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Cowhage is a bean-like plant. It grows wild in the tropics, including India and the Bahamas, and its range may extend to southern Florida. The bean, seed, and hair of the bean pod are used to make medicine.

Cowhage has been used since ancient times in Ayurvedic medicine for Parkinson disease. Today, cowhage is still tried for Parkinson disease, anxiety, joint and muscle pain, and many other conditions, but there is no good scientific evidence to support many of these uses.

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

Cowhage contains levodopa (L-dopa), a medication that is used to treat Parkinson disease. Symptoms of Parkinson disease occur in patients due to low levels of dopamine in the brain. L-dopa is changed to dopamine in the brain. Unfortunately, most L-dopa is broken down in the body before it ever reaches the brain unless special chemicals are used. These chemicals are available as medication, but are not present in cowhage.

When taken by mouth: A powdered preparation of cowhage seed, called Zandopa (formerly HP-200; Zandu Pharmaceuticals), is POSSIBLY SAFE for most people when taken by mouth for up to 20 weeks. The most common side effects include nausea and a sensation of abdominal bloating. Less common side effects include vomiting, abnormal body movements, and insomnia. Rare but possible side effects of other cowhage preparations include headache, pounding heartbeat, confusion, agitation, hallucinations, and delusions.

The hair of the cowhage bean pod is POSSIBLY UNSAFE. It is a strong irritant and can cause severe burning and swelling.

When applied to the skin: The hair of the cowhage bean pod is POSSIBLY UNSAFE. It is a strong irritant and can cause severe itching, burning, and swelling.

Special Precautions & Warnings:

Pregnancy and breast-feeding: There isn't enough reliable information to know if cowhage is safe to use when pregnant or breast-feeding. Stay on the safe side and avoid use.

Diseases of the heart and blood vessels (cardiovascular disease): Due to the levodopa (L-dopa) in cowhage, it should be avoided or used cautiously in people with cardiovascular disease. L-dopa can frequently cause low blood pressure on standing (orthostatic hypotension), dizziness, and fainting. Much less frequently, L-dopa can also cause pounding or irregular heartbeat.

Diabetes: There is some evidence that cowhage can lower blood sugar levels and might cause blood sugar to drop too low. If you have diabetes and use cowhage, be sure to monitor you blood sugar carefully. The doses of your diabetes medications might need to be adjusted.

Low blood sugar (hypoglycemia): There is some evidence that cowhage can lower blood sugar levels and might make low blood sugar worse.

Liver disease: Cowhage contains levodopa (L-dopa). L-dopa seems to raise the blood levels of chemicals that indicate liver damage. This may mean that the cowhage is making liver disease worse. If you have liver disease, don't use cowhage.

Skin cancer called melanoma: The body can use the levodopa (L-dopa) in cowhage to make to the skin pigment called melanin. There is some concern that this extra melanin might make melanoma worse. Don't use cowhage if you have a history of melanoma or a suspicious changes in the skin.

Stomach or intestinal ulcers (peptic ulcer disease): There have been reports that levodopa (L-dopa) can cause gastrointestinal (GI) bleeding in people with ulcers. Since cowhage contains L-dopa, there is some concern that it might cause gastrointestinal (GI) bleeding in patients with ulcers. However, this problem has not yet been reported with cowhage.

Mental illness: Due to the levodopa (L-dopa) content, cowhage might make mental illness disease worse.

Surgery: Since cowhage might affect blood sugar levels, there is some concern that it might interfere with blood sugar control during and after surgery. Stop taking cowhage at least 2 weeks before a scheduled surgery.

Guanethidine (Ismelin)

Interaction Rating=Moderate Be cautious with this combination.

Cowhage can decrease blood pressure. Guanethidine (Ismelin) can also decrease blood pressure. Taking cowhage and guanethidine together might cause blood pressure to go too low.

Medications for depression (MAOIs)

Interaction Rating=Major Do not take this combination.

Cowhage contains chemicals that stimulate the body. Some medications used for depression can increase these chemicals. Taking cowhage along with these medications used for depression might cause serious side effects including fast heartbeat, high blood pressure, seizures, nervousness, and others.
Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.

Medications for diabetes (Antidiabetes drugs)

Interaction Rating=Moderate Be cautious with this combination.

Cowhage might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking cowhage along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

Medications for mental conditions (Antipsychotic drugs)

Interaction Rating=Moderate Be cautious with this combination.

Cowhage seems to increase a chemical in the brain called dopamine. Some medications for mental conditions help to decrease dopamine. Taking cowhage along with some medications for mental conditions might decrease the effectiveness of some medications for mental conditions.
Some medications for mental conditions include chlorpromazine (Thorazine), clozapine (Clozaril), fluphenazine (Prolixin), haloperidol (Haldol), olanzapine (Zyprexa), perphenazine (Trilafon), prochlorperazine (Compazine), quetiapine (Seroquel), risperidone (Risperdal), thioridazine (Mellaril), thiothixene (Navane), and others.

Medications used during surgery (Anesthesia)

Interaction Rating=Moderate Be cautious with this combination.

Cowhage contains a chemical called L-dopa (levodopa). Taking L-dopa along with medications used for surgery can cause heart problems. Be sure to tell your doctor what natural products you are taking before having surgery. You should stop taking cowhage at least two weeks before surgery.

Medications used for depression (Tricyclic antidepressants)

Interaction Rating=Moderate Be cautious with this combination.

Some medications used for depression can slow down the stomach and intestines. This might decrease how much cowhage is absorbed. Taking some medications used for depression might decrease the effects of cowhage.

Methyldopa (Aldomet)

Interaction Rating=Major Do not take this combination.

Cowhage can lower blood pressure. Methyldopa (Aldomet) can also lower blood pressure. Taking cowhage and methyldopa together might lower blood pressure too much.
Some of these medicines used for depression include amitriptyline (Elavil), imipramine (Tofranil), and others.

Herbs and supplements that might lower blood sugar: There is some evidence that cowhage might lower blood sugar. Using it along with other natural products that have the same effect might increase the risk of blood sugar dropping too low. Some of these products include bitter melon, ginger, goat's rue, fenugreek, kudzu, willow bark, and others.
Kava: Kava might reduce the effectiveness of cowhage because kava contains chemicals that can affect the levodopa (L-dopa) in cowhage.
Vitamin B6: Vitamin B6 can decrease the amount of levodopa (L-dopa) that stays in the body after taking cowhage. If you are taking cowhage for Parkinson disease, avoid taking vitamin B6 supplements.

There are no known interactions with foods.

The appropriate dose of cowhage depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for cowhage. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Atmagupta, Couhage, Cowitch, Cow-Itch Plant, Dolichos Pruriens, Feijao Macaco, HP 200, HP-200, Kapi Kacchu, Kapikachchhu, Kapikachhu, Kapikachu, Kaunch, Kawach, Kawanch, Kevanch, Kiwach, Mucuna, Mucuna hirsuta, Mucuna pruriens, Mucuna Prurient, Mucuna Prurita, Nescafé, Ojo de Buey, Ojo de Venado, Pica-Pica, Pois à Gratter, Pois Mascate, Pois Velu, Stizolobium pruriens, Velvet Bean.

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