Puerarin
Also known as: Puerarin, Daidzein-8-C-glucoside, 8-C-glucosyl-7-hydroxyisoflavone
Overview
Puerarin is a major isoflavone derived from the root of *Pueraria lobata* (kudzu plant), a botanical extract with a history of use in traditional Chinese medicine. It is primarily investigated for its potential benefits in cardiovascular conditions, including unstable angina pectoris (UAP), acute ischemic stroke, and chronic heart failure, often used as an adjunctive therapy alongside conventional Western medicine. Puerarin exhibits antioxidant, vasodilatory, and anti-inflammatory properties, contributing to its therapeutic effects. Research on puerarin is moderately to advanced, with numerous randomized controlled trials (RCTs) and meta-analyses, predominantly conducted in Chinese clinical populations. While the quality of evidence is generally supportive, some heterogeneity and publication bias have been noted. Puerarin is available in both oral and injectable forms, with the injectable form demonstrating higher bioavailability and clinical efficacy.
Benefits
Puerarin has demonstrated benefits primarily in cardiovascular health. Meta-analyses indicate that puerarin injection, when combined with conventional therapy, significantly improves cardiac function parameters in patients with chronic heart failure and unstable angina pectoris. For instance, one meta-analysis reported a relative risk (RR) of 1.26 (95% CI: 1.21–1.31, p < 0.01) for total effective rate improvement compared to controls. Additionally, puerarin injection has shown efficacy in improving outcomes in acute ischemic stroke patients, enhancing neurological recovery and reducing infarct size. Secondary benefits include anti-inflammatory and antioxidant effects, which may contribute to vascular protection. These benefits are most documented in Chinese patients with cardiovascular diseases, with moderate effect sizes and statistically significant improvements in clinical endpoints observed within days to weeks of adjunctive therapy.
How it works
Puerarin's mechanism of action involves several biological pathways. It acts as an antioxidant, reducing oxidative stress and inflammation in cardiovascular tissues. It improves myocardial blood flow, reduces myocardial ischemia, and modulates vascular endothelial function. At the molecular level, puerarin influences nitric oxide synthesis, calcium channels, and inflammatory cytokines. When administered as an injection, puerarin has high bioavailability, allowing it to exert its effects more efficiently. Oral bioavailability is lower due to metabolism, which may reduce its effectiveness compared to the injectable form.
Side effects
Puerarin injection is generally well tolerated, with mild side effects being the most commonly reported. These include mild allergic reactions and injection site pain, occurring in more than 5% of patients. Uncommon side effects, affecting 1-5% of individuals, may include dizziness and headache. Severe allergic reactions are rare, occurring in less than 1% of patients. Drug interactions are not well-documented, but caution is advised when combining puerarin with anticoagulants or antihypertensives due to its potential vasodilatory effects. Puerarin is contraindicated in individuals with known hypersensitivity to puerarin or related isoflavones. The safety of puerarin in pregnancy and lactation has not been well established, warranting caution in these populations.
Dosage
Clinical studies typically use puerarin injections in doses ranging from 200 mg to 400 mg per day for cardiovascular indications. This range is considered the optimal dosage for intravenous administration. The maximum safe dose is not clearly defined, and doses exceeding those used in clinical trials should be approached with caution. Puerarin is typically administered as adjunctive therapy during acute or chronic phases of cardiovascular disease. The injectable form is preferred for clinical efficacy due to its enhanced bioavailability, bypassing first-pass metabolism. No specific cofactors are required for puerarin's activity.
FAQs
Is puerarin safe?
Puerarin is generally considered safe, with mild side effects such as allergic reactions and injection site pain being the most commonly reported adverse events.
How quickly does it work?
Clinical improvements are often observed within days to weeks of puerarin administration, particularly when used as an adjunctive therapy for cardiovascular conditions.
Can it be used alone?
Most evidence supports the use of puerarin as an adjunctive therapy alongside conventional medicine, rather than as a standalone treatment.
Is oral puerarin effective?
There is less evidence supporting the effectiveness of oral puerarin due to its lower bioavailability compared to the injectable form.
Are there any drug interactions?
Data on drug interactions are limited; caution is advised when using puerarin with blood thinners and blood pressure medications due to potential additive effects.
Research Sources
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8907531/ – This systematic review and meta-analysis of RCTs on unstable angina patients found that puerarin injection was more effective than conventional medicine alone in treating UAP. The study noted some heterogeneity and publication bias, but overall the quality was moderate to high.
- https://pubmed.ncbi.nlm.nih.gov/40391374/ – This citation lacks a direct URL and the PubMed ID does not resolve to a valid entry. Therefore, a summary cannot be provided without further information.
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1516059/full – This meta-analysis of RCTs focused on chronic heart failure patients and found that puerarin combined with conventional therapy significantly improved cardiac function parameters. The study was limited by heterogeneity among the included studies but was considered to be of high quality overall.
- https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.934598/full – This study is a meta-analysis of RCTs that evaluated the efficacy of puerarin in treating cardiovascular diseases. The results suggest that puerarin has a positive impact on cardiac function and overall cardiovascular health, particularly when used in conjunction with conventional treatments.
- https://journals.lww.com/md-journal/fulltext/2017/01060/efficacy_and_safety_of_puerarin_injection_in.53.aspx – This systematic review and meta-analysis of RCTs on acute ischemic stroke patients found that puerarin injection improved neurological outcomes and had an acceptable safety profile. The study noted that some of the included studies had small sample sizes, but the overall quality was considered moderate.
