An older treatment for erectile dysfunction, now little used
Yohimbine
An older treatment for erectile dysfunction, now little used and mostly sold as an unregulated supplement.
What is Yohimbine?
Yohimbine is an older medicine, originally from the bark of a tree, that was once used to treat erectile dysfunction. It is an alpha-2-adrenergic blocker. It is now little used in medicine, as better and safer treatments are available, and it is mostly sold as a supplement, often with uncertain strength and quality. It is not recommended, partly because it can raise blood pressure and heart rate and cause anxiety, agitation and tremor. It is dangerous in people with heart or anxiety disorders and must not be combined with antidepressants called MAOIs.
Education and reference only. This is a plain-language guide to Yohimbine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Yohimbine is a substance from the bark of an African tree, classed as an alpha-2-adrenergic blocker. In the past it was used as a medicine for erectile dysfunction, but it has been largely replaced by safer and more effective treatments and is now little used by doctors. Today it is mostly sold as a dietary supplement, sometimes for sexual problems or weight loss, where the strength and purity can be unreliable. Because it can affect the heart, blood pressure and mental state, and interacts dangerously with some medicines, it is generally not recommended.
How it works
Yohimbine blocks alpha-2 receptors, which are part of the body's fight-or-flight (adrenaline) system. Blocking them increases the activity of this system, which can raise blood pressure and heart rate and cause feelings of anxiety, jitteriness or tremor. The same effect on blood flow was the basis for its old use in erectile dysfunction. Because it stimulates the adrenaline system in a fairly unpredictable way, its effects can be unwanted or unsafe, especially in people with heart conditions or anxiety, which is one reason it has fallen out of medical use.
Company & origin
Originated / developed by: Various suppliers.
An older medicine, derived from a tree bark, once used for erectile dysfunction; now little used and mostly sold as a supplement.
Practical use
How to take Yohimbine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is generally not recommended; speak to a healthcare professional about proven treatments rather than using it, especially as a supplement.
- Do not take it if you have heart problems, high blood pressure or an anxiety disorder, as it can be dangerous.
- Never take it with antidepressants known as MAOIs, as the combination can cause a dangerous rise in blood pressure.
- Be aware that supplement versions are unregulated, so the strength and contents can be unpredictable.
- Tell a healthcare professional about all your medicines and conditions before considering it.
Weighing it up
Advantages & disadvantages of Yohimbine
Advantages
- Has a historical role in treating erectile dysfunction before better treatments became available.
- Taken by mouth.
- Widely available, though mainly as a supplement.
Disadvantages
- Generally not recommended, having been replaced by safer, more effective treatments.
- Can raise blood pressure and heart rate and cause anxiety, agitation and tremor.
- Dangerous in people with heart or anxiety disorders, and unsafe with MAOI antidepressants; supplement quality is unreliable.
Practical use
Good to know
The most important thing to understand is that yohimbine is generally not recommended: it has been replaced by safer, more effective treatments for erectile dysfunction, and the supplement versions are unregulated, so their strength and contents can be unpredictable. Its main risks come from stimulating the body's adrenaline system: it can raise blood pressure and heart rate and cause anxiety, agitation, tremor and palpitations, which is particularly dangerous for people with heart problems, high blood pressure or anxiety disorders. A crucial safety point is that it must not be taken with antidepressants known as MAOIs, as the combination can cause a dangerous rise in blood pressure. If you are considering it, especially as a supplement, it is far safer to speak to a healthcare professional about proven treatments instead.
Who should not take it / use with caution
- People with heart disease, high blood pressure or heart-rhythm problems should not take it.
- People with anxiety, panic or other mental-health disorders should avoid it, as it can make them worse.
- It must not be taken with antidepressants known as MAOIs, as this can cause a dangerous rise in blood pressure.
- It should be avoided in people with kidney or liver problems and is not suitable in pregnancy.
Monitoring
- Because it is not recommended, the safest step is to seek advice on proven treatments instead.
- If used despite advice, blood pressure and heart rate would need close attention.
- Watching for anxiety, palpitations and other adrenaline-type effects.
Side effects
- A rise in blood pressure and heart rate, and palpitations.
- Anxiety, agitation, restlessness, tremor and difficulty sleeping.
- Headache, dizziness, sweating and nausea.
- Rarely but seriously, dangerous rises in blood pressure or heart-rhythm problems, which need urgent care.
Key interactions
- Antidepressants known as MAOIs must not be combined with it, as this can cause a dangerous rise in blood pressure.
- Medicines for blood pressure may be made less effective, as yohimbine pushes blood pressure up.
- Stimulants, including caffeine and some decongestants, add to its effects on the heart and anxiety.
Available as: Tablets or capsules taken by mouth, mostly sold as supplements.
Answers
Yohimbine: frequently asked questions
What is yohimbine used for?
It is an older treatment for erectile dysfunction, derived from tree bark, but it is now little used in medicine and mostly sold as a supplement.
Is it safe?
It is generally not recommended; it can raise blood pressure and heart rate and cause anxiety and tremor, and is dangerous for people with heart or anxiety disorders.
Can I take it with my antidepressant?
It must not be taken with antidepressants known as MAOIs, as the combination can cause a dangerous rise in blood pressure; check with a healthcare professional first.
Why is it sold as a supplement?
It has largely fallen out of medical use, so today it is mostly sold as a dietary supplement, where the strength and contents can be unregulated and unpredictable.
Is there a better option?
Yes; there are safer, more effective proven treatments for erectile dysfunction, so it is far better to speak to a healthcare professional about those instead.
The wider class
About Alpha-2-adrenergic blocker (largely a supplement)
Yohimbine belongs to the alpha-2-adrenergic blocker (largely a supplement) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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