditional immune support, antifungal tradition, antioxidant bark compounds. Pau D'Arco has been used in traditional South American medicine as a general immune tonic. Preclinical evidence shows naphthoquinones can inhibit growth of certain bacteria, yeasts, and parasites in vitro, which informs the supplement's marketed immu…

Are there side effects from taking Pau D'Arco Bark Extract?

Reported potential side effects may include: Anti-vitamin-K bleeding risk: at high doses lapachol can prolong prothrombin time and increase bleeding susceptibility. Gastrointestinal upset: nausea, vomiting, or diarrhea at higher doses or prolonged use. Always consult a healthcare provider before starting any new supplement, especially if you have underlying conditions or take medications.

Does Pau D'Arco Bark Extract interact with medications?

Known drug interactions may include: Warfarin and other anticoagulants — additive bleeding risk from anti-vitamin-K activity; avoid combination Antiplatelet drugs (aspirin, clopidogrel) — increased bleeding risk; use only with prescriber oversight Consult a pharmacist or healthcare provider if you take prescription medications.

Is Pau D'Arco Bark Extract good for immune support?

Yes, Pau D'Arco Bark Extract is researched for Immune Support support. Pau D'Arco has been used in traditional South American medicine as a general immune tonic. Preclinical evidence shows naphthoquinones can inhibit growth of certain bacteria, yeasts, and parasites in vitro, which informs the supplement's marketed immune-support positioning.

References(2 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. McKelvey EM, Lomedico M, Lu K, Chadwick M, Loo TL. Dichloroallyl lawsone. Clin Pharmacol Ther. 1979;25(5 Pt 1):586-90. doi: 10.1002/cpt1979255part1586.PubMedUsed to support: Early Phase I clinical pharmacokinetic study of a lapachol-related naphthoquinone (dichloroallyl lawsone) in cancer patients, including dose-limiting cardiac toxicity findings that informed clinical development of this drug class
  2. Maeda M, Murakami M, Takegami T, Ota T. Promotion or suppression of experimental metastasis of B16 melanoma cells after oral administration of lapachol. Toxicol Appl Pharmacol. 2008;229(2):232-8. doi: 10.1016/j.taap.2008.01.008.PubMedUsed to support: Animal toxicology study of oral lapachol in mouse melanoma model documenting dose-dependent effects (both pro- and anti-metastatic depending on dose) and underscoring narrow therapeutic margin of the parent naphthoquinone