Cissus quadrangularis

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • 3,3′,4,4′-Tetrahydroxybiphenyl, 6-O-[2,3-dimethoxy]-trans-cinnamoyl catalpol, 6-O-meta-methoxy-benzoyl catalpol, ascorbic acid, asthisonhara, beta-sitosterol, beta-sitosterol glycoside, calcium, carotene, carotenoids, chadhuri, chaudhari, cissus, cissus extract, cissus formula, cissus formulation, C. quadrangularis, Cissus quadrangularis extract, Cissus succulent, Cissus tetragona, CQ, CQE, CQR-300, cysteine proteases, delta-amyrin, delta-amyrone, epifriedelinol, flavonoids, hadjod, hadjora, harbhanga, harsankari, hasjora, indanes, iridoids, isinwasi (Zulu), isoarborenol, kandavela, ketosteroids, kun koat (Thai), lupenone, mangaroli, nalleru, namunungwa, onocer-7-ene-3alpha,21beta-diol, pallidol, phet cha sung khaat, phet sang kat, phet sang khat (Thai), phet sangkhat, phytosterols, picroside-1, pirandai, polyphenols, quadrangularin A, quadrangularis, quercitin, quercitrin, sam roi tow (Thai), samroi to, san cha khuat, san cha koat (Thai), stemmed vine, stilbenes, tannins, triterpenoids, vajravalli, vedhari, veld grape, veld grave vine, veldt-grape, vitamin C, vitamin E, vitis, vitis quadrangularis, winged treebine.

  • Select combination products: Calzbone® extract (containing Cissus quadrangularis, boswellia, vitamin D, and calcium), CORE™ (containing Cissus quadrangularis, ChromeMateTM [niacin-bound 10% chromium concentrate], green tea extract, selenium, AbumaSoyTM [soy albumin], vitamin B6, vitamin B12, and folic acid), Cylaris™ (containing Cissus quadrangularis, ChromeMateTM [niacin-bound 10% chromium concentrate], green tea extract, selenium, soy albumin extract, vitamin B6, vitamin B12, and folic acid).

  • Note: The Cissus quadrangularis plant is referred to by several other names, such as Cissus succulent, Cissus tetragona, Vitis quadrangularis, and Vitis succulent. However, Cissus quadrangularis will be the principal name used throughout the remainder of this monograph.

  • Though other species of Cissus have been previously studied, such as Cissus assamica, Cissus deblis Planch., Cissus hamaderohensis, Cissus ibuensis Hook, Cissus pteroclada, Cissus populnea, Cissus repens, Cissus rheifolia, Cissus rotundifolia, Cissus rubiginosa, Cissus rufescens, Cissus sicyoides, and Cissus verticillata, the intent of this monograph will be to focus solely on Cissus quadrangularis.

Background

  • Cissus quadrangularis is a vine native to Africa, Southeast Asia, and India. Historically, Cissus quadrangularis was used for bone health, pain relief, and stomach conditions.

  • Traditionally, parts of the Cissus plant have been mashed, roasted, juiced, pulped, or cooked before application. In modern times, Cissus quadrangularis has been taken as a powder or capsule.

  • Cissus quadrangularis has been studied for its potential to treat osteoporosis and obesity. Additional research on these topics is needed.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Obesity/weight loss

Cissus quadrangularis may decrease body weight, body fat, and waist circumference. Additional research is needed in this area.

Broken bones

Limited research suggested that a combination product containing Cissus quadrangularis may improve bone healing and bone density. Additional research is needed in this area.

Dental conditions

The effect of Cissus quadrangularis on tooth regrowth is unclear. Additional research is needed in this area.

Hemorrhoids

Limited research suggests Cissus quadrangularis may reduce the size, pain, and inflammation of hemorrhoids. Additional research is needed in this area.

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Anorexia, antibacterial, antifungal, anti-inflammatory, antioxidant, antispasmodic (inhibits muscle spasms), asthma, body building (increase muscle mass), cancer, colds, convulsions, cough, dehydration, depression, diabetes, ear discomfort, gastric ulcers, gonorrhea (a sexually transmitted disease), high cholesterol, immune system regulation, indigestion, liver damage, malaria, menstrual problems, metabolic disorders, osteoporosis, pain relief, schistosomiasis (parasite infection), scurvy, sickle cell disease, skin diseases.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • In general, the appropriate dose of Cissus quadrangularis depends on the person’s age, health, and other conditions. Sufficient information to determine an appropriate range of doses for Cissus quadrangularis is lacking.

  • For obesity or weight loss, 150 milligrams of Cissus quadrangularis (standardized to 2.5% ketosteroids) has been taken by mouth twice daily for 10 weeks.

  • For hemorrhoids, three 500-milligram Cissus quadrangularis tablets have been taken by mouth twice daily for four days, followed by two tablets twice daily for three days.

Children (under 18 years old)

  • There is no proven safe or effective dose for Cissus quadrangularis in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in people with known allergy or sensitivity to Cissus quadrangularis, its parts, or any member of the Vitaceae family.

Side Effects and Warnings

  • Cissus quadrangularis is likely safe in specific commercial products, when used according to package label instructions in adults for 6-8 weeks.

  • Cissus quadrangularis may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

  • Use cautiously in people taking central nervous system (CNS) depressants (sedatives or tranquilizers) or agents that increase or decrease serotonin levels, such as 5-HTP receptor agonists (triptans), selective serotonin reuptake inhibitors (SSRIs), and selective serotonin/norepinephrine reuptake inhibitors (SNRIs). Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.

  • Use cautiously in people with autoimmune disorders or in those taking agents that alter the immune system.

  • Avoid Cissus quadrangularis during pregnancy or breastfeeding.

  • Avoid in persons with a known allergy or sensitivity to Cissus quadrangularis, its parts, or other members of the Vitaceae family.

  • Cissus quadrangularis may also cause diarrhea, dry mouth, headache, gas, altered levels of plasma 5-HT, inflammation of the stomach lining, insomnia, and stimulation of the immune system.

Pregnancy and Breastfeeding

  • There is a lack of scientific evidence on the use of Cissus quadrangularis during pregnancy or breastfeeding.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Cissus quadrangularis may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Cissus quadrangularis may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

  • Cissus quadrangularis may also interact with 5-HT receptor agonists (which mimic serotonin); agents for cancer, malaria, or osteoporosis; agents for inflammation or pain relief; agents that inhibit convulsions or spasms; agents that stimulate or suppress immune function; agents that treat disorders of the nervous system, stomach, or intestines; agents toxic to the liver; antibiotics; antidepressants; antifungals; cholesterol-lowering agents; cholinergics (which mimic acetylcholine); sedatives; SSRIs; and weight loss agents.

Interactions with Herbs and Dietary Supplements

  • Cissus quadrangularis may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment

  • Cissus quadrangularis may increase the amount of drowsiness caused by some herbs or supplements.

  • Cissus quadrangularis may also interact with 5-HT receptor agonists (which mimic serotonin); African mango; antibiotics; antidepressants; antifungals; antioxidants; cholesterol-lowering herbs and supplements; cholinergics (which mimic acetylcholine); herbs and supplements for cancer, malaria, or osteoporosis; herbs and supplements for inflammation or pain relief; herbs and supplements that inhibit convulsions or spasms; herbs and supplements that stimulate or suppress immune function; herbs and supplements that treat disorders of the nervous system, stomach, or intestines; herbs and supplements toxic to the liver; sedatives; SSRIs; and weight loss herbs and supplements.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Dhatrak Sarang, Thawani Vijay Gharpure Kunda Apte Indrayani Masand Anil Hingorani Lal and Khiyani Raj. Effect of Herbal Combination in Low Bone Mass Density Patients. International Journal of Drug Discovery and Technology 2011;2(1):9-14.
  2. Hasani-Ranjbar, S., Nayebi, N., Larijani, B., and Abdollahi, M. A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity. World J Gastroenterol 7-7-2009;15(25):3073-3085. View Abstract
  3. Oben, J. E., Enyegue, D. M., Fomekong, G. I., Soukontoua, Y. B., and Agbor, G. A. The effect of Cissus quadrangularis (CQR-300) and a Cissus formulation (CORE) on obesity and obesity-induced oxidative stress. Lipids Health Dis 2007;6:4. View Abstract
  4. Oben, J. E., Ngondi, J. L., Momo, C. N., Agbor, G. A., and Sobgui, C. S. The use of a Cissus quadrangularis/Irvingia gabonensis combination in the management of weight loss: a double-blind placebo-controlled study. Lipids Health Dis 2008;7:12. View Abstract
  5. Oben, J., Kuate, D., Agbor, G., Momo, C., and Talla, X. The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome. Lipids Health Dis 2006;5:24. View Abstract
  6. Panpimanmas, S., Sithipongsri, S., Sukdanon, C., and Manmee, C. Experimental comparative study of the efficacy and side effects of Cissus quadrangularis L. (Vitaceae) to Daflon (Servier) and placebo in the treatment of acute hemorrhoids. J Med Assoc.Thai. 2010;93(12):1360-1367. View Abstract
  7. Thawani VR, Kimmatkar N Hingorani LL Khiyani RM. Effect of herbal combination containing cissus quadrangularis in fracture healing. The Antiseptic 2002;99(9):345-347.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.