Yohimbe / Yohimbine
Pausinystalia johimbe
A stimulant aphrodisiac with real cardiovascular danger.
Evidence tier
Mixed
Research weight
Citations
16 verified / 16
Classification
Performance
❝
What the evidence says. Conflicting results across studies; benefit uncertain.
⚠
Health warning. Yohimbe raises blood pressure and heart rate and has been linked to arrhythmias, heart attacks and seizures. It is dangerous with heart conditions or stimulants, and supplement labeling is frequently inaccurate.
What is Yohimbe / Yohimbine?
Yohimbe / Yohimbine (Pausinystalia johimbe) is a performance supplement used for possible erectile-dysfunction benefit (prescription yohimbine). NutriDex grades the human evidence as Mixed. Yohimbe bark contains yohimbine, which older trials found more effective than placebo for erectile dysfunction — but the American Urological Association advises against it given limited evidence and safety concerns. There is no good evidence for weight loss. Crucially, supplements are notoriously mislabeled (wildly variable yohimbine content), and the compound can cause serious cardiovascular and neurological effects.
Purported Benefits
✓Possible erectile-dysfunction benefit (prescription yohimbine)
✓(Claimed, unproven) fat loss
Dosing & Compounds
Typical Dose
Highly variable and often mislabeled in supplements; prescription yohimbine HCl is the only regulated, dosed form.
Active Compounds
Safety & Cautions
⚠ Raises blood pressure and heart rate; linked to arrhythmia, heart attack, seizures and anxiety. Dangerous with heart/blood-pressure conditions, MAOIs, or stimulants. Restricted or banned in several countries. Educational only — always check with your doctor or pharmacist before combining Yohimbe / Yohimbine with any medicine.
Yohimbe / Yohimbine drug interactions
Known or theoretical interactions between Yohimbe / Yohimbine and common medications — educational, not exhaustive. Always check with your doctor or pharmacist before combining Yohimbe / Yohimbine with any medicine.
Avoid
Blood-pressure drugs
Yohimbine raises blood pressure and heart rate, opposing antihypertensive therapy.
Alpha-2 adrenergic antagonism increases sympathetic noradrenaline release, raising BP and pulse. NCCIH — Yohimbe
Avoid
MAOIs, stimulants, some antidepressants
With MAOIs/stimulants can cause dangerous hypertension, anxiety and arrhythmia.
Alpha-2 antagonism plus impaired catecholamine breakdown causes additive sympathomimetic effects. NCCIH — Yohimbe
Key Studies ★ 16 studies
systematic review/meta-analysis
ED meta-analysis (2021)
✓ PubMed
In a 2021 systematic review/meta-analysis of 8 RCTs, yohimbine monotherapy improved erectile function vs placebo (OR 2.08, 95% CI 1.30-3.32), with larger effect when combined with other agents (OR 6.35, 95% CI 3.01-13.41).
government agency advisory
DoD OPSS safety advisory (2025)
✓ Source
US military supplement-safety advisory warns of severe adverse events with yohimbe/yohimbine and notes the ingredient is banned in supplements in Canada, Australia, the Netherlands and the UK due to potential harm.
Meta-analysis
Rhim 2019 (systematic review & meta-analysis, 10 RCTs)
✓ PubMed
Meta-analysis of arginine-based supplements for ED (J Sex Med) that included yohimbine-containing combinations: supplements significantly improved ED vs placebo (OR 3.37, 95% CI 1.29-8.77); informs the consistent finding that yohimbine combinations outperform yohimbine monotherapy, with adverse-event rate ~8.3% vs 2.3% placebo (none severe).
Meta-analysis
ED meta-analysis
✓ PubMed
Yohimbine beat placebo for ED in older trials; the AUA still advises against routine use.
Guideline
Burnett / AUA Erectile Dysfunction Guideline 2018
✓ PubMed
The American Urological Association evidence-based ED guideline does NOT recommend yohimbine (or other herbal/non-prescription therapies) for the treatment of erectile dysfunction, citing insufficient/low-quality evidence relative to PDE5 inhibitors. Authoritative society position against routine clinical use.
regulatory/risk assessment
EFSA scientific opinion (2013)
✓ Full text
The EFSA Panel concluded the chemical/toxicological characterisation of yohimbe bark preparations is inadequate to establish safety as a food ingredient, and that theoretical maximum daily intake from supplements may exceed the maximum approved medicinal dose of yohimbine, so no safe intake level could be defined.
randomized controlled trial
Fear-memory consolidation RCT (Sperl 2022)
✓ Source
In a placebo-controlled fear-conditioning trial in 51 healthy men, a single 10 mg dose of yohimbine (alpha-2 antagonist) given after fear acquisition enhanced fear-memory consolidation, producing stronger cardiac and electrocortical (N170/late positive potential) threat responses at 24-hour recall versus placebo and sulpiride.
Agency / regulator
NCCIH
✓ Source
Insufficient evidence for weight loss; notable safety concerns.
RCT
Ostojic 2006 (randomized double-blind placebo-controlled trial)
✓ PubMed
In 20 elite male soccer players, yohimbine 20 mg/day for 21 days reduced body fat (9.3% to 7.1%; lower than placebo postsupplementation, p<0.05) with no change in body mass, muscle mass, or exercise performance and no reported side effects, supporting yohimbine as a targeted fat-loss aid without lean-mass or performance effects.
narrative review
FDA regulation narrative review (2023)
✓ Full text
Narrative review cites yohimbine as a case of weak FDA oversight, noting California Poison Control logged 238 yohimbine adverse events (2000-2006; 134 hospitalized) including myocardial infarction, arrhythmia, QTc prolongation, seizures and acute renal failure.
Observational
Cohen et al, JAMA Netw Open 2023
✓ PubMed
Analysis of 57 botanical sports supplements (including yohimbine-class alkaloids) found 40% contained none of the declared ingredient and actual quantities ranged 0.02%-334% of label; several contained FDA-prohibited ingredients.
NIH toxicology database
NIH LiverTox
✓ Full text
NIH LiverTox assigns yohimbine a likelihood score of E (unlikely cause of clinically apparent liver injury), noting it has not been linked to serum enzyme elevations or acute liver injury despite frequent use in weight-loss and bodybuilding supplements.
Observational
Am J Emerg Med 2022
✓ PubMed
Case report of a 39-year-old woman who developed acute basal ganglia and subarachnoid hemorrhage (BP 198/93) after a single dose of a yohimbine-containing sexual-enhancement supplement while on chronic clonidine.
retrospective case review
California Poison Control review (Kearney 2010)
✓ PubMed
Retrospective review of 238 California Poison Control System yohimbine cases (2000-2006, 98.7% herbal products) found GI distress (46%), tachycardia (43%), anxiety/agitation (33%) and hypertension (25%); exposures were far more likely than average to cause severe outcomes (OR 5.81, 95% CI 4.43-7.64) and require healthcare-facility management (OR 2.35, 95% CI 1.82-3.04).
case series
Poisoning case series (2021)
✓ PubMed
Forensic report of four simultaneous acute yohimbine poisonings (high-dose powder) presenting with tachycardia, hypertension, flushing and seizures; three survived and one died, illustrating severe sympathomimetic toxicity.
Study
Label analyses
✓ PubMed
Supplement yohimbine content is frequently inaccurate or undeclared.