Herb & supplement monograph

Fever Bark Drug Interactions, Uses, Effectiveness, Safety & More

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Interaction report

Drugs that interact with Fever Bark

801 medications have a known interaction with Fever Bark, graded by severity. Select any drug for the full evidence-based detail.

40 major interactions. These combinations can be clinically significant — best avoided, or used only with close professional supervision. Always check with your pharmacist before combining them with Fever Bark.

2,830 drugs
AlfentanilAlfenta› AmphetamineAdensys XR-ODT, Adzenys ER, Dyanavel XR, Mydayis› Articaine, EpinephrineSeptocaine› Benzocaine, Cetylpyridinium ChlorideMax Lozenger› BupivacaineExparel, Marcaine, Posimir› Bupivacaine HciXaracoll› Bupivacaine, MeloxicamZynrelef Kit› ChloroprocaineNesacaine, Nescaine-MPF› Chloroprocaine HydrochlorideClorotekal› DesfluraneSuprane› EnfluraneEthrane› EtidocaineDuranest› Etidocaine, EpinephrineDuranest MPF› EtomidateAmidate› HalothaneFluothane› IsocarboxazidMarplan› IsofluraneAErrane, Forane, Isoflurane› KetamineKetalar› LevobupivacaineChirocaine› LidocaineDilocaine, Duo-Trach Kit, Lidoderm, Lidoject-1, Lidoject-2, Nervocaine +4 more› MepivacaineCarbocaine, Isocaine, Polocaine, Polocaine MPF› MethohexitalBrevital Sodium› MidazolamNayzilam, Seizalam, Versed› MoclobemideManerix, Moclobemide› Oxymetazoline Hydrochloride, Tetracaine HydrochlorideKovanaze› Ozanimod HydrochlorideZeposia› Phenelzine SulfateNardil› PrilocaineCitanest Plain› Prilocaine, EpinephrineCitanest Forte› Procaine (prescription Drug)Novocain›
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Fever Bark combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Fever Bark affects

Every type of medication (drug category) Fever Bark is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 9 drug categories Fever Bark interacts with
AnesthesiaMonoamine Oxidase Inhibitors (maois)Antihypertensive DrugsCytochrome P450 2d6 (cyp2d6) InhibitorsCytochrome P450 2d6 (cyp2d6) SubstratesCytochrome P450 3a4 (cyp3a4) InhibitorsPhenothiazinesStimulant DrugsAnticoagulant/antiplatelet Drugs
Anesthesia

Theoretically, fever bark might increase the risk of cardiovascular instability with general anesthesia.
Reserpine, a constituent of fever bark, has been shown to increase the risk of cardiovascular instability in patients receiving general anesthesia. It is not known if this could occur with fever bark.

Likelihood Probable Evidence D
Monoamine Oxidase Inhibitors (Maois)

Concomitant use of MAOIs with fever bark can result in additive effects.
Yohimbine, a constituent of fever bark, has MAO inhibitory effects. At high doses, yohimbine is a non-selective inhibitor of MAO. It is not known if this would occur with fever bark.

Likelihood Likely Evidence D
Antihypertensive Drugs

Theoretically, fever bark might alter the effects of antihypertensive drugs.
Yohimbine, a constituent of fever bark, is an alpha-2 adrenoceptor antagonist and has been reported to increase blood pressure in clinical research. Conversely, reserpine can reduce both systolic and diastolic blood pressure. Theoretically, concomitant use of fever bark and antihypertensive drugs can interfere with blood pressure control.

Likelihood Probable Evidence D
Cytochrome P450 2D6 (Cyp2D6) Inhibitors

Theoretically, CYP2D6 inhibitors might increase the levels and clinical effects of yohimbine, a constituent of fever bark.
In vitro and clinical research shows that the fever bark constituent, yohimbine, is metabolized by CYP2D6 isoenzymes.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, fever bark might increase the levels and clinical effects of CYP2D6 substrates.
In vitro research suggests that yohimbine, a constituent of fever bark, inhibits CYP2D6 enzyme activity. The effects of fever bark itself are unclear.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Inhibitors

Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of yohimbine, a constituent of fever bark.
In vitro and clinical research shows that the fever bark constituent, yohimbine, is metabolized by CYP3A4 enzymes.

Likelihood Possible Evidence D
Phenothiazines

Theoretically, the toxicity of fever bark might be increased by phenothiazines.
Phenothiazines might increase the toxicity of yohimbine, a constituent of fever bark, due to alpha-2 adrenoreceptor antagonism. It is not known if this would occur with fever bark.

Likelihood Possible Evidence D
Stimulant Drugs

Theoretically, fever bark might increase or decrease the effects of stimulant drugs.
Reserpine, a constituent of fever bark, might increase or decrease effects of sympathomimetics. Also, yohimbine, another constituent of fever bark, has sympathomimetic effects and increases blood pressure in a dose-dependent manner. It is not known if this would occur with fever bark.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, combining fever bark with antiplatelet or anticoagulant drugs might have additive effects; however, this has not been reported in clinical research.
Research in healthy adults shows that taking yohimbine, a constituent of fever bark, in doses of 8 mg or more, seems to inhibit platelet aggregation in vitro by binding to the alpha-2 adrenoceptor. The effects of fever bark itself are unclear.

Likelihood Possible Evidence D
Monograph

Fever Bark: Uses, Safety & Side Effects

The bottom line

Fever bark is the bark of the Australian tree Alstonia constricta, used in traditional medicine for fever, diarrhea, and infections. There is very little reliable human research to support these uses, and the bark contains potent alkaloids that may cause serious side effects. It is best avoided unless used under direct medical supervision.

Fever Bark
Scientific name
Alstonia constricta
Family
Apocynaceae
Part used
Bark
Common forms
Bark powder, tincture, liquid extract, capsules
People commonly use it for
  • Fever
  • Diarrhea
  • Malaria (traditional)
  • Digestive complaints
  • Bitter tonic

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

The bark contains strong alkaloids and is not recommended without professional supervision.

PregnancyInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full pregnancy detail
BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Fever bark comes from Alstonia constricta, an evergreen tree in the dogbane (Apocynaceae) family. It is native to Australia, where it is sometimes called Australian quinine, Australian fever bush, or bitterbark. A related tree, Alstonia scholaris (dita bark), grows in tropical Asia and is also sold under similar names.

The bark is very bitter and has long been used in folk and traditional medicine. People have taken it to bring down fevers, settle the stomach, and treat diarrhea or infections. It is usually prepared as a bark powder, a tincture, or a liquid extract.

Despite the name "Australian quinine," fever bark is not known to contain quinine, the antimalarial compound found in cinchona bark. Its effects come from a different group of plant chemicals.

How it works

Fever bark contains several plant alkaloids, including reserpine-like and yohimbine-like compounds, as well as other indole alkaloids. These chemicals can be biologically active in the body.

Some of these alkaloids may affect blood pressure, heart rate, and the nervous system. The intense bitterness of the bark may also stimulate digestion and saliva, which is the traditional basis for using it as a bitter tonic.

It is important to understand that most of what is known about these compounds comes from laboratory and animal studies, not from human trials. The exact way fever bark might help with fever or infection in people is not well established.

Effectiveness

Does Fever Bark work?

Evidence overview · 4 uses evaluated
4 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.

For Fever Bark, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 4 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Diarrhea
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral fever bark for diarrhea, there is insufficient reliable information about the clinical effects of fever bark for this condition.

Insufficient Reliable Evidence To Rate Hypertension
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral fever bark for hypertension, there is insufficient reliable information about the clinical effects of fever bark for this condition.

Insufficient Reliable Evidence To Rate Malaria
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral fever bark for malaria, there is insufficient reliable information about the clinical effects of fever bark for this condition.

Insufficient Reliable Evidence To Rate Rheumatoid arthritis (RA)
Rating & evidence shown verbatim from Natural Medicines

Although there is interest in using oral fever bark for RA, there is insufficient reliable information about the clinical effects of fever bark for this condition.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

Fever bark should be treated with caution. The alkaloids it contains, such as reserpine-like and yohimbine-like substances, can have real effects on the heart, blood pressure, and nervous system, and can cause harm if misused.

People with heart disease, high or low blood pressure, depression or other mental health conditions, ulcers, or any chronic illness should be especially careful and should not use it without medical guidance. Older adults and anyone taking prescription medicine should also avoid self-treating with this herb.

Pregnancy and breastfeeding: Avoid fever bark if you are pregnant or breastfeeding. There is not enough safety information, and the potent alkaloids could be harmful to a developing baby or an infant.

Because of these concerns, fever bark is generally not recommended unless you are under the direct supervision of a qualified healthcare professional. Always check with a pharmacist or doctor first.

Side effects

Reported and expected side effects relate to the bark's alkaloid content. These may include nausea, vomiting, stomach upset, and diarrhea, especially in higher amounts.

More serious effects could include changes in blood pressure, slowed or irregular heart rate, dizziness, drowsiness, nasal congestion, and mood changes such as depression, which are linked to reserpine-like compounds. Yohimbine-like compounds may instead cause anxiety, a racing heart, or raised blood pressure.

Because the strength of these compounds can vary from product to product, the risk of unexpected reactions is real. Stop using it and seek medical care if you have chest pain, fainting, a very fast or irregular heartbeat, or severe vomiting.

Fever Bark: Reported Adverse Effects

Documented safety reports on Fever Bark from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, no adverse effects have been reported with fever bark; however, a thorough evaluation of safety outcomes has not been conducted. Theoretically, fever bark might cause the known adverse effects of its constituents, reserpine and yohimbine, and should be used with caution.

Reports by condition
Anxiety Psychiatric

The yohimbine constituent of fever bark, when taken alone, causes malaise, fatigue, irritability insomnia, restlessness, agitation, and anxiety . The reserpine constituent of fever bark, when taken alone, causes depression. It is not known if these effects occur with fever bark.

  1. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4.
  2. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
  3. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
  4. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9.
  5. Adeniyi, A. A., Brindley, G. S., Pryor, J. P., and Ralph, D. J. Yohimbine in the treatment of orgasmic dysfunction. Asian J Androl 2007;9(3):403-407.
  6. Giampreti, A., Lonati, D., Locatelli, C., Rocchi, L., and Campailla, M. T. Acute neurotoxicity after yohimbine ingestion by a body builder. Clin Toxicol.(Phila) 2009;47(8):827-829.
  7. Myers, A. and Barrueto, F., Jr. Refractory priapism associated with ingestion of yohimbe extract. J Med Toxicol. 2009;5(4):223-225.
  8. Cimolai, N. and Cimolai, T. Yohimbine use for physical enhancement and its potential toxicity. J Diet.Suppl 2011;8(4):346-354.
  9. Susset, J. G., Tessier, C. D., Wincze, J., Bansal, S., Malhotra, C., and Schwacha, M. G. Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. J Urol. 1989;141(6):1360-1363.
  10. Charney, D. S., Price, L. H., and Heninger, G. R. Desipramine-yohimbine combination treatment of refractory depression. Implications for the beta-adrenergic receptor hypothesis of antidepressant action. Arch.Gen.Psychiatry 1986;43(12):1155-1161.
  11. Morgan, C. A., III, Southwick, S. M., Grillon, C., Davis, M., Krystal, J. H., and Charney, D. S. Yohimbine-facilitated acoustic startle reflex in humans. Psychopharmacology (Berl) 1993;110(3):342-346.
  12. Mann, K., Klingler, T., Noe, S., Roschke, J., Muller, S., and Benkert, O. Effects of yohimbine on sexual experiences and nocturnal penile tumescence and rigidity in erectile dysfunction. Arch.Sex Behav. 1996;25(1):1-16.
  13. Rowland, D. L., Kallan, K., and Slob, A. K. Yohimbine, erectile capacity, and sexual response in men. Arch Sex Behav 1997;26(1):49-62.
  14. Riley AJ, Goodman R, Kellett JM, and et al. Double blind trial of yohimbine hydrochloride in the treatment of erection inadequacy. Sexual Marital Ther 1989;4(1):17-26.
  15. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
Cluster headache Neurologic/CNS

The yohimbine constituent of fever bark, when taken alone in high doses, causes general central nervous system and autonomic excitation, tremulousness, head twitching, seizure threshold changes, dizziness, vertigo, and headache. It is not known if this occurs with fever bark.

  1. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4.
  2. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
  3. Cameron, O. G., Zubieta, J. K., Grunhaus, L., and Minoshima, S. Effects of yohimbine on cerebral blood flow, symptoms, and physiological functions in humans. Psychosom.Med 2000;62(4):549-559.
  4. Bowes, M. P., Peters, R. H., Kernan, W. J., Jr., and Hopper, D. L. Effects of yohimbine and idazoxan on motor behaviors in male rats. Pharmacol.Biochem.Behav. 1992;41(4):707-713.
  5. Adeniyi, A. A., Brindley, G. S., Pryor, J. P., and Ralph, D. J. Yohimbine in the treatment of orgasmic dysfunction. Asian J Androl 2007;9(3):403-407.
  6. Myers, A. and Barrueto, F., Jr. Refractory priapism associated with ingestion of yohimbe extract. J Med Toxicol. 2009;5(4):223-225.
  7. Susset, J. G., Tessier, C. D., Wincze, J., Bansal, S., Malhotra, C., and Schwacha, M. G. Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. J Urol. 1989;141(6):1360-1363.
  8. Charney, D. S., Heninger, G. R., and Redmond, D. E., Jr. Yohimbine induced anxiety and increased noradrenergic function in humans: effects of diazepam and clonidine. Life Sci. 7-4-1983;33(1):19-29.
  9. Biaggioni, I., Robertson, R. M., and Robertson, D. Manipulation of norepinephrine metabolism with yohimbine in the treatment of autonomic failure. J Clin Pharmacol. 1994;34(5):418-423.
  10. Rowland, D. L., Kallan, K., and Slob, A. K. Yohimbine, erectile capacity, and sexual response in men. Arch Sex Behav 1997;26(1):49-62.
  11. Bremner, J. D., Innis, R. B., Ng, C. K., Staib, L. H., Salomon, R. M., Bronen, R. A., Duncan, J., Southwick, S. M., Krystal, J. H., Rich, D., Zubal, G., Dey, H., Soufer, R., and Charney, D. S. Positron emission tomography measurement of cerebral metaboli
Cough Pulmonary/Respiratory
Diarrhea Gastrointestinal

The yohimbine constituent of fever bark, when taken alone, causes salivation, diarrhea, and gastrointestinal distress. The reserpine constituent of fever bark, when taken alone, can cause peptic ulceration. It is not known if these effects occur with fever bark.

  1. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
  2. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9.
  3. Abebe, W. An overview of herbal supplement utilization with particular emphasis on possible interactions with dental drugs and oral manifestations. J Dent.Hyg. 2003;77(1):37-46.
  4. Bagheri, H., Schmitt, L., Berlan, M., and Montastruc, J. L. Effect of 3 weeks treatment with yohimbine on salivary secretion in healthy volunteers and in depressed patients treated with tricyclic antidepressants. Br J Clin Pharmacol 1992;34(6):555-558.
  5. Bagheri, H., Bompart, G., Girolami, J. P., Montastruc, J. L., and Montastruc, P. Is yohimbine-induced increase in salivary secretion a kinin-dependent mechanism? Fundam.Clin Pharmacol 1992;6(1):17-20.
  6. Adeniyi, A. A., Brindley, G. S., Pryor, J. P., and Ralph, D. J. Yohimbine in the treatment of orgasmic dysfunction. Asian J Androl 2007;9(3):403-407.
  7. Giampreti, A., Lonati, D., Locatelli, C., Rocchi, L., and Campailla, M. T. Acute neurotoxicity after yohimbine ingestion by a body builder. Clin Toxicol.(Phila) 2009;47(8):827-829.
  8. Myers, A. and Barrueto, F., Jr. Refractory priapism associated with ingestion of yohimbe extract. J Med Toxicol. 2009;5(4):223-225.
  9. Bagheri, H., Berlan, M., Montastruc, J. L., and Montastruc, P. Yohimbine and lacrimal secretion. Br J Clin Pharmacol. 1990;30(1):151-152.
  10. Susset, J. G., Tessier, C. D., Wincze, J., Bansal, S., Malhotra, C., and Schwacha, M. G. Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. J Urol. 1989;141(6):1360-1363.
  11. Chatelut, E., Rispail, Y., Berlan, M., and Montastruc, J. L. Yohimbine increases human salivary secretion. Br.J Clin Pharmacol. 1989;28(3):366-368.
  12. Montastruc, P., Berlan, M., and Montastruc, J. L. Effects of yohimbine on submaxillary salivation in dogs. Br J Pharmacol 1989;98(1):101-104.
  13. Bagheri, H., Chale, J. J., Guyen, L. N., Tran, M. A., Berlan, M., and Montastruc, J. L. Evidence for activation of both adrenergic and cholinergic nervous pathways by yohimbine, an alpha 2-adrenoceptor antagonist. Fundam.Clin Pharmacol 1995;9(3):248-254.
  14. Mann, K., Klingler, T., Noe, S., Roschke, J., Muller, S., and Benkert, O. Effects of yohimbine on sexual experiences and nocturnal penile tumescence and rigidity in erectile dysfunction. Arch.Sex Behav. 1996;25(1):1-16.
  15. Rowland, D. L., Kallan, K., and Slob, A. K. Yohimbine, erectile capacity, and sexual response in men. Arch Sex Behav 1997;26(1):49-62.
  16. Riley AJ, Goodman R, Kellett JM, and et al. Double blind trial of yohimbine hydrochloride in the treatment of erection inadequacy. Sexual Marital Ther 1989;4(1):17-26.
  17. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
Fever Immunologic

The yohimbine constituent of fever bark, when taken alone, causes allergic reactions. It is not known if this occurs with fever bark.

  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
  3. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  4. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  5. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
Fever Musculoskeletal

The yohimbine constituent of fever bark, when taken alone, causes may cause muscle aches. It is not known if this occurs with fever bark.

  1. Charney, D. S., Heninger, G. R., and Sternberg, D. E. Assessment of alpha 2 adrenergic autoreceptor function in humans: effects of oral yohimbine. Life Sci 6-7-1982;30(23):2033-2041.
Fever Renal

The yohimbine constituent of fever bark, when taken alone, may cause urinary frequency. It is not known if this occurs with fever bark.

  1. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4.
  2. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
  3. Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992;53:207-9.
  4. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9.
  5. Myers, A. and Barrueto, F., Jr. Refractory priapism associated with ingestion of yohimbe extract. J Med Toxicol. 2009;5(4):223-225.
  6. Susset, J. G., Tessier, C. D., Wincze, J., Bansal, S., Malhotra, C., and Schwacha, M. G. Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. J Urol. 1989;141(6):1360-1363.
  7. Charney, D. S., Heninger, G. R., and Sternberg, D. E. Assessment of alpha 2 adrenergic autoreceptor function in humans: effects of oral yohimbine. Life Sci 6-7-1982;30(23):2033-2041.
  8. Knoll, L. D., Benson, R. C., Jr., Bilhartz, D. L., Minich, P. J., and Furlow, W. L. A randomized crossover study using yohimbine and isoxsuprine versus pentoxifylline in the management of vasculogenic impotence. J Urol. 1996;155(1):144-146.
  9. Rowland, D. L., Kallan, K., and Slob, A. K. Yohimbine, erectile capacity, and sexual response in men. Arch Sex Behav 1997;26(1):49-62.
Hypertension Cardiovascular
Lupus Dermatologic
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no well-established, standardized dose for fever bark. Because the bark contains potent alkaloids that vary between products, a safe and effective dose has not been reliably determined in modern research.

If a product is used at all, follow the directions on the label and do not exceed them. More importantly, talk with a pharmacist or doctor before taking it, since this is an herb best used only under professional supervision.

Pregnancy & Breastfeeding

Fever Bark & Pregnancy

Insufficient reliable information

Insufficient reliable information available; avoid using.

Fever Bark & Breastfeeding

Insufficient reliable information

Insufficient reliable information available; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 50 references that drive our Fever Bark monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
  3. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  4. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  5. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  6. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  7. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
  8. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  9. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  10. Sklar S, et al. Drug therapy screening system. Indianapolis, IN: First Data Bank 99.1-99. 2 eds.
  11. Teloken C, Rhoden EL, Sogari P, et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998;159:122-4. PubMed
  12. Jacobsen FM. Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992;53:119-22.
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  14. Kearney T, Tu N, Haller C. Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases. Ann Pharmacother 2010;44:1022-9. PubMed
  15. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed
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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Pharmacist Counseling Corner

Fever Bark: Common Questions

What is Fever Bark used for, and does it work?
People use Fever Bark for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Fever Bark interact with prescription medications?
Yes. We list 801 medications with a known interaction with Fever Bark, including 40 rated major. Use the checker above to see how Fever Bark interacts with a specific drug.
How are Fever Bark interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Fever Bark with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Fever Bark interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Fever Bark used for?
Traditionally it is used for fever, diarrhea, indigestion, and infections, and as a bitter digestive tonic. However, there is little solid scientific evidence that it works for any of these uses.
Does Fever Bark contain quinine?
No. Even though it is sometimes called Australian quinine, Fever Bark is not known to contain quinine and should not be relied on to treat malaria.
Is Fever Bark safe to take?
It is not considered safe for casual use because it contains potent alkaloids that can affect the heart, blood pressure, and nervous system. It should only be used under direct medical supervision.
Can I take Fever Bark while pregnant or breastfeeding?
No. There is not enough safety information, and the alkaloids it contains could be harmful, so it should be avoided during pregnancy and breastfeeding.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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