Chondrodendron tomentosum

01 Identity and provenance

Accepted binomial: Chondrodendron tomentosum
Common names: Curare Vine
Family (APG IV): Menispermaceae
Part used: Stem bark
Verification tier: Tier 2 · Verified Clinical columns reviewed and a source is on record.
Reviewer note (2026 audit): Griffith HR & Johnson GE, 1942 (first clinical use of Intocostrin) | Britannica, Chondrodendron tomentosum | VERIFIED 2026 (batch 5) - synthetic analogue, application, interactions, side effects and references populated from retrieved primary/regulatory sources. Interactions labelled CLINICAL vs THEORETICAL. Marketed-formulation column intentionally blank. | ROUTE

02 Constituent chemistry

Chemical class	Marker compound	Synthetic analogue in use
Bisbenzylisoquinoline alkaloids	(+)-Tubocurarine Stem bark	Cisatracurium, rocuronium, vecuronium (modern non-depolarising blockers that replaced it). Tubocurarine is the prototype of the class.

The analogue column is what makes the interaction reasoning tractable: where a constituent has a marketed structural counterpart, the counterpart's interaction profile is the starting hypothesis for the plant.

Looking up structures and physicochemical properties from PubChem…

03 Stated application

Reported activity: HISTORICAL ONLY. Source of d-tubocurarine, the first clinically used non-depolarising neuromuscular blocker (Intocostrin, 1942), which made lighter general anaesthesia possible. Now effectively obsolete - safer synthetics with faster onset and shorter duration have replaced it.
Reported adverse effects: Flaccid paralysis progressing to respiratory muscles. HISTAMINE RELEASE is the hallmark and the reason it was abandoned: hypotension and bronchospasm, particularly hazardous in asthma or cardiovascular disease. Slow onset (300 s or more) and long duration (60-120 min) made it hard to titrate. CRITICAL: it is a paralytic, NOT an anaesthetic or analgesic - the patient remains conscious and can feel pain, so it must never be given without adequate anaesthesia. ROUTE-DEPENDENT: tubocurarine is poorly absorbed across mucous membranes, which is why hunters could safely eat game killed with curare-tipped arrows - the mirror image of the Conium secondary-exposure route (entry 183).

04 Interaction matrix

Source column, verbatim: CLINICAL: reversed by anticholinesterases (neostigmine, and galantamine - see entry for Galanthus nivalis). Additive with aminoglycosides, magnesium and volatile anaesthetics, which potentiate blockade.
Normalised onto 3 canonical drug classes below.

Curated from the reviewed source

Drug class	Severity	Mechanism type	Provenance	Expected effect
Cholinesterase inhibitors and cholinergic drugs Autonomic	4Contraindicated	PD-additive	curated A	Cholinergic crisis: bradycardia, bronchorrhoea, bronchospasm, miosis, sei…	why ▾
Class mechanism. Physostigmine-, galantamine- and arecoline-type constituents inhibit acetylcholinesterase or agonise muscarinic receptors, adding to donepezil, rivastigmine, neostigmine or pyridostigmine. Expected Cholinergic crisis: bradycardia, bronchorrhoea, bronchospasm, miosis, seizures, weakness that mimics myasthenic crisis. Management Avoid. In suspected crisis distinguish cholinergic from myasthenic weakness before giving further anticholinesterase. Onset rapid Evidence A - human data with a cited source Matched on “neostigmine” Find evidence for this pair Map this mechanism
General and local anaesthetics (perioperative) Perioperative	3Major	PD-additive + PK-CYP	curated A	Prolonged emergence, intraoperative haemodynamic instability, excess surg…	why ▾
Class mechanism. Botanical CNS depressants prolong anaesthetic recovery, antiplatelet and coumarin constituents raise surgical bleeding, and sympathomimetics destabilise intraoperative haemodynamics. CYP modulation changes opioid and muscle-relaxant handling. Expected Prolonged emergence, intraoperative haemodynamic instability, excess surgical bleeding, delayed neuraxial haematoma. Management Ask about all botanicals at pre-anaesthetic assessment and stop them 1-2 weeks before surgery unless there is a reason not to. Onset rapid Evidence A - human data with a cited source Matched on “anaesthetics” Find evidence for this pair Map this mechanism
Nephrotoxic drugs Organ toxicity	3Major	Organ-toxicity additive	curated A	Rising creatinine, tubulointerstitial nephritis, urothelial carcinoma wit…	why ▾
Class mechanism. Aristolochic acid, high oxalate loads and anthraquinone-driven volume depletion add to aminoglycoside, NSAID, contrast and calcineurin-inhibitor nephrotoxicity. Expected Rising creatinine, tubulointerstitial nephritis, urothelial carcinoma with aristolochic acid, oxalate nephropathy. Management Check creatinine and urinalysis. Aristolochia-containing material must never be dispensed; verify identity of any Fangchi or Mu Tong substitute. Onset unspecified Evidence A - human data with a cited source Matched on “aminoglycosides” Find evidence for this pair Map this mechanism

Predicted from constituent chemistry

These edges are not clinical findings. Each one is a rule inference: a constituent class in this plant is known to act on a target that the drug class also acts on. They are shown because a blank cell reads as “safe”, and for a Tier 1 entry a blank cell only means “not yet looked at”. Treat them as a literature-search agenda, not as a warning.

Drug class	Severity	Mechanism type	Provenance	Expected effect
Immunosuppressants (ciclosporin, tacrolimus, mycophenolate) Transplant	4Contraindicated	PK-CYP3A4/P-gp + PD-antagonistic	predicted D	Acute graft rejection with inducers; nephrotoxicity, neurotoxicity and hy…	why ▾
Chemistry of this pair. Berberine inhibits CYP3A4 and P-glycoprotein, lowers glucose through AMPK activation, and displaces bilirubin from albumin. Class mechanism. These are narrow-therapeutic-index CYP3A4 and P-glycoprotein substrates. Botanical induction collapses trough levels; inhibition causes toxic accumulation. Immunostimulant botanicals separately oppose the therapeutic goal. Expected Acute graft rejection with inducers; nephrotoxicity, neurotoxicity and hypertension with inhibitors; autoimmune flare with immunostimulants. Management Treat as contraindicated in transplant recipients. Any exposure requires immediate trough level measurement and transplant team notification. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Narrow-therapeutic-index CYP3A4 substrates Pharmacokinetic	4Contraindicated	PK-CYP3A4	predicted D	Toxic accumulation or subtherapeutic failure of the co-prescribed drug, s…	why ▾
Chemistry of this pair. Berberine inhibits CYP3A4 and P-glycoprotein, lowers glucose through AMPK activation, and displaces bilirubin from albumin. Class mechanism. Furanocoumarins, bergamottin, piperine, glabridin and berberine inhibit CYP3A4; hyperforin, andrographolide and several diterpenes induce it through PXR. Because CYP3A4 handles roughly half of marketed drugs, the affected list is broad and the direction is product-specific. Expected Toxic accumulation or subtherapeutic failure of the co-prescribed drug, sometimes fatal for antiarrhythmics, immunosuppressants and oncology agents. Management Screen the full regimen for 3A4 substrates. Where the substrate has a narrow index, avoid rather than monitor. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Antidiabetic drugs (insulin, sulfonylureas, biguanides, GLP-1, SGLT2) Endocrine	3Major	PD-additive	predicted D	Symptomatic hypoglycaemia, sweating, tremor, confusion; severe events rep…	why ▾
Chemistry of this pair. Berberine inhibits CYP3A4 and P-glycoprotein, lowers glucose through AMPK activation, and displaces bilirubin from albumin. Class mechanism. Hypoglycaemic botanicals act through insulin secretagogue, insulin-sensitising, alpha-glucosidase-inhibiting or glucose-transport routes. Added to a titrated pharmacological regimen the effects summate rather than plateau. Expected Symptomatic hypoglycaemia, sweating, tremor, confusion; severe events reported with insulin and sulfonylureas. Management Increase self-monitoring frequency for 2 weeks after starting or stopping. Anticipate a downward dose adjustment of insulin or sulfonylurea. Onset rapid Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Antacids, PPIs and H2 blockers Gastrointestinal	2Moderate	PK-absorption	predicted D	Reduced or erratic absorption of alkaloids; heartburn and reflux from pre…	why ▾
Chemistry of this pair. Alkaloidal bases have pH-dependent absorption and commonly interact with hepatic CYP isoenzymes and efflux transporters. Class mechanism. Gastric pH elevation alters the dissolution and ionisation of alkaloidal and enteric-coated botanical products; menthol- and peppermint-oil products lose their enteric protection at high pH and can be released prematurely. Expected Reduced or erratic absorption of alkaloids; heartburn and reflux from premature release of volatile-oil preparations. Management Separate administration by 2 hours. Avoid non-enteric peppermint oil in reflux disease. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism

05 Hazard register

exposure route - poorly absorbed across mucous membranes (game k

06 Confusable material

No same-genus or shared-common-name entry in the corpus.

07 Mechanism map

Chemistry sorts to the left, pharmacology to the right. Dashed edges are predicted. Drag nodes, scroll to zoom, export at 3× for a figure.

species

chemical class

marker compound

drug class

expected effect

hazard

08 Open literature

Abstract-scoped query built from this binomial, its common names and its marker compounds, run live against Europe PMC, PubMed and OpenAlex, then ranked locally against an evidence hierarchy.

Checking openFDA spontaneous reports…

09 Isomechanistic neighbours

Species whose interaction profile overlaps this one, ranked by shared severity weight rather than by count — a shared contraindication counts for more than a shared minor signal. Practical use: these are the plants you should not stack with this one, because the mechanisms summate.

Species	Family	Shared classes	Jaccard
Tinospora cordifolia Giloy	Menispermaceae	4	0.57
Chelidonium majus Greater Celandine	Papaveraceae	4	0.50
Berberis vulgaris Barberry	Berberidaceae	4	0.57
Coptis chinensis Chinese Goldthread	Ranunculaceae	4	0.57
Stephania tetrandra Han Fang Ji	Menispermaceae	4	0.57
Corydalis yanhusuo Yan Hu Suo	Papaveraceae	4	0.57

10 References and notes

Source column: Bowman WC. Br J Pharmacol 2006;147:S277-86 (neuromuscular block, historical review)

147:S277-86 (neuromuscular block, historical review)

Narrative review manual

Bowman WC. Br J Pharmacol 2006

Bowman WC 2006 manual

BibTeX for all 2 records

@article{anon,
  title = {147:S277-86 (neuromuscular block, historical review)},
}

@article{BowmanWC2006,
  title = {Bowman WC. Br J Pharmacol 2006},
  author = {Bowman WC},
  year = {2006},
}

Curator notes

No notes yet.

Sign in to add notes and save monographs.

PhytoNexus