Sangre de Grado

Sangre de Grado

• Sangre de grado (Croton lechleri) is a tree native to certain countries in South America. The red sap produced by the tree is used as medicine to treat certain condi-tions. The sap contains alkaloids, the main one being taspine, as well as proantho-cyanidins.

• Sangre de grado is thought to have multiple mechanisms including blocking sensory afferent nerves to improve pain and inhibiting chloride channels in the gastrointestinal tract to minimize sodium and water loss, improving diarrhea.

Dosage:

• Crofelemer (FDA approved to treat HIV-related diarrhea) is dosed at 125 mg twice a day for 4 weeks [1]. For traveler's diarrhea, 125-500 mg up to four times a day for 2 days has been used. For genital herpes, formulations of a sangre de grado ointment containing 15% Crofelemer used three times a day for 21 days has been studied.

• The main uses for sangre de grado are listed below:

• HIV-induced diarrhea: A randomized, placebo-controlled trial in 2013 showed that Crofelemer, which contains multiple proanthocyanidins, improved diarrheal episodes in HIV/AIDS patients [2]. Crofelemer has been FDA approved for this use.

• Traveler's diarrhea: A product called SP-303, which contains a concentrated version of certain components of sangre de grado was studied in a randomized placebo-controlled trial in 2002 [4]. It was shown to shorten the duration of traveler's diarrhea.

• Genital herpes: In patients with HIV/AIDs who has anogenital warts or herpes eruption, a topical form of sangre de grado was studied back in 1997.

• Compared to placebo, the study did show shorter time to heal compared to placebo; however, there was a small sample size. There are currently no recent studies that further evaluated the topical form.

Safety:

• While the medication is safe and well-tolerated, overdose is possible. Side effects in animal studies have been shown at varying doses.

Medication Interaction:

• No known current interactions at this time.