Generic Name: Yohimbine Hydrochloride 5 mg & 5.4 mg
Therapeutic Class: Alpha-2 Adrenergic Blocker / ED Agent
Indications
Yohimbine Hydrochloride is a selective competitive alpha-2 adrenergic receptor antagonist primarily indicated for:
- Erectile Dysfunction (ED): Specifically effective in cases of psychogenic, vascular, or diabetic-related ED where autonomic nerve function is involved.
- Sexual Dysfunction: Used as an adjunct to counter the sexual side effects (such as decreased libido or anorgasmia) caused by Selective Serotonin Reuptake Inhibitors (SSRIs).
- Lipid Mobilization: Utilized off-label in sports medicine and bodybuilding to assist in localized fat loss by blocking alpha-2 receptors in adipose tissue.
- Orthostatic Hypotension: Occasionally investigated for patients experiencing significant blood pressure drops upon standing.
Presentation
Tablet: Available as 2 mg, 5 mg, and 5.4 mg crystalline powder tablets for oral administration.
Description
Yohimbine is an indole alkaloid derived from the bark of the Central African tree Pausinystalia johimbe. As a selective pre-synaptic alpha-2 adrenergic blocker, it inhibits the feedback loop that normally limits norepinephrine release. This results in an increased sympathetic outflow to the periphery. In the genital region, it enhances cholinergic activity while decreasing adrenergic activity, leading to increased blood inflow and decreased outflow from the cavernous tissues, thereby facilitating an erection.
Dosage & Administration
Dosage must be individualized and monitored by a healthcare professional due to its narrow therapeutic index and cardiovascular effects.
- Standard Adult Dose: 5.4 mg taken three times a day (TID).
- Titration Strategy: Treatment often begins with 2.7 mg TID (half a 5.4 mg tablet). If tolerated, the dose is increased to 5.4 mg TID.
- Maximum Dose: Should not exceed 30 mg per day.
- Duration: Clinical efficacy is typically not observed immediately; it may require 2 to 4 weeks of continuous therapy to evaluate the drug's effectiveness.
- Administration: Take with a full glass of water. Absorption is rapid, but effects on the CNS vary between individuals.
Side Effects
Yohimbine is associated with a high frequency of adverse reactions due to CNS stimulation:
- Cardiovascular: Significant increase in blood pressure (hypertension), tachycardia (rapid heart rate), and palpitations.
- Neurological: Anxiety, nervousness, irritability, tremors, and insomnia.
- Gastrointestinal: Nausea, vomiting, and occasional abdominal pain.
- General: Flushing, headache, dizziness, and increased sweating.
Pregnancy & Lactation
Pregnancy: Not indicated for use in women. It is categorized as a drug with potential fetal risk and should be avoided.
Lactation: It is not known whether Yohimbine is excreted in human milk. It is not recommended for nursing mothers.
Lactation: It is not known whether Yohimbine is excreted in human milk. It is not recommended for nursing mothers.
Precautions & Contraindications
Contraindications:
- Patients with renal or hepatic insufficiency.
- Patients with a history of gastric or duodenal ulcers.
- Patients with hypertension, angina pectoris, or recent myocardial infarction.
- Patients with psychiatric disorders such as schizophrenia or chronic anxiety.
Storage
Store in a cool, dry place between 15°C to 30°C. Keep protected from direct sunlight and moisture. Ensure the container is tightly closed and out of reach of children.
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