Skip navigation

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

URL of this page: https://medlineplus.gov/druginfo/natural/647.html

Pau D'Arco

What is it?

Pau d'arco (Tabebuia impetiginosa) is a tree that is native to the Amazon. Its bark and wood have been used for many conditions, but with little evidence.

The pau d'arco tree is used by native peoples in the regions where it grows for making hunting bows. The name "pau d'arco" is Portuguese for "bow tree." Pau d'arco bark and wood might prevent cancer cells from growing and slow tumor growth. But the doses needed to cause these effects seem to be unsafe.

People use pau d'arco for cancer, diabetes, stomach ulcers, and many other conditions, but there is no good scientific evidence to support these uses. Using pau d'arco can also be unsafe, especially at higher doses.

Pau d'arco is sometimes called quebracho. Don't confuse this with a different plant called Quebracho Blanco. These are not the same.

How effective is it?

There is interest in using pau d'arco for a number of purposes, but there isn't enough reliable information to say whether it might be helpful.

Is it safe?

When taken by mouth: Pau d'arco is possibly unsafe. In high doses, a chemical found in pau d'arco can cause severe nausea, vomiting, diarrhea, dizziness, and internal bleeding. The safety of pau d'arco in typical doses is not known.

When applied to the skin: There isn't enough reliable information to know if pau d'arco is safe to use or what the side effects might be.

Special precautions & warnings:

Pregnancy: Pau d'arco is possibly unsafe when taken by mouth. There isn't enough reliable information to know if pau d'arco is safe when applied to the skin during pregnancy. Stay on the safe side and avoid any use.

Breast-feeding: There isn't enough reliable information to know if pau d'arco is safe to use when breast-feeding. Stay on the safe side and avoid use.

Surgery: Pau d'arco might slow blood clotting and could increase the chance of bleeding during and after surgery. Stop using it at least 2 weeks before a scheduled surgery.

Are there interactions with medications?

Moderate
Be cautious with this combination.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Pau d'arco might slow blood clotting. Taking pau d'arco along with medications that also slow clotting might increase the risk of bruising and bleeding.

Are there interactions with herbs and supplements?

Herbs and supplements that might slow blood clotting
Pau d'arco might slow blood clotting and increase the risk of bleeding. Taking it with other supplements with similar effects might increase the risk of bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, nattokinase, and Panax ginseng.

Are there interactions with foods?

There are no known interactions with foods.

How is it typically used?

There isn't enough reliable information to know what an appropriate dose of pau d'arco might be. Some products containing pau d'arco, including capsules, tablets, extracts, powders, and teas, have been found to be mislabeled and adulterated. Be sure to consult a healthcare professional before using.

Other names

Ébénier de Guyane, Ébène Vert, Handroanthus impetiginosus, Ipe, Ipe Roxo, Ipes, Lapacho, Lapacho Colorado, Lapacho Morado, Lapacho Negro, Lébène, Pink Trumpet Tree, Purple Lapacho, Quebracho, Red Lapacho, Tabebuia avellanedae, Tabebuia heptaphylla, Tabebuia impetiginosa, Tabebuia palmeri, Taheebo, Taheebo Tea, Tecoma impetiginosa, Thé Taheebo, Trumpet Bush.

Methodology

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

References

  1. McClure C, Bollen M, Buttolph L, et al. Safety and tolerability of Pau d' Arco (Tabebuia avellanedae) for primary dysmenorrhea: A single-arm, open-label trial on adults ages 18-45. Adv Integr Med 2022;9:159-166. View abstract.
  2. Algranti E, Mendonça EM, Ali SA, Kokron CM, Raile V. Occupational asthma caused by Ipe (Tabebuia spp) dust. J Investig Allergol Clin Immunol 2005;15:81-3. View abstract.
  3. Zhang L, Hasegawa I, Ohta T. Anti-inflammatory cyclopentene derivatives from the inner bark of Tabebuia avellanedae. Fitoterapia 2016;109:217-23. View abstract.
  4. Lee S, Kim IS, Kwak TH, Yoo HH. Comparative metabolism study of ß-lapachone in mouse, rat, dog, monkey, and human liver microsomes using liquid chromatography-tandem mass spectrometry. J Pharm Biomed Anal 2013;83:286-92. View abstract.
  5. Hussain H, Krohn K, Ahmad VU, et al. Lapachol: an overview. Arkivok 2007 (ii):145-71.
  6. Pereira IT, Burci LM, da Silva LM, et al. Antiulcer effect of bark extract of Tabebuia avellanedae: activation of cell proliferation in gastric mucosa during the healing process. Phytother Res 2013;27:1067-73. View abstract.
  7. Macedo L, Fernandes T, Silveira L, et al. ß-Lapachone activity in synergy with conventional antimicrobials against methicillin resistant Staphylococcus aureus strains. Phytomedicine 2013;21:25-9. View abstract.
  8. Pires TC, Dias MI, Calhelha RC, et al. Bioactive properties of Tabebuia impetiginosa-based phytopreparations and phytoformulations: a comparison between extracts and dietary supplements. Molecules 2015;1;20:22863-71. View abstract.
  9. Awang DVC. Commercial taheebo lacks active ingredient. Information Letter 726 Can Pharm J. 1991;121:323-26.
  10. Awang DVC, Dawson BA, Ethier J-C, et al. Naphthoquinone Constituents of Commercial Lapacho/Pau d'arco/Taheebo Products. J Herbs Spic Med Plants. 1995;2:27-43.
  11. Nepomuceno JC. Lapachol and its derivatives as potential drugs for cancer treatment. In: Plants and Crop - The Biology and Biotechnology Research, 1st ed. iConcept Press Ltd.. Retrieved from: https://www.researchgate.net/profile/Julio_Nepomuceno/publication/268378689_Lapachol_and_its_derivatives_as_potential_drugs_for_cancer_treatment/links/5469c8640cf20dedafd103e1.pdf.
  12. Paes JB, Morais VM, Lima CR. Resistência natural de nove madeiras do semi-árido brasileiro a fungos causadores da podridão-mole. R. Árvore, 2005;29:365-71.
  13. Kreher B, Lotter H, Cordell GA, Wagner H. New Furanonaphthoquinones and other Constituents of Tabebuia avellanedae and their Immunomodulating Activities in vitro. Planta Med. 1988 ;54:562-3. View abstract.
  14. de Almeida ER, da Silva Filho AA, dos Santos ER, Lopes CA. Antiinflammatory action of lapachol. J Ethnopharmacol. 1990 ;29:239-41. View abstract.
  15. Guiraud P, Steiman R, Campos-Takaki GM, Seigle-Murandi F, Simeon de Buochberg M. Comparison of antibacterial and antifungal activities of lapachol and beta-lapachone. Planta Med. 1994;60:373-4. View abstract.
  16. Block JB, Serpick AA, Miller W, Wiernik PH. Early clinical studies with lapachol (NSC-11905). Cancer Chemother Rep 2. 1974;4:27-8. View abstract.
  17. Kung, H. N., Yang, M. J., Chang, C. F., Chau, Y. P., and Lu, K. S. In vitro and in vivo wound healing-promoting activities of beta-lapachone. Am.J Physiol Cell Physiol 2008;295:C931-C943. View abstract.
  18. Byeon, S. E., Chung, J. Y., Lee, Y. G., Kim, B. H., Kim, K. H., and Cho, J. Y. In vitro and in vivo anti-inflammatory effects of taheebo, a water extract from the inner bark of Tabebuia avellanedae. J Ethnopharmacol. 9-2-2008;119:145-152. View abstract.
  19. Twardowschy, A., Freitas, C. S., Baggio, C. H., Mayer, B., dos Santos, A. C., Pizzolatti, M. G., Zacarias, A. A., dos Santos, E. P., Otuki, M. F., and Marques, M. C. Antiulcerogenic activity of bark extract of Tabebuia avellanedae, Lorentz ex Griseb. J Ethnopharmacol. 8-13-2008;118:455-459. View abstract.
  20. Queiroz, M. L., Valadares, M. C., Torello, C. O., Ramos, A. L., Oliveira, A. B., Rocha, F. D., Arruda, V. A., and Accorci, W. R. Comparative studies of the effects of Tabebuia avellanedae bark extract and beta-lapachone on the hematopoietic response of tumour-bearing mice. J Ethnopharmacol. 5-8-2008;117:228-235. View abstract.
  21. Savage, R. E., Tyler, A. N., Miao, X. S., and Chan, T. C. Identification of a novel glucosylsulfate conjugate as a metabolite of 3,4-dihydro-2,2-dimethyl-2H-naphtho[1,2-b]pyran-5,6-dione (ARQ 501, beta-lapachone) in mammals. Drug Metab Dispos. 2008;36:753-758. View abstract.
  22. Yamashita, M., Kaneko, M., Iida, A., Tokuda, H., and Nishimura, K. Stereoselective synthesis and cytotoxicity of a cancer chemopreventive naphthoquinone from Tabebuia avellanedae. Bioorg.Med Chem.Lett. 12-1-2007;17:6417-6420. View abstract.
  23. Kim, S. O., Kwon, J. I., Jeong, Y. K., Kim, G. Y., Kim, N. D., and Choi, Y. H. Induction of Egr-1 is associated with anti-metastatic and anti-invasive ability of beta-lapachone in human hepatocarcinoma cells. Biosci Biotechnol Biochem 2007;71:2169-2176. View abstract.
  24. Kung, H. N., Chien, C. L., Chau, G. Y., Don, M. J., Lu, K. S., and Chau, Y. P. Involvement of NO/cGMP signaling in the apoptotic and anti-angiogenic effects of beta-lapachone on endothelial cells in vitro. J Cell Physiol 2007;211:522-532. View abstract.
  25. Woo, H. J., Park, K. Y., Rhu, C. H., Lee, W. H., Choi, B. T., Kim, G. Y., Park, Y. M., and Choi, Y. H. Beta-lapachone, a quinone isolated from Tabebuia avellanedae, induces apoptosis in HepG2 hepatoma cell line through induction of Bax and activation of caspase. J Med Food 2006;9:161-168. View abstract.
  26. Son, D. J., Lim, Y., Park, Y. H., Chang, S. K., Yun, Y. P., Hong, J. T., Takeoka, G. R., Lee, K. G., Lee, S. E., Kim, M. R., Kim, J. H., and Park, B. S. Inhibitory effects of Tabebuia impetiginosa inner bark extract on platelet aggregation and vascular smooth muscle cell proliferation through suppressions of arachidonic acid liberation and ERK1/2 MAPK activation. J Ethnopharmacol. 11-3-2006;108:148-151. View abstract.
  27. Lee, J. I., Choi, D. Y., Chung, H. S., Seo, H. G., Woo, H. J., Choi, B. T., and Choi, Y. H. beta-lapachone induces growth inhibition and apoptosis in bladder cancer cells by modulation of Bcl-2 family and activation of caspases. Exp.Oncol. 2006;28:30-35. View abstract.
  28. Pereira, E. M., Machado, Tde B., Leal, I. C., Jesus, D. M., Damaso, C. R., Pinto, A. V., Giambiagi-deMarval, M., Kuster, R. M., and Santos, K. R. Tabebuia avellanedae naphthoquinones: activity against methicillin-resistant staphylococcal strains, cytotoxic activity and in vivo dermal irritability analysis. Ann.Clin.Microbiol.Antimicrob. 2006;5:5. View abstract.
  29. Felicio, A. C., Chang, C. V., Brandao, M. A., Peters, V. M., and Guerra, Mde O. Fetal growth in rats treated with lapachol. Contraception 2002;66:289-293. View abstract.
  30. Guerra, Mde O., Mazoni, A. S., Brandao, M. A., and Peters, V. M. Toxicology of Lapachol in rats: embryolethality. Braz.J Biol. 2001;61:171-174. View abstract.
  31. Lemos OA, Sanches JC, Silva IE, et al. Genotoxic effects of Tabebuia impetiginosa (Mart. Ex DC.) Standl. (Lamiales, Bignoniaceae) extract in Wistar rats. Genet Mol Biol 2012;35:498-502. View abstract.
  32. Kiage-Mokua BN, Roos N, Schrezenmeir J. Lapacho Tea (Tabebuia impetiginosa) Extract Inhibits Pancreatic Lipase and Delays Postprandial Triglyceride Increase in Rats. Phytother Res 2012 Mar 17. doi: 10.1002/ptr.4659. View abstract.
  33. de Melo JG, Santos AG, de Amorim EL, et al. Medicinal plants used as antitumor agents in Brazil: an ethnobotanical approach. Evid Based Complement Alternat Med 2011;2011:365359. Epub 2011 Mar 8. View abstract.
  34. Gómez Castellanos JR, Prieto JM, Heinrich M. Red Lapacho (Tabebuia impetiginosa)--a global ethnopharmacological commodity? J Ethnopharmacol 2009;121:1-13. View abstract.
  35. Park BS, Lee HK, Lee SE, et al. Antibacterial activity of Tabebuia impetiginosa Martius ex DC (Taheebo) against Helicobacter pylori. J Ethnopharmacol 2006;105:255-62. View abstract.
  36. Park BS, Kim JR, Lee SE, et al. Selective growth-inhibiting effects of compounds identified in Tabebuia impetiginosa inner bark on human intestinal bacteria. J Agric Food Chem 2005;53:1152-7. View abstract.
  37. Koyama J, Morita I, Tagahara K, Hirai K. Cyclopentene dialdehydes from Tabebuia impetiginosa. Phytochemistry 2000;53:869-72. View abstract.
  38. Park BS, Lee KG, Shibamoto T, et al. Antioxidant activity and characterization of volatile constituents of Taheebo (Tabebuia impetiginosa Martius ex DC). J Agric Food Chem 2003;51:295-300. View abstract.
Last reviewed - 08/02/2024