Annona muricata

Graviola/Drug Interactions:

  • AntibioticsAntibiotics: Graviola has been historically used as a broad-spectrum internal and external antibacterial agent. Acetogenins isolated from graviola have antimicrobial activity against Leishmania species in vitro (12). The effects of graviola with antibacterial agents are not well understood.
  • Antidepressant agentsAntidepressant agents: In vitro data suggest that graviola contains constituents which may have antidepressant effects (26). Graviola reduced a stress-induced rise in brain serotonin (5-hydroxytryptamine, or 5-HT) and 5-Hydroxyindoleacetic acid (5-HIAA), and increased MAO (monoamine oxidase) activity (27). Theoretically, concurrent use of graviola with MAO inhibitors may increase the risk of hypertensive crisis.
  • AntifungalsAntifungals: Based on historical use and in vitro data, graviola may have antifungal properties (28; 29). The effects of graviola with antifungal agents are not well understood.
  • AntihypertensivesAntihypertensives: Graviola has demonstrated hypotensive activities in animal studies (41; 42). Theoretically, concurrent use of graviola with antihypertensives may have additive effects and increase the risk of hypotension.
  • Antineoplastic agentsAntineoplastic agents: Based on in vitro data, graviola is especially cytotoxic to cancer cells (8; 9; 10; 11; 12; 13; 14; 15; 14; 16; 15; 8; 17; 15; 18; 19; 20; 21; 22) and inhibits NADH oxidase in cancer cells, depleting cellular ATP (6; 23; 11; 24; 25; 7). The effects of graviola with antineoplastic agents are not well understood.
  • Antiparkinsonian agentsAntiparkinsonian agents: In epidemiological studies, graviola was found to contain neurotoxins that induced parkinsonism in humans (43; 39; 47); this association was also found in animal study (43; 38). A significant loss of dopaminergic neurons in the substantia nigra, and cholinergic and dopamine and GABAergic neurons in the striatum, accompanied by a significant increase in the number of astrocytes and microglial cells similar to that observed in patients with atypical parkinsonism, was observed in animal study (43; 38; 39). Theoretically, graviola may interfere with antiparkinsonian agents.
  • AntiprotozoalsAntiprotozoals: Based on historical use and in vitro data, graviola may have antiparasitic effects (30; 31; 12). The effects of graviola with antiprotozoal agents are not well understood.
  • Antiviral agentsAntiviral agents: Graviola has shown activity against herpes simplex virus-1 (HSV-1) in vitro (32; 33). The effects with antiviral agents are not well understood.
  • CNS depressantsCNS depressants: Based on historical use, graviola may have tranquilizing effects (26). Theoretically, concurrent use of graviola with CNS depressants may have additive effects.
  • VasodilatorsVasodilators: Graviola has demonstrated vasodilator activities in animal studies (41; 42). Theoretically, concurrent use of graviola with vasodilators may have additive effects.

    • Graviola/Herb/Supplement Interactions:

  • AntibacterialsAntibacterials: Graviola has been historically used as a broad-spectrum internal and external antibacterial agent. Acetogenins isolated from graviola have antimicrobial activity against Leishmania species in vitro (12). Based on historical use and in vitro data, graviola may have antiparasitic effects (30). The effects with antibacterial agents are not well understood.
  • AntineoplasticsAntineoplastics: Based on in vitro data, graviola is especially cytotoxic to cancer cells (8; 9; 10; 11; 12; 13; 14; 15; 14; 16; 15; 8; 17; 15; 18; 19; 20; 21; 22) and inhibits NADH oxidase in cancer cells, depleting cellular ATP (6; 23; 11; 24; 25; 7). The effects of graviola with antineoplastic agents are not well understood.
  • Antidepressants, monoamine oxidase inhibitors (MAOIs)Antidepressants, monoamine oxidase inhibitors (MAOIs): In vitro data suggest that graviola contains constituents which may have antidepressant effects (26). Graviola reduced a stress-induced rise in brain serotonin (5-hydroxytryptamine, or 5-HT) and 5-Hydroxyindoleacetic acid (5-HIAA), and increased MAO (monoamine oxidase) activity (27). Theoretically, concurrent use of graviola with MAO inhibitors may increase the risk of hypertensive crisis.
  • Antidepressants, selective serotonin reuptake inhibitors (SSRIs)Antidepressants, selective serotonin reuptake inhibitors (SSRIs): Certain alkaloids to have agonistic properties towards 5-HT1A receptors in the hippocampus (26; 27). Graviola reduced a stress-induced rise in brain serotonin (5-hydroxytryptamine, or 5-HT) and 5-Hydroxyindoleacetic acid (5-HIAA), and increased MAO (monoamine oxidase) activity (27).
  • AntifungalsAntifungals: Based on historical use and in vitro data, graviola may have antifungal properties (28; 29). The effects of graviola with antifungal agents are not well understood.
  • Antiprotozoal herbs and supplementsAntiprotozoal herbs and supplements: Based on historical use and in vitro data, graviola may have antiparasitic effects (30; 31; 12). The effects of graviola with antiprotozoal agents are not well understood.
  • AntiparasiticsAntiparasitics: Based on historical use and in vitro data, graviola may have antiparasitic effects (30; 31; 12). The effects of graviola with antiprotozoal agents are not well understood.
  • AntiviralsAntivirals: Graviola has shown activity against herpes simplex virus-1 (HSV-1) in vitro (32; 33). The effects with antiviral agents are not well understood.
  • HypotensivesHypotensives: Graviola has demonstrated hypotensive activities in animal studies (41; 42). Theoretically, concurrent use of graviola with antihypertensives may have additive effects and increase the risk of hypotension.
  • Neurologic herbs and supplementsNeurologic herbs and supplements: In epidemiological studies, graviola was found to contain neurotoxins that induced parkinsonism in humans (43; 39; 47); this association was also found in animal study (43; 38). A significant loss of dopaminergic neurons in the substantia nigra, and cholinergic and dopamine and GABAergic neurons in the striatum, accompanied by a significant increase in the number of astrocytes and microglial cells similar to that observed in patients with atypical parkinsonism, was observed in animal study (43; 38; 39).
  • SedativesSedatives: Based on historical use, graviola may have tranquilizing effects (26). Theoretically, concurrent use of graviola with sedatives may have additive effects.
  • Vasodilator herbs and supplementsVasodilator herbs and supplements: Graviola has demonstrated vasodilator activities in animal studies (41; 42). Theoretically, concurrent use of graviola with vasodilators may have additive effects.

    • Graviola/Food Interactions:

  • Insufficient available evidence.

    • Graviola/Lab Interactions:

  • Blood pressureBlood pressure: Graviola has demonstrated blood pressure-lowering effects in animal studies (41; 42).