American Mandrake, Citron Sauvage, Citronnier, Devil's Apple, Duck's Foot, Ground Lemon, Himalayan Mayapple, Hog Apple, Indian Apple, Indian Podophyllum, Ipécacuanha de la Caroline, Mandrake, Mayapple, Pa Giao Lian, Pied de Canard, Podófilo, Podophyllin, Podophyll Pelati Rhizoma/Resina, Podophylle, Podophylle en Bouclier, Podophylle à Feuilles Peltées, Podophylle Indien, Podophylle Pelté, Podophyllum emodi, Podophyllum hexandrum, Podophyllum peltatum, Pomme de Mai, Raccoon Berry, Sinopodophyllum emodi, Umbrella Plant, Vegetable Calomel, Vegetable Mercury, Wild Lemon, Wild Mandrake.
Overview InformationPodophyllum is a plant. The root and underground stem (rhizome) are used to make medicine.
Podophyllum is poisonous when taken by mouth. Despite this, some people take it orally for yellowed skin (jaundice), liver ailments, fever, syphilis, hearing loss, and cancer. Podophyllum is also used to empty the bowels, kill parasitic worms in the intestine, and counteract snakebites. Some women take it to cause an abortion.
Podophyllum has been used as a laxative. But it has been removed from the market due to safety concerns.
Podophyllum is applied directly to the skin for removal of warts, including plantar warts and genital warts. It is also used topically for white patches on the tongue in people with weakened immune systems (hairy leukoplakia) and for corns.
How does it work?Podophyllum can stop cell duplication and new growth. It can also have laxative effects.
Uses & Effectiveness
Likely Effective for
- Genital warts. Applying podophyllum resin, also called podophyllin, as a 10% to 25% suspension in tincture of benzoin or as a 2% to 4% gel directly to the affected area is effective for the removal of warts caused by human papillomavirus. But podophyllotoxin (podofilox, Condylox), a chemical found in podophyllum that is also an FDA-approved drug, is usually used instead because it is less toxic and might be more effective.
Insufficient Evidence for
- Corns. Early research suggests that applying a specific product (Canthacur PS) containing cantharidin, salicylic acid, and 5% podophyllum resin after corn removal can help to clear corns without scarring.
- White patches on the tongue in people with weakened immune systems (hairy leukoplakia). Early research suggests that a single application of 25% podophyllum resin in tincture of benzoin to the affected area can help heal wounds caused by hairy leukoplakia. Other research shows that adding acyclovir cream to 25% podophyllum resin is more effective than the resin alone.
- Liver problems.
- Other conditions.
Side Effects & SafetyWhen taken by mouth: Podophyllum is poisonous and is LIKELY UNSAFE when taken by mouth. It may cause nausea, vomiting, dizziness, headache, spasms, fever, visual changes and hallucinations, low blood pressure, bone marrow problems, paralysis, coma, liver problems, kidney problems, and death. It can take up to 13 hours for symptoms of poisoning to appear.
When applied to the skin: When applied by medical professionals in small amounts to unbroken skin, podophyllum is POSSIBLY SAFE for most people. It should be washed off within 4 to 6 hours.
Podophyllum is poisonous and LIKELY UNSAFE when applied to the skin in higher concentrations over large areas of the body. It may cause nausea, vomiting, dizziness, headache, spasms, fever, visual changes and hallucinations, low blood pressure, bone marrow problems, paralysis, coma, liver problems, kidney problems, and death. It can take up to 13 hours for symptoms of poisoning to appear.
Podophyllotoxin, a chemical found in podophyllum, is safer and has largely replaced podophyllum as a treatment.
Special Precautions & Warnings:Pregnancy and breast-feeding:It is LIKELY UNSAFE to take podophyllum by mouth or apply it to your skin if you are pregnant. There have been reports of death and multiple birth defects in babies whose mothers used podophyllum during pregnancy.
It is also LIKELY UNSAFE to use podophyllum if you are breast-feeding. The poisons in podophyllum can endanger you and your nursing baby.
We currently have no information for PODOPHYLLUM Interactions.
The following doses have been studied in scientific research:
APPLIED TO THE SKIN:
- Podophyllum should not be used for self-treatment. Covering too much skin with podophyllum or applying it to broken skin increases the chance of getting poisoned. It's safer to use podophyllotoxin, which is an FDA-approved drug.
- For genital warts: A 0.5% podophyllotoxin gel is applied twice daily for three days in a row and repeated for two to four cycles. Podophyllotoxin is a chemical taken from podophyllum. Podophyllotoxin (podofilox, Condylox) is an FDA-approved drug. Podophyllotoxin might be more effective than podophyllum and is less toxic.
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- Botachini, D. D. G., Valente, M. N., Lascasa, R. C., Batista, K. J., and Rodrigues, D. L. G. Therapeutic of cervicovaginal human papillomavirus infection. Randomized study with four drugs [Tratamento da infecção por papilomavirus humano (HPV). Estudo aleatorizado com quatro fármacos]. J Bras Ginecol 1993;103(6):205-210.
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- Chang, L. W., Yang, C. M., Chen, C. F., and Deng, J. F. Experimental podophyllotoxin (bajiaolian) poisoning: I. Effects on the nervous system. Biomed.Environ.Sci 1992;5(4):283-292. View abstract.
- Chang, L. W., Yang, C. M., Chen, C. F., and Deng, J. F. Experimental podophyllotoxin (bajiaolian) poisoning: II. Effects on the liver, intestine, kidney, pancreas and testis. Biomed.Environ.Sci 1992;5(4):293-302. View abstract.
- Chattopadhyay, S., Bisaria, V. S., Panda, A. K., and Srivastava, A. K. Cytotoxicity of in vitro produced podophyllotoxin from Podophyllum hexandrum on human cancer cell line. Nat.Prod.Res. 2004;18(1):51-57. View abstract.
- CostaPinto, L., Grassi, M. F., Serravalle, K., Travessa, A. C., Olavarria, V. N., and Santiago, M. B. Giant disseminated condylomatosis in SLE. Lupus 2012;21(3):332-334. View abstract.
- Dedo, H. H. and Jackler, R. K. Laryngeal papilloma: results of treatment with the CO2 laser and podophyllum. Ann.Otol.Rhinol.Laryngol. 1982;91(4 Pt 1):425-430. View abstract.
- Fait, T., Dvorak, V., Skrivanek, A., Rokyta, Z., and Pilka, R. [Epidemiology of genital warts in female population of Czech Republic]. Ceska.Gynekol. 2012;77(4):360-363. View abstract.
- Gilson, R. J., Ross, J., Maw, R., Rowen, D., Sonnex, C., and Lacey, C. J. A multicentre, randomised, double-blind, placebo controlled study of cryotherapy versus cryotherapy and podophyllotoxin cream as treatment for external anogenital warts. Sex Transm.Infect. 2009;85(7):514-519. View abstract.
- Goel, H. C., Prasad, J., Sharma, A., and Singh, B. Antitumour and radioprotective action of Podophyllum hexandrum. Indian J Exp Biol 1998;36(6):583-587. View abstract.
- Gowdey, G., Lee, R. K., and Carpenter, W. M. Treatment of HIV-related hairy leukoplakia with podophyllum resin 25% solution. Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod. 1995;79(1):64-67. View abstract.
- Kacar, N., Tasli, L., Korkmaz, S., Ergin, S., and Erdogan, B. S. Cantharidin-podophylotoxin-salicylic acid versus cryotherapy in the treatment of plantar warts: a randomized prospective study. J Eur Acad.Dermatol Venereol. 2012;26(7):889-893. View abstract.
- Karol, M. D., Conner, C. S., Watanabe, A. S., and Murphrey, K. J. Podophyllum: suspected teratogenicity from topical application. Clin.Toxicol. 1980;16(3):283-286. View abstract.
- Komericki, P., Akkilic-Materna, M., Strimitzer, T., and Aberer, W. Efficacy and safety of imiquimod versus podophyllotoxin in the treatment of anogenital warts. Sex Transm.Dis. 2011;38(3):216-218. View abstract.
- Kumar, M., Shanmugham, A., Prabha, S., Adhisivam, B., Narayanan, P., and Biswal, N. Permanent neurological sequelae following accidental podophyllin ingestion. J Child Neurol. 2012;27(2):209-210. View abstract.
- Larsen, A., Petersson, I., and Svensson, B. Podophyllum derivatives (CPH 82) compared with placebo in the treatment of rheumatoid arthritis. Br.J.Rheumatol. 1989;28(2):124-127. View abstract.
- Martin, L. K., Rubin, A. I., Theocharous, C., and Murrell, D. F. Podophyllin reaction mimicking Bowen's disease in a patient with delusions of verrucosis. Clin Exp.Dermatol 2008;33(4):443-445. View abstract.
- Moher, L. M. and Maurer, S. A. Podophyllum toxicity: case report and literature review. J.Fam.Pract. 1979;9(2):237-240. View abstract.
- Moura, M. D., Guimaraes, T. R., Fonseca, L. M., de, Almeida Pordeus, I, and Mesquita, R. A. A random clinical trial study to assess the efficiency of topical applications of podophyllin resin (25%) versus podophyllin resin (25%) together with acyclovir cream (5%) in the treatment of oral hairy leukoplakia. Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod. 2007;103(1):64-71. View abstract.
- Moura, M. D., Haddad, J. P., Senna, M. I., Ferreira e Ferreira, and Mesquita, R. A. A new topical treatment protocol for oral hairy leukoplakia. Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod. 2010;110(5):611-617. View abstract.
- Paeschke, K. D. [Radio-chemotherapy of cervix carcinoma. I. Clinical part]. Strahlentherapie. 1976;151(4):311-317. View abstract.
- Sherrard, J. and Riddell, L. Comparison of the effectiveness of commonly used clinic-based treatments for external genital warts. Int J STD AIDS 2007;18(6):365-368. View abstract.
- Stockfleth, E. and Meyer, T. The use of sinecatechins (polyphenon E) ointment for treatment of external genital warts. Expert.Opin.Biol Ther 2012;12(6):783-793. View abstract.
- Svecova, D., Havrankova, M., Weismanova, E., and Babal, P. Anogenital squamous cell carcinoma in neglected patient. Bratisl.Lek.Listy 2012;113(4):246-248. View abstract.
- Tchernev, G. Sexually transmitted papillomavirus infections: epidemiology pathogenesis, clinic, morphology, important differential diagnostic aspects, current diagnostic and treatment options. An Bras.Dermatol 2009;84(4):377-389. View abstract.
- Triantos, D., Porter, S. R., Scully, C., and Teo, C. G. Oral hairy leukoplakia: clinicopathologic features, pathogenesis, diagnosis, and clinical significance. Clin Infect.Dis. 1997;25(6):1392-1396. View abstract.
- von Krogh, G. Topical treatment of penile condylomata acuminata with podophyllin, podophyllotoxin and colchicine. A comparative study. Acta Derm.Venereol. 1978;58(2):163-168. View abstract.
- Wallin, J. 5-Fluorouracil in the treatment of penile and urethral condyloma acuminata. Br J Vener Dis 1977;53(4):240-243.
- White, D. J., Billingham, C., Chapman, S., Drake, S., Jayaweera, D., Jones, S., Opaneye, A., and Temple, C. Podophyllin 0.5% or 2.0% v podophyllotoxin 0.5% for the self treatment of penile warts: a double blind randomised study. Genitourin.Med 1997;73(3):184-187. View abstract.
- Wollina, U. Er:YAG laser followed by topical podophyllotoxin for hard-to-treat palmoplantar warts. J Cosmet.Laser Ther. 2003;5(1):35-37. View abstract.
- Xie, F. M., Zeng, K., Chen, Z. L., Li, G. F., Lin, Z. F., Zhu, X. L., and Sun, L. D. [Treatment of recurrent condyloma acuminatum with solid lipid nanoparticle gel containing podophyllotoxin: a randomized double-blinded, controlled clinical trial]. Nan.Fang Yi.Ke.Da.Xue.Xue.Bao. 2007;27(5):657-659. View abstract.
- Cassidy DE, Drewry J, Fanning JP. Podophyllum toxicity: a report of a fatal case and a review of the literature. J Toxicol Clin Toxicol 1982;19:35-44. View abstract.
- Frasca T, Brett AS, Yoo SD. Mandrake toxicity. A case of mistaken identity. Arch Intern Med 1997;157:2007-9. View abstract.
- Gupta D, Arora R, Garg AP, Goel HC. Radiation protection of HepG2 cells by Podophyllum hexandrum Royale. Mol Cell Biochem 2003;250:27-40. View abstract.
- Lacey CJ, Goodall RL, Tennvall GR, et al. Randomised controlled trial and economic evaluation of podophyllotoxin solution, podophyllotoxin cream, and podophyllin in the treatment of genital warts. Sex Transm Infect 2003;79:270-5. View abstract.
- Longstaff E, von Krogh G. Condyloma eradication: self-therapy with 0.15-0.5% podophyllotoxin versus 20-25% podophyllin preparations--an integrated safety assessment. Regul Toxicol Pharmacol 2001;33:117-37. View abstract.
- Lozada-Nur F, Costa C. Retrospective findings of the clinical benefits of podophyllum resin 25% sol on hairy leukoplakia. Clinical results in nine patients. Oral Surg Oral Med Oral Pathol 1992;73:555-8. View abstract.
- Mack RB. Living mortals run mad. Mandrake (podophyllum) poisoning. N C Med J 1992;53:98-9. View abstract.
- Prem Kumar I, Rana SV, Samanta N, Goel HC. Enhancement of radiation-induced apoptosis by Podophyllum hexandrum. J Pharm Pharmacol 2003;55:1267-73. View abstract.
- Rosenstein G, Rosenstein H, Freeman M, Weston N. Podophyllum-a dangerous laxative. Pediatrics 1976;57:419-21.
- Schwartz J, Norton SA. Useful plants of dermatology. VI. The mayapple (Podophyllum). J Am Acad Dermatol 2002;47:774-5. View abstract.
- Wiley DJ, Douglas J, Beutner K, et al. External genital warts: diagnosis, treatment, and prevention. Clin Infect Dis 2002;35:S210-24. View abstract.
- Akdemir, O., Bilkay, U., Tiftikcioglu, Y. O., Ozek, C., Yan, H., Zhang, F., and Akin, Y. New alternative in treatment of callus. J Dermatol 2011;38(2):146-150. View abstract.
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