American Pawpaw
Natural Standard evidence-based flashcard. Copyright © 2008 (www.naturalstandard.com). Commercial distribution prohibited. This flashcard is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions. 		Image
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Summary:
Asimina triloba is a fruiting tree native to North America. However, plantings of the tree can be found in Asia, Australia, and Europe. The tree produces a large brown edible oval fruit (2-6 inches long) that can be eaten as a fresh fruit or processed into desserts. Pawpaw extract is made from the twigs of the tree.

Uses
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.
Grade*
Cancer treatment C
Lice C
*Key to grades: A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Safety:
Avoid if allergic/hypersensitive 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). Use cautiously with gastrointestinal problems or a history of dermatological reactions. Avoid if pregnant or breastfeeding.
Note: No well-designed studies on the long-term effects of pawpaw extracts have been conducted. The consituents in pawpaw extract are cytotoxic. Therefore, oral use of pawpaw extract is not recommended without the supervision of a physician.

Possible side effects:
Contact dermatitis, nausea, pruritis (severe itching), urticaria (hives), and vomiting.

Possible interactions:
Antioxidant drugs, 7-keto, coenzyme Q-10, and other herbs and supplement with similar effects.

Dosing:

Adults (18 years and older):

Oral (Taken by mouth):
Cancer: 12.5-50mg extract four times a day with food for periods of up to 18 months has been used.

Topical:
Lice: 40mL 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):

Topical:
Lice: 40mL 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.
Natural Standard Monograph (www.naturalstandard.com)
Copyright © 2008 Natural Standard Inc. Commercial distribution or reproduction prohibited.
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.