Rauwolfia Alkaloids (Systemic)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For rauwolfia alkaloids, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to rauwolfia alkaloids. Also tell your health care professional if you are allergic to any other substance, such as foods, preservatives, or dyes.

Pregnancy - Rauwolfia alkaloids have not been studied in pregnant women. However, too much use of rauwolfia alkaloids during pregnancy may cause unwanted effects (difficult breathing, low temperature, loss of appetite) in the baby. In rats, use of rauwolfia alkaloids during pregnancy causes birth defects and in guinea pigs decreases newborn survival rates. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding - Rauwolfia alkaloids pass into breast milk and may cause unwanted effects (difficult breathing, low temperature, loss of appetite) in infants of mothers taking large doses of this medicine. Be sure you have discussed this with your doctor before taking this medicine.

Children - Although there is no specific information comparing use of rauwolfia alkaloids in children with use in other age groups, rauwolfia alkaloids are not expected to cause different side effects or problems in children than they do in adults.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of rauwolfia alkaloids in the elderly with use in other age groups, dizziness or drowsiness may be more likely to occur in the elderly, who are more sensitive to the effects of rauwolfia alkaloids.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking rauwolfia alkaloids, it is especially important that your health care professional know if you are taking any of the following:

• Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) - Taking a rauwolfia alkaloid while you are taking or within 2 weeks of taking MAO inhibitors may increase the risk of central nervous system depression or may cause a severe high blood pressure reaction

Other medical problems - The presence of other medical problems may affect the use of rauwolfia alkaloids. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergies or other breathing problems such as asthma - Rauwolfia alkaloids can cause breathing problems

• Epilepsy

• Gallstones or
• Stomach ulcer or
• Ulcerative colitis - Rauwolfia alkaloids increase activity of the stomach, which may make the condition worse

• Heart disease - Rauwolfia alkaloids can cause heart rhythm problems or slow heartbeat

• Kidney disease - Some patients may not do well when blood pressure is lowered by rauwolfia alkaloids

• Mental depression (or history of) - Rauwolfia alkaloids cause mental depression

• Parkinson's disease - Rauwolfia alkaloids can cause parkinsonism-like effects

• Pheochromocytoma