PRESCRIBING INFORMATION

Actions	Analgesic, spasmolytic, mild sedative
Potential Indications	Based on appropriate evaluation of the patient, practitioners should consider prescribing Jamaica dogwood in formulations in the context of: • Insomnia, anxiety (5,7) • Painful conditions, neuralgia, sciatica, headache, toothache (5) • Dysmenorrhea, muscular spasm, rheumatism (5)

Contraindications Pregnancy, bradycardia, cardiac insufficiency² Warnings and Precautions The recommended dose must not be exceeded. Although Jamaica dogwood has been used as a fish and insect poison (the component rotenone impairs oxygen consumption in these species), the herb has been found to have negligible toxicity in rodents.^3,4 Interactions None known. Use in Pregnancy and Lactation Contraindicated in pregnancy. Side Effects Traditional texts suggest that Jamaica dogwood may cause nausea, vomiting, and headache in some patients prescribed even small, therapeutic doses and that overdose produces toxic effects.^5,6 Dosage Dose per day^* Dose per week^*   3-6 ml of 1:2 liquid extract 20-40 ml of 1:2 liquid extract

* This dose range is extrapolated from the British Pharmaceutical Codex 1934, the British Herbal Pharmacopoeia 1983, the British Herbal Compendium 1992, and the author’s education and experience.

SUPPORTING INFORMATION

Traditional Prescribing	Traditional Western herbal medicine uses include: • Pain relief, spasm, nervous excitability and to induce sleep6 • Neuralgia, particularly sciatica; painful conditions of the mouth, migraine, dysmenorrhea, muscular spasm, rheumatism, asthma6,7 • Insomnia, nervous tension6,7
Pharmacologic Research	Jamaica dogwood root bark contains nearly 60 isoflavonoid constituents and rotenoids.2,8 • Oral administration of Jamaica dogwood extract demonstrated central nervous system activity in an experimental model. Activity was intermediate between the anxiolytic activity of passion flower and the sedative activity of valerian and hawthorn.9 • The isoflavones may be responsible for the antispasmodic activity, as demonstrated with isolated tissue.10 In addition to sedative and antispasmodic activity, the following activities have been demonstrated in experimental models:antipyretic, antiinflammatory, hypotensive, and antitussive.3 • In an early study, Jamaica dogwood extract given by injection did not influence uterine tone or contractions in vivo,11 although a later study found it to exert appreciable spasmolytic activity.4
Clinical Studies	No clinical studies using Jamaica dogwood have been found; however, anecdotal clinical reports of the late nineteenth century and early twentieth century indicate its usefulness in treating tuberculosis, neuralgia, and whooping cough.4