Rauwolfia Alkaloid (Oral)

Rauwolfia alkaloids are hypertensive medicines, used in the treatment of people who suffer from high blood pressure.


Rauwolfia alkaloids are part of the family of hypertensive medicines, used in the treatment of people who suffer from high blood pressure.

Antihypertensives work by helping to control the neural signals that pass along certain nerves that act on the blood vessels and the muscle of the heart, effectively lowering blood pressure.

When a person's blood pressure becomes too high, an added effort is demanded of the arteries and the heart. If the condition is left untreated or unmanaged for too long, the function of both the arteries and the heart may be compromised. As a result, the kidneys, heart, brain, and blood vessels may all become damaged, potentially leading to a stroke, kidney failure, heart failure, or a heart attack. These serious health conditions are much less likely to develop if the patient's blood pressure is kept under control.

These medications can also be used to treat certain other health conditions, if applicable.

In the US, rauwolfia alkaloids are sold under the brand names, Resa, Serpalan, and Rauwolfemms. All these drugs are only available when prescribed to you by your healthcare professional, and they come in tablet form.

Conditions Treated

Type of Medicine

  • Antihypertensive
  • Tablet

Side Effects

Although tests carried out on mice and rats have shown an increase in the amount of cancerous tumors following treatment with rauwolfia alkaloids, there is no evidence to suggest that using this drug presents an increased risk of breast cancer in people. If you have concerns in this regard, you may wish to discuss this matter with your treating physician.

In addition to the effects is it designed to produce, rauwolfia alkaloids can sometimes cause other undesirable side effects in some patients. Although you probably will not notice anything out of the ordinary while you are taking this medicine, you must mention any unusual effects to your GP, as you may need further medical treatment.

If you experience any of the following effects, speak to your treating physician immediately:

  • Weakness or lack of energy
  • Vivid nightmares, dreams or early-morning sleeplessness
  • Stomach cramps or pain
  • Slow heartbeat
  • Shortness of breath
  • Irregular heartbeat
  • Impotence or decreased libido
  • Headache
  • Feeling faint or drowsy
  • Dizziness
  • Depression or inability to concentrate
  • Unusual bruising or bleeding
  • Trembling and shaking of fingers and hands
  • Stiffness
  • Skin rash or itching
  • Painful or difficult urination
  • Chest pain
  • Bloody vomit
  • Black, tarry stools
  • Anxiety or nervousness

If an overdose of rauwolfia alkaloids occurs, you will notice the following signs:

  • Severe dizziness or drowsiness
  • Flushing of the skin
  • Pinpoint pupils of eyes
  • Slow pulse

If you or someone in your household overdoses on this medication, seek emergency medical help straight away.

There are a number of less serious side effects that generally do not need to be referred to a doctor. These effects can sometimes happen because your body is not used to the medication, and they will subside by themselves as your system adjusts. Your treating physician might be able to give you some guidance on how to manage or prevent these symptoms from occurring. If these effects are particularly annoying or make life difficult for you, ask your healthcare professional for advice.

  • Swelling of lower legs and feet
  • Stuffy nose
  • Nausea and vomiting
  • Loss of appetite
  • Dryness of mouth
  • Diarrhea

Once your course of treatment with this drug has finished, you may still have a few persistent effects that will require medical attention. There may be some effects that affect a small number of patients, which are not listed here. If you have any concerns about your health while taking this medication, talk to your doctor.


Your doctor may prescribe you rauwolfia alkaloids as part of a holistic approach to treating your hypertension. Additional recommendations may include a weight control program and being careful in your choice of diet, especially foods that contain a large amount of salt. Before changing your diet, you should always take guidance from your GP.

Some people who have hypertension are unaware of the problem. Many feel perfectly normal, even though they are actually very sick. For this reason, it is essential that you take your medication exactly as prescribed and keep all the check-up appointments that have been scheduled with your GP, even if you feel fine.

Rauwolfia alkaloids will not cure your hypertension, but this medication can be an excellent aid to controlling the condition. If you want to lower your blood pressure and maintain it at a healthy level, you must follow the treatment regimen that has been given to you by your treating specialist. This regimen may be necessary for the rest of your life in order to prevent serious health conditions, including heart attack, blood vessel diseases, stroke, heart failure, or kidney disease.

It is important that you take your medication at the same time each day so that the levels remain constant in your body.

You may be taking this drug in combination with other medication. If so, you must try to take each different drug at the correct time and not mix them together. Your doctor will help you to devise a plan to ensure that you take your drugs at the correct times each day.

Some people find that rauwolfia alkaloids cause stomach upsets. This effect can be overcome by taking the tablets with a meal or with milk. If stomach problems, including cramps, pain, diarrhea, vomiting, or nausea persist or get worse, have a chat with your doctor.

Rauwolfia alkaloids are prescribed in different doses for different patients. You should keep to your GP's directions or observe the instructions on the dispensary label. The dosage information contained in this guide is purely based on the average amount given. If your dose varies, do not alter it unless your treating specialist instructs you to do so.

The size of your dose will be dependent on the strength of the medication you are taking. The number of daily doses that you take, the length of allowed time between them, and the total length of your course of treatment will largely depend on the health condition that you are being treated for.

Deserpidine oral tablets for hypertension:

  • Adults: 250 mcg to 500 mcg daily, taken as one dose or split into two doses.
  • Children: Dose and frequency as advised by your child's GP.

Rauwolfia serpentina oral tablets for hypertension:

  • Adults: 50 mg to 200 mg daily, taken as one dose or split into two doses.
  • Children: Dose and frequency as advised by your child's GP.

Reserpine oral tablets for hypertension:

  • Adults: 100 mcg to 250 mcg daily.
  • Children: Dose and frequency is based on body weight and must be as advised by your child's GP. Usually, 2.27 to 9.1 mcg per pound of body weight daily, taken as one dose or split into two.

In the event that you omit a dose of this medication, just skip the omitted dose and revert to your original schedule. Do not take twice the dose to try to catch up.


There are some medicines that you should never use together. However, in some instances, two or more different drugs can be mixed, even though this could cause an interaction to take place. In such cases, it may be appropriate to change the dose or frequency of one or both of the drugs. If you are prescribed rauwolfia alkaloids, you must remember to tell your doctor if you are also taking any of the drugs that are listed below. It should be noted that this list is not definitively inclusive.

The use of rauwolfia alkaloids is not recommended with any of the drugs listed below. Your GP may decide to give you an alternative medicine of this type or may alter some of your other prescribed drugs:

  • Tranylcypromine
  • Toloxatone
  • Tetrabenazine
  • Selegiline
  • Rasagiline
  • Procarbazine
  • Phenytoin
  • Phenelzine
  • Pargyline
  • Nialamide
  • Moclobemide
  • Linezolid
  • Lazabemide
  • Isocarboxazid
  • Iproniazid
  • Iobenguane I 123
  • Furazolidone
  • Fosphenytoin
  • Colchicine
  • Clorgyline
  • Brofaromine

You should not eat certain foodstuffs, drink alcohol, or use tobacco with some forms of medication, as to do so could cause an interaction. Ask your GP for guidance on your use of this medication with food, alcohol, or tobacco.


You must remember to let your GP know if you have ever suffered an allergic reaction to rauwolfia alkaloids or to any other form of medication in this group. You must also mention any bad reactions you have noticed to particular food groups, animal derivatives, food colors or preservatives. This list should also extend to herbal remedies and vitamin supplements.

Elderly people tend to be more sensitive to the effects of rauwolfia alkaloids than people in other treatment groups, especially to drowsiness and dizziness.

Although no definitive studies have been carried out into the effects of rauwolfia alkaloids on pregnant women, it is known that taking excessive amounts of this type of medication can cause many unwanted effects in babies, including low temperature, poor appetite, and breathing difficulties. There may also be a risk of the fetus developing birth defects. It is therefore important that you tell your doctor if you are pregnant or if you are planning on getting pregnant while you are taking this medication.

Rauwolfia alkaloids pass readily into breast milk and can cause side effects in nursing infants. There is a risk of babies developing breathing problems, low temperature, or a poor appetite where the mother is taking large doses of rauwolfia alkaloids. You should discuss this with your midwife or GP before you start a course of treatment with this medication. You might want to stop breastfeeding temporarily and use a suitable baby formula instead, until your course of treatment has concluded.

Some existing and historical medical conditions can affect how rauwolfia alkaloids work. Be sure to let your GP know if you have any other health conditions, particularly any of those mentioned below.

Rauwolfia alkaloids can cause breathing difficulties in people who are asthma sufferers or who have other respiratory conditions.

This class of medicines can cause an increase in stomach activity, potentially worsening the following conditions:

Rauwolfia alkaloids may slow the heartbeat or cause irregular heart rhythms to develop. This medication should therefore be used with caution in patients who have heart disease.

Patients who have kidney disease should be aware that rauwolfia alkaloids cause the blood pressure to become lower, potentially having an adverse effect.

This medication should not be used in people who have suffered from depression, as rauwolfia alkaloids can exacerbate this condition.

Rauwolfia alkaloids should not be given to people with Parkinson's disease as the drug can cause parkinsonism-like effects.

You must attend regular check-ups with your GP to check that your medication is working correctly.

Do not use any other medication unless you have previously cleared it with your GP. In particular, you should avoid taking cold and cough combination remedies, hay fever treatments or decongestants for sinus conditions. All these medicines may increase your blood pressure.

Be sure to tell your treating physician that you are taking rauwolfia alkaloids if you are having any form of surgery, cosmetic procedures, emergency treatment, or dental surgery.

Rauwolfia alkaloids can cause mental depression in some patients. Be sure to tell your GP immediately if you or your friends or family notice changes in your general demeanour or mood. You should also alert your doctor if you begin to have uncharacteristically vivid nightmares or dreams, or early-morning sleeplessness.

Rauwolfia alkaloids can exacerbate the effects of medication that slows down your nervous system. Before taking any of the following, check with your GP that it is safe to do so:

  • Antihistamines
  • Hay fever medicine
  • Sedatives
  • Sleeping drugs
  • Prescription pain drugs
  • Narcotics
  • Muscle relaxants
  • Anesthetics (including dental anesthetic)

If you do think that you are less alert than usual or if you begin to suddenly feel drowsy, avoid driving, operating machinery, or taking part in any potentially risky activity that demands your full attention. This effect generally affects people when they first begin to take the drug or when the dose is increased.

You might notice that you mouth becomes very dry while you are taking rauwolfia alkaloids. You can gain short-term relief from this annoying effect by using sugar-free gum or candy. Alternatively, try using a saliva substitute or melting small pieces of ice in your mouth. This effect should self-resolve within two weeks, but if it doesn't, have a chat with your doctor or dentist. You should be aware that persistent dry mouth can lead to dental problems, tooth decay, fungal infections, and gum disease.

Rauwolfia alkaloids can cause feelings of nasal congestion in some patients. You must NOT use nasal decongestant drugs unless you have first checked this with your doctor.


To ensure that your prescription of rauwolfia alkaloid medication stays in good condition and is safe to use, you must store it correctly.

Keep the tablets in a sealed container and at room temperature. Do not place the tablets next to a direct heat source or where they will exposed to direct sunlight. Do not refrigerate or freeze the medicine.

Keep your medication well away from pets and children. If a pet does eat any of your rauwolfia alkaloid tablets, contact your vet immediately.

Do not take any rauwolfia alkaloid tablets that have exceeded their use-by date. Do not use any tablets that appear damaged or crumbly in texture. Do not accept tablets in packaging that appears to have been opened or damaged.

If you have any leftover or unwanted rauwolfia alkaloid tablets, you should dispose of them responsibly. Do not discard your tablets in your trash can where children or animals could get hold of them. Do not flush the tablets down the toilet or drain. Place all unused medication in a waterproof bag, seal it, and place it in your garbage can.


Rauwolfia alkaloid drugs belong to the family of hypertensive medicines, which are widely used in the treatment of people who suffer from hypertension (high blood pressure).

Antihypertensives drugs work by damping down the neural signals that pass from the brain along certain nerves that act on the blood vessels and the muscle of the heart, effectively lowering the blood pressure. Although these drugs do work well in preventing serious conditions that may be caused by hypertension, they cannot cure the condition and you may have to take some form of antihypertensive for the rest of your life.

Rauwolfia alkaloid tablets are extremely effective and beneficial to patients who have high blood pressure. However, they can react adversely with a range of prescription and over the counter medicines, and can also cause complications in patients who have existing health conditions. For this reason, it is extremely important that you discuss your full medical history with your treating physician, before you begin taking this medication.

During the course of your treatment you must attend your doctor for check-ups and blood pressure readings to make sure that the medication is working as it should be.


Last Reviewed:
January 31, 2018
Last Updated:
April 05, 2018