Pau d'Arco


What is pau d’arco used for?

Pau d’arco (Tabebuia avellanedae) is a tree that is native to South American countries, such as Brazil. The plant has vibrant, pink-colored flowers, but the medically important part of the tree is the bark.

There are two active constituents in pau d’arco: lapachol and beta-lapachone. These compounds are known as naphthoquinones and have been shown to have antimicrobial and anti-inflammatory properties in in-vitro studies.

Pau d’arco has the following uses:

  • Antifungal
  • Antiviral
  • Antihelminth
  • Antibacterial
  • Antineoplastic

How does it work?

The naphthoquinone content of pau d’arco exerts antimicrobial properties in non-human lab studies. The mechanism of action involves reducing mitochondrial membrane potential, triggering the start of apoptosis or cell death.

Consult with your doctor or pharmacist for more information.

Precautions and warnings

What should I know before using pau d’arco?

Herbal supplements are generally safe to take in moderate amounts as directed by a health professional. However, because most herb and food supplements are not approved by the FDA for treating and preventing specific diseases, recommended daily values are not always established.

Despite being advertised as “all-natural” or “safe”, natural or food supplements must be treated as conventional medication. Certain herbal preparations can interact with other medications you are taking, increasing the risk of adverse drug reactions and toxicity.

Before using this medication, inform your doctor if:

  • You have ever had an allergic reaction to pau d’arco or other supplements.
  • You have a history of allergy to other medications, food, or other substances.
  • You are taking other medications.
  • You have underlying health conditions.

Is it safe during pregnancy or breastfeeding?

There is insufficient data regarding the use and safety of this supplement during pregnancy. Because pau d’arco may increase the risk of bleeding, it is not recommended to use it while pregnant. This supplement should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus, as determined by your doctor.

This supplement is not likely excreted in breast milk. This supplement should be used while breastfeeding only if the potential benefit justifies the potential risk to the child, as determined by your doctor.

Side effects

What side effects can occur from pau d’arco?

All supplements have the potential to elicit side effects even with normal use. Many side effects are dose-related and will resolve when it is adjusted or at the end of therapy.

Potential side effects while using this supplement include:

  • Gastrointestinal discomfort
  • Bleeding
  • Skin irritation (if applied to the skin)

You may experience some, none, or other side effects not mentioned above. If you have any concerns about a side effect or it becomes bothersome, consult your doctor or pharmacist.


What drugs may interact with pau d’arco?

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and inform your doctor and pharmacist.

Some medications that can interact with pau d’arco:

  • Warfarin
  • Clopidogrel
  • Aspirin
  • Other blood thinners
  • The liquid extract preparation of this medication may contain alcohol. Avoid taking the following together with this preparation:

    • Antihistamines
    • Sedatives
    • CNS depressants

    If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Your dose may need to be adjusted, substituted with another drug, or discontinue using the drug.

    Does food or alcohol interact with pau d’arco?

    This medication may be taken with or without food. If you experience any gastrointestinal discomfort, taking this medication with meals may prevent this symptom. It is important to drink enough water while taking this medication.

    The liquid extract preparation of this medication may contain alcohol thus alcohol consumption should be limited to prevent intoxication, especially in children or adults who need to drive or operate machinery.

    Inform your doctor or pharmacist if you have any concerns regarding food-drug interactions.

    What health conditions may interact with pau d’arco?

    This supplement should be taken with caution if you have any of the following conditions or risk factors:

    • Allergy to any of the ingredients

    Inform your doctor or pharmacist if you have any concerns regarding specific health conditions.


    The information provided is not a substitute for professional medical advice. You should ALWAYS consult with your doctor or pharmacist before using pau d’arco.

    What is the dose of pau d’arco for an adult?

    The recommended dosage of this drug has not been established for treating any specific disease or condition. Consult with a doctor for the appropriate indication and dosage.

    What is the dose of pau d’arco for a child?

    This supplement is not recommended for use in children and the recommended dose has not been established. Consult with a doctor or pharmacist for alternatives and more information.

    How is pau d’arco available?

    This supplement is available in the following dosage forms:

    • Liquid extract
    • Tea
    • Oral tablet

    What should I do in case of an emergency or overdose?

    In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

    What should I do if I miss a dose?

    If you miss a dose of this supplement, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Written by

    Stephanie Nera, RPh, PharmD


    Updated May 31, 2021