Brava, Chondrodendron tomentosum, Cissampelos pareira, ice vine, pareira velvet leaf

The useful constituents of pareira are obtained from fresh or dried bark, roots, and stems of Chondrodendron tomentosum. The effects of pareira depend on the toxic derivatives that enter the blood-stream and cause systemic effects. Pareira Contains dibenzoyl isoquinoline alkaloids, such as D-tubocurarine, chondrocurarine, curine, chondrofoline, chondrocurine, and isochondrodendrine. These alkaloids have emmenagogic, diuretic, and muscle-relaxing effects. Tubocurarine chloride is used medicinallyas a muscle relaxant during anesthesia. It works as a nondepolarizing (competitive) neuromuscular blocker by competing with acetylcholine for cholinergic receptors, thus decreasing the response to acetylcholine and inhibiting skeletal muscle contraction. This effect isn’t seen with oral administration unless the amount absorbed is increased because of cuts or ulcers in the mouth or GI tract. Paralysis of the skeletal muscles may occur, except with oral administration. Pareira is available as powder or granules, and in various combination products; however, it isn’t commercially available in the United States.

Reported uses

Pareira is used as a laxative, tonic, and diuretic. It’s also used to relieve kidney inflammation and induce menstruation. Brazilians use pareira for snakebites; they drink an infusion of the plant and apply bruised leaves to the bite. The herb is also used to make curare, a paralyzing arrow poison used for hunting.

Administration

Dosage information for pareira isn’t well documented.

Hazards

Adverse effects associated with the use of pareira include sedation, flushing, hypotension, tachycardia, blurred vision, decreased GI motility, nausea, skeletal muscle relaxation or paralysis, jaw weakness, bronchospasm, and apnea.

Ketamine, quinidine, and procainamide; calcium channel blockers, such as diltiazem and verapamil; anesthetics such as vecuronium; anticonvulsants such as phenytoin; and other drugs containing tubocurarine may potentiate the neuromuscular blocking action of pareira.

Safety Risk The plant is considered poisonous and shouldn’t be consumed.

Clinical considerations

• Advise patient not to use this poisonous herb.
• Nausea and heavy urine flow have been observed in patients poisoned with tubocurare.
• Tell patient to remind prescriber and pharmacist of any herbal and dietary supplement that he’s taking when obtaining a new prescription.
• Advise patient to consult his health care provider before using an herbal preparation because a treatment with proven efficacy may be available.

Research summary

The concepts behind the use of pareira and the claims made regarding its effects haven’t yet been validated scientifically.