Guarana GWA- rah-na

What are other names for this remedy?

Type of medicine: natural remedy

Scientific and common names: Paullinia cupana, Paullinia sorbilis, Brazilian cocoa, guarana seed, guarana gum, zoom

What is guarana?

Guarana is a creeping shrub. The seeds are used medicinally.

What is it used for?

This remedy has been used to treat several conditions. Studies in humans or animals have not proved that this remedy is safe or effective for all uses. Before using this remedy for a serious condition, you should talk with your healthcare provider. There may be other uses that are not listed below.

Guarana contains caffeine and is a stimulant. It has been used to:

• help with weight loss
• increase alertness
• relieve tiredness
• treat fluid retention
• treat joint pain

The US Food and Drug Administration (FDA) does not approve uses for natural remedies. The FDA does not inspect or regulate natural remedies the way they do prescription medicines.

How is it taken?

Guarana may be taken as a capsule or liquid. It can also be prepared as a tea to drink. Guarana is found in many energy drinks and energy candy bars. Follow the directions printed on the product label or given by your healthcare provider.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

Do not take guarana if you have:

• diabetes
• glaucoma
• heart disease or irregular heartbeat
• high blood pressure
• kidney or liver disease
• problems with anxiety or panic attacks
• osteoporosis
• seizures
• thyroid disease
• ulcers

Females of childbearing age: Do not take this remedy if you are pregnant or breast-feeding. It may cause premature labor.

Do not drink a lot of coffee, tea, or cola while you are taking this medicine. These drinks also contain caffeine, and the combination may overstimulate you and cause side effects. Also check the labels of all nonprescription and prescription medicines you take. Other medicines that contain caffeine may also cause problems. Ask your healthcare provider or pharmacist if you have any questions.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Talk to your healthcare provider or pharmacist about any natural remedy that you are using or thinking about using. If your provider does not tell you how to take it, follow the directions that come with the package. Do not take more or take it longer than recommended. Ask about anything you do not understand. Remember:

• Natural remedies are not always safe.
• You should not take them if you are pregnant or breast-feeding without your healthcare provider's approval. They should not be taken by infants, children, or older adults without your provider's approval.
• They affect your body and may interact with prescription medicines that you take.
• Natural remedies are not standardized and may have different strengths and effects. They may be contaminated.

What are the possible side effects?

Along with its desirable effects, this remedy may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the remedy. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away). If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Severe headache with no known cause; ringing in the ears; trouble walking, dizziness, loss of balance; tremors; trouble urinating; chest pain; fast or irregular heartbeat; shortness of breath; seizures; fainting.

Other: Minor headache, irritability, confusion, nausea, restlessness, vomiting, stomach cramps, increased urination, trouble sleeping, loss of appetite.

What products might interact with this remedy?

When you take this remedy with other medicines, it can change the way the remedy or the medicines work. Vitamins and certain foods may also interact. Using these products together might cause harmful side effects. Before taking guarana, talk to your healthcare provider if you are taking:

• alcohol
• antibiotics such as ciprofloxacin (Cipro), levofloxacin (Levaquin), and norfloxacin (Noroxin)
• antidepressants such as bupropion (Wellbutrin) and fluvoxamine (Luvox)
• antiarrhythmics such as adenosine (Adenocard, Adenoscan) and mexiletine (Mexitil)
• antiplatelet medicines such as clopidogrel (Plavix) or dipyridamole (Persantine)
• aspirin or other salicylates
• antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and terbinafine (Lamisil)
• clozapine (Clozaril)
• birth control pills, rings, patches, and implants and hormones such as conjugated estrogens (Premarin), estradiol (Estrace), medroxyprogesterone (Provera), and norethindrone (Aygestin, Camila, Jolivette, Micronor)
• bronchodilators such as aminophylline and theophylline
• caffeine or other stimulants, found in coffee, black tea, green tea, colas, some sports drinks, amphetamines (Desoxyn, Dexedrine), dextroamphetamines (Adderall, Adderall XR), methylphenidate (Ritalin), and pemoline
• natural remedies such as bitter orange, creatine, ephedra (ma huang), garlic, ginger, ginseng, ginkgo, and mate
• calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiamate, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Procardia, Adalat), and verapamil (Calan, Isoptin, Verelan)
• diabetes medicines such as insulin, acarbose (Precose), glipizide (Glucotrol), glyburide (DiaBeta), metformin (Glucophage), pioglitazone (Actos), repaglinide (Prandin), and rosiglitazone (Avandia),
• disulfiram (Antabuse)
• diuretics such as bumetanide, ethacrynic acid (Edecrin), furosemide (Lasix), and torsemide (Demadex)
• ephedrine, epinephrine (EpiPen), and pseudoephedrine (Sudafed, and other cold medicines)
• heartburn or ulcer medicines such as antacids, cimetidine (Tagamet), omeprazole (Prilosec), ranitidine (Zantac), and sucralfate (Carafate)
• lithium (Lithobid)
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• medicine that reduces the chance of blood clots forming such as dalteparin (Fragmin), enoxaparin sodium (Lovenox), fondaparinux (Arixtra), heparin, and warfarin (Coumadin)
• riluzole (Rilutek)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

Keep all natural remedies and medicines out of the reach of children.

This advisory includes select information only. The information was obtained from scientific journals, study reports, and other documents. The author and publisher make no warranty, expressed or implied, as to the information. The advisory may not include all side effects associated with a remedy or interactions with other medicines. Nothing herein shall constitute a recommendation for the use of any remedy. Ask your healthcare provider or pharmacist for more information.