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  Yohimbine
 
Author: Donna Karasic, PharmD Last modified: February 24, 2002
 

  INDICATIONS

  • Yohimbine has no FDA sanctioned indications
  • Male Erectile Impotence - unlabeled use
  • Yohimbine is primarily known for its alleged aphrodisiac properties (data are lacking to document this)

  DOSAGE

  • 5.4mg three times a day
  • If side effects occur, reduce dose to one-half tablet three times a day followed by gradual increases to 1 tablet three times a day
  • Results beyond 10 weeks of therapy are not known

  PHARMACOKINETICS

  • Although pharmacologic effects appear diverse, yohimbine primarily functions as a centrally-acting alpha-2 adrenoreceptor blocking agent, which increases sympathetic outflow
  • In male sexual performance, erection is linked to cholinergic activity, which results in increased penile blood inflow, decreased outflow, or both

  ADVERSE EFFECTS

  • Increases in systolic blood pressure
  • Autonomic symptoms such as piloerection and rhinorrhea
  • Anxiety
  • Nausea, vomiting, flushing and headache

  CONTRAINDICATIONS

  • Hypersensitivity to yohimbine
  • Renal Disease

  DRUG INTERACTIONS

  • Antidepressants

  FORMS

  • 5.4mg tablet

  MECHANISM OF ACTION

  • Centrally-acting alpha-2 adrenoreceptor blocking agent (pre-synaptic), which increases sympathetic outflow
  • Its peripheral autonomic nervous system effect is to incrase parasympathetic (cholinergic) and decrease sympathetic (adrenergic) activity
  • In male sexual performance, erection is linked to cholinergic activity, which results in increased penile blood inflow, decreased outflow, or both
 
IMPORTANT POINTS/RECOMMENDATIONS
  • Has properties similar to rauwolfia alkaloids
  • Results of therapy beyond 10 weeks is unknown
  • Not intended for use in geriatric, psychiatric, or cardio-renal patients with a history of gastric or duodenal ulcers
  • Generally not used in females
 
REFERENCES
  1. Hutchinson TA & Shahan DR (Eds) ;  Yohimbine ;  MICROMEDEX Healthcare Series; MICROMEDEX, Greenwood Village, Colorado (edition expires 3-2002)

  2. Hebel SK & Kastrup EK (Eds) ;  Yohimbine ;  Drug Facts and Comparisons, St. Louis, MO (updated Feb 2002)

Copyright © 2002 The Johns Hopkins University School of Medicine. All rights reserved.