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American pawpaw (Asimina triloba)

Last Updated on May 19, 2021 by MyFormulary

Alternate Title

  • Asimina triloba

Related Terms

  • Acetogenin, alkaloids, American paw paw, annomontacin, Annonaceae (family), Annonaceous acetogenins, Annona cherimola, Annona diversifolia, Annona glabra, Annona muricata, Annona palustris, Annona purpurea, Annona reticulata, Annona squamosa, Annona squamosa X A. cherimola, Annona triloba L., annonacin, annonacin-A, asimicin, asimin, Asimina incarna, Asimina longifolia, Asimina obovata, Asimina parviflora, Asimina pygmaea, Asimina reticulata, Asimina tetramera, Asimina triloba (L.) Dunal, Asimina X nashii, asiminacin, asiminecin, asiminocin, asimitrin, asimilobin, asitrocin, asitrilobins, atemoya, benzyltetrahydroisoquinolone alkaloids, biriba, Brazilian pawpaw, bullanin, bullatacin, bullatacinone, bullatetrocin, bulletin, Carica papaya, cherimoya, coumaroyltyramine, custard apple, Deeringothamnus rugelii, Deeringothamnus puchellus, Disepalum, dog banana, dwarf pawpaw, feruloyltyramine, flag pawpaw, flavonoids, gigantetrocinone, Goniothalanus, graviola, guanabana, Hoosier banana, ilama, Indiana banana, isoannonacin, murisolinone, nicotiflorine, octanoate, opossum pawpaw, Ozark banana, papaya, paw paw, Paw Paw Cell-Reg®, poor man’s banana, prairie banana, Rollinia mucosa, rutin, soncoya, soursop, squamolone, sugar apple, sweetsop, syringaresinol, trilobacin, trilobalicin, Uvaria, West Virginia banana, xylomaticin, Xylopia.
  • Note: American pawpaw (Asimina triloba) is not a papaya and should not be confused with Carica papaya or Annona muricata (graviola) although the species have similar common names and may be called “pawpaw.”

Background

  • American pawpaw (Asimina triloba) is a fruiting tree native to North America. However, plantings of the tree can be found in Asia, Australia, and Europe. Pawpaw extract is made from the twigs of the tree.
  • In the 1980s and 1990s, researchers at Purdue University isolated compounds from pawpaw bark extracts. Many of these compounds were found to have cytotoxic effects on cancer cell lines. Currently, there is a lack of available scientific evidence supporting the safety or effectiveness of pawpaw for any condition.

Evidence Table

    Disclaimer

    These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

    C Cancer treatment

    Pawpaw extract may have some anticancer activity, but additional study is needed to make a firm recommendation.

    C Lice

    Pawpaw extract in combination with thymol and tea tree oil in a shampoo formulation may be effective for the eradication of lice. Better-quality study using pawpaw alone is needed before a firm recommendation can be made.

*Key to grades:

Tradition

    Disclaimer

    The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

    Disclaimer

    The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

  • Adults (18 years and older)

    • Dosing from scientific studies has not been proven safe or effective. For cancer, 12.5-50 milligrams of extract has been taken by mouth four times a day with food for periods of up to 18 months. For lice, 40 milliliters of Paw Paw Lice Remover Shampoo® (0.5% pawpaw extract, 1% thymol, and 0.5% tea tree oil) applied three times to dry hair, once every 8 days for up to 24 days, has been used.
  • Children (younger than 18 years)

    • Dosing from scientific trials has not been proven safe or effective. For lice, 40 milliliters of Paw Paw Lice Remover Shampoo® (0.5% pawpaw extract, 1% thymol, and 0.5% tea tree oil) applied three times to dry hair, once every 8 days for up to 24 days, has been used.

Safety

    Disclaimer

    The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

  • Allergies

    • Avoid in individuals with a known allergy or hypersensitivity to Asimina triloba, or any other members of the Annonaceae plant family (including other species of Asimina, and those in the genera Annona, Deeringothamnus, Disepalum, Goniothalanus, Rollinia, Uvaria, and Xylopia).
  • Side Effects and Warnings

    • There is a lack of safety information about pawpaw extracts. The constituents in pawpaw extract are cytotoxic. Taking pawpaw extract by mouth is not recommended without the supervision of a qualified healthcare professional, including a pharmacist.
    • Patients with gastrointestinal problems or a history of skin reactions should use pawpaw cautiously, because both nausea and vomiting have been reported after taking pawpaw by mouth.
    • Patients with known allergy or hypersensitivity to Asimina triloba, or any other members of the Annonaceae plant family should avoid pawpaw due to the possibility of developing urticaria (“hives”), reddening of the skin or itching.
  • Pregnancy and Breastfeeding

    • Use during pregnancy or breastfeeding is not recommended due to the cytotoxic effects of pawpaw extract.

Interactions

    Disclaimer

    Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

  • Interactions with Drugs

    • Pawpaw extracts may interact with antioxidant medications. Caution is advised.
  • Interactions with Herbs and Dietary Supplements

    • The combined use of 7-keto and pawpaw extract may lessen the effect of 7-keto and combined use of these agents may be ineffective. Patients taking herbs and supplements should consult with a qualified healthcare professional, including a pharmacist, before combining therapies.
    • Pawpaw may interact with coenzyme Q10. It may also interact with antioxidant herbs and supplements. Caution is advised.

Attribution

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration ().

Bibliography

    Disclaimer

    Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to . Selected references are listed below.

  • Alali FQ, Liu XX, McLaughlin JL. Annonaceous acetogenins: recent progress. J Nat Prod 1999;62(3):504-540.
    View Abstract
  • Caparros-Lefebvre D, Elbaz A. Possible relation of atypical parkinsonism in the French West Indies with consumption of tropical plants: a case-control study. Caribbean Parkinsonism Study Group. Lancet 7-24-1999;354(9175):281-286.
    View Abstract
  • Haribal M, Feeny P. Combined roles of contact stimulant and deterrents in assessment of host-plant quality by ovipositing zebra swallowtail butterflies. J Chem Ecol. 2003;29(3):653-670.
    View Abstract
  • He K, Zhao GX, Shi G, et al. Additional bioactive annonaceous acetogenins from Asimina triloba (Annonaceae). Bioorg.Med.Chem. 1997;5(3):501-506.
    View Abstract
  • Kim EJ, Suh KM, Kim DH, et al. Asimitrin and 4-hydroxytrilobin, new bioactive annonaceous acetogenins from the seeds of Asimina triloba possessing a bis-tetrahydrofuran ring. J Nat Prod 2005;68(2):194-197.
    View Abstract
  • Martin JM, Madigosky SR, Gu ZM, et al. Chemical defense in the zebra swallowtail butterfly, Eurytides marcellus, involving annonaceous acetogenins. J Nat Prod 1999;62(1):2-4.
    View Abstract
  • McCage CM, Ward SM, Paling CA, et al. Development of a paw paw herbal shampoo for the removal of head lice. Phytomedicine 2002;9(8):743-748.
    View Abstract
  • McLaughlin, JL. A novel mechanism for the control of clinical cancer: inhibition of the production of adenosine triphosphate (ATP) with a standardized extract of paw paw (Asimina triloba, Annonaceae) (Unpublished). 2001.
  • McLaughlin JL, Zeng L, Oberlies NH, et al. Annonaceous acetogenins as new natural pesticide: Recent progress In: Phytochemicals for pest control. 1997;119-133.
  • Woo MH, Cho KY, Zhang Y, et al. Asimilobin and cis- and trans-murisolinones, novel bioactive Annonaceous acetogenins from the seeds of Asimina triloba. J.Nat.Prod. 1995;58(10):1533-1542.
    View Abstract
  • Woo MH, Chung SO, Kim DH. Asitrilobins C and D: two new cytotoxic mono-tetrahydrofuran annonaceous acetogenins from Asimina triloba seeds. Bioorg.Med.Chem. 2000;8(1):285-290.
    View Abstract
  • Woo MH, Kim DH, McLaughlin JL. Asitrilobins A and B: cytotoxic mono-THF annonaceous acetogenins from the seeds of Asimina triloba. Phytochemistry 1999;50(6):1033-1040.
    View Abstract
  • Wood R, Peterson S. Lipids of the pawpaw fruit: Asimina triloba. Lipids 1999;34(10):1099-1106.
    View Abstract
  • Ye Q, He K, Oberlies NH, Zeng L, et al. Longimicins A-D: novel bioactive acetogenins from Asimina longifolia (annonaceae) and structure-activity relationships of asimicin type of annonaceous acetogenins. J Med Chem 4-26-1996;39(9):1790-1796.
    View Abstract
  • Zhao GX, Chao JF, Zeng L, et al. The absolute configuration of adjacent bis-THF acetogenins and asiminocin, a novel highly potent asimicin isomer from Asimina triloba. Bioorg.Med.Chem. 1996;4(1):25-32.
    View Abstract
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