Common names: Lapacho, Taheebo
Botanical names: Tabebuia avellanedae, Tabebuia
© Steven Foster
Parts used and where grown
Various related species of pau d’arco trees grow in rain forests throughout Latin
America. The bark is used for medical purposes.
Pau d’arco has been
used in connection with the following conditions (refer to the
individual health concern for complete information):
Historical or traditional use (may
or may not be supported by scientific studies)
Native peoples in Central and South America reportedly use pau d’arco bark to treat
cancer, lupus, infectious diseases, wounds, and many other health conditions.1
Caribbean folk healers use the leaf of this tree in addition to the bark for the treatment of
backache, toothache, sexually transmitted diseases, and as an aphrodisiac.
Lapachol and beta-lapachone (known collectively as naphthaquinones) are two primary active
compounds in pau d’arco. According to laboratory tests, both have anti-fungal properties
as potent as ketoconazole, a common antifungal
drug.2 However, amounts of these constituents needed to exert an antifungal effect
may be toxic to humans. Although these compounds also have anticancer properties according to
test tube studies, the effective amount for this effect may also be toxic.3
4 Therefore, pau d’arco cannot currently be recommended as a treatment for
How much is usually taken?
A traditional recommendation is 2–3 teaspoons (10–15 grams) of the inner bark
simmered in a pint (500 ml) of water for fifteen minutes three times per day.5
However, the naphthaquinones believed to give pau d’arco its major effects are very
poorly extracted in water, so teas are not usually recommended in modern herbal
medicine.6 Capsules or tablets providing 500–600 mg of powdered bark can be
taken three times per day. A tincture, 1/8–1/4 teaspoon (0.5–1 ml) three times per
day, can also be used.
Are there any side effects or interactions?
High amounts (several grams daily over several days) of lapachol can cause uncontrolled
bleeding, nausea, and vomiting.7 Use of the whole bark is typically safer than
isolated lapachol—side effects have included nausea and gastrointestinal
upset.8 Pregnant or breast-feeding
women should avoid use of pau d’arco.
One case report exists of a 28-year-old man who died of liver failure after taking
unspecified amounts of pau d’arco, scullcap, and zinc.9 It appears likely
that this may have been a case of adulteration of scullcap with germander.10
At the time of writing, there were no well-known drug interactions
with pau d’arco.
1. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC
Press, 1985, 470–1.
2. Guiraud P, Steiman R, Campos-Takaki GM, et al. Comparison of
antibacterial and antifungal activities of lapachol and beta-lapachone. Planta Med
3. Tyler VE. Herbs of Choice: The Therapeutic Use of
Phytomedicinals. Binghamton, NY: Pharmaceutical Products Press, 1994, 180.
4. Oswald EH. Lapacho. Br J Phytother 1993/4;3:112–7.
5. Foster S. Herbs for Your Health. Loveland, CO: Interweave
Press, 1996, 70–1.
6. Awang DVC, Dawson BA, Ethier JC, et al. Naphthoquinone constituents of
commercial lapacho/pau d’arco/taheebo products. J Herbs Spices Med Plants
7. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC
Press, 1985, 470–1.
8. Oswald EH. Lapacho. Br J Phytother 1993/4;3:112–7.
9. Hullar TE, Sapers BL, Ridker PM, et al. Herbal toxicity and fatal
hepatic failure [letter]. Am J Med 1999;106:267–8.
10. Brown D. A case of fatal liver failure associated with herbal
products. Healthnotes Rev Complement Integrative Med 1999;6:176–7.