Vinca minor L.

Last updated: 1 Sept 2016

Scientific Name

Vinca minor L.   

Synonyms

Pervinca heterophyla Raf., Pervinca minor (L.) Garsault [Invalid], Pervinca procumbens Gilib., Pervinca repens Raf., Vinca acutiflora Bertol. ex W.D.J.Koch, Vinca ellipticifolia Stokes, Vinca humilis Salisb., Vinca intermedia Tausch [1]

Vernacular Name

English Common periwinkle, lesser periwinkle, myrtle, running myrtle [2]
China Hua ye man chang chun hua [2].

Geographical Distributions

No documentation.

Botanical Description

V. minor is a member of theApocynaceae family [1].

Cultivation

No documentation.

Chemical Constituent

V. minor has been reported to contain alkaloid namely vincamine which was chemically developed into Vinpocetine and has been used widely in Japan, Hungary, Germany, Poland, and Russia for the treatment of cerebrovascular-related pathologies. [3][4][5][6]

Plant Part Used

No documentation.

Traditional Use

No documentation.

Preclinical Data

Neuroprotective activity

It is assumed that this inhibition enhances intracellular GMP levels in the vascular smooth muscle leading to reduced resistance of cerebral vessels and increase of cerebral flow. This effect might also beneficially contribute to the neuroprotective action [7][8][9]. The antioxidant effect of vinpocetine may contribute to the protective role in reducing neuronal damage in pathological situations [10][11].

Brain ischemia protective activity

Vinpocetine reportedly has anticonvulsant action, possibly linked to its neuronal protective capacity and/or its modulation of several chemical transmitter systems [12]. In these respects, vinpocetine resembles adenosine, thought to be a major endogenous anticonvulsant and cerebral protectant. Vinpocetine happens to be an effective adenosine re-uptake inhibitor. It reportedly increases cerebral metabolism and raises ATP levels in nerve cells, perhaps also raising neuronal excitability more directly by modulating cellular enzymatic control systems [6].

Antiototoxicity activity

Another study of interest found that vinpocetine, a Na+ channel antagonist, prevented ototoxicity induced the aminoglycoside amikacin in laboratory animals. [13]

Clinical Data

Clinical findings

Neuro- and cerebral protection

Experiments with vinpocetine have indicated the main pharmacological and biochemical actions include selective enhancement of the brain circulation and oxygen utilization without significant alteration in parameters of systemic circulation; increased tolerance of the brain toward hypoxia and ischemia; anticonvulsant activity; inhibitory effect on phosphodiesterase (PDE) enzyme; and improvement of rheological properties of the blood and inhibition of aggregation of thrombocytes [14] as well as endothelial vasodilation [15][16].

Evidence has been obtained that the neuroprotective action of vinpocetine is related to the inhibition of operation of voltage dependent neuronal Na+-channels, indirect inhibition of some molecular cascades initiated by the rise of intracellular Ca2+-levels, and to a lesser extent, inhibition of adenosine reuptake [17]. Vinpocetine has been reported to be a selective inhibitor of Ca2+-calmodulin dependent cGMP-PDE [18]

Several double-blind trials conducted with patients suffering from mild-to-moderate vascular dementia reported vinpocetine benefited memory, learning, and global clinical measures of cognitive performance [19][20][21][22]. Vinpocetine (TCV-3B) (15 mg/d) administered orally for duration of 3 weeks in 8 patients with vascular dementia of the Biswanger type which is characterized by diffuse myelin pallor and multiple lacunes in the cerebral white matter significantly increased oxygen affinity of hemoglobin and red blood cell (RBC) ATP concentrations [23]. Speech and language, but not mood or coordination, also were reportedly improved by vinpocetine [24]. In the only double-blind trial conducted to date assessing vinpocetine's effect against Alzheimer's Disease, no significant benefits were reported [25].

Acute ischaemic stroke

Cochrane Database System Review found that the evidence of vinpocetine use in patients with acute ischaemic stroke was inconclusive and larger studies need to be performed. [26][27] 

Tumoral calcinosis in haemodialysis patients with renal failure 

Vinpocetine appears to be an effective scavenger of tumoral calcinosis in hemodialysis patients with renal failure without any side effects during treatment. [28] 

Hearing loss

Several human studies report improvement in loss of hearing when using vinpocetine [29]. Vinpocetine may be beneficial in treating symptoms associated with tinnitus, due to its positive effects on microvasculature [30]

Chronic stroke

The effects of vinpocetine on the cerebral glucose metabolism of chronic stroke patients have been studied with positron emission tomography (PET). Results indicated that a single-dose vinpocetine treatment, although not significantly affecting the regional or global metabolic rates of glucose, improved the transport of glucose (both uptake and release) through the blood-brain barrier in the whole brain, the entire contralateral hemisphere, and in the brain tissue around the infarct area of the symptomatic hemisphere. [31]

Vinpocetine may have clinical utility in the management of stroke, and has been reported to improve the quality of life in chronic cerebrovascular patients [3][32]. Vinpocetine is a highly potent vasodilator, acting by direct relaxation of the vascular smooth muscle, and has been reported to enhance cerebral blood flow in patients with cerebrovascular disorders [33]. Patients from this population who also manifest increased blood viscosity are at greater risk for thrombotic complications. In one such group of patients, vinpocetine had a viscosity-lowering effect on the blood and plasma [34]. Vinpocetine is reported to decrease platelet and red cell aggregation, and to increase red cell membrane flexibility in stroke patients, as well as in healthy subjects. Any or all of these mechanisms could be involved in vinpocetine's capacity to lower the viscosity of the blood in vivo [35][36][37].

Red blood cell deformability

A reduction in red blood cell deformability was reported with the use of vinpocetine [37]. Red blood cell deformity is a contributory factor in stroke disease, and it has been postulated that improvement of red blood cell rigidification may improve stroke rate and survival, even being more effective than pentoxifylline in this regard [38].

Precautions

No documentation.

Interaction & Depletion

No documentation.

Interaction with drug

Vasodilator medications

Studies report that vinpocetine may act in the body like some of these medications, which may alter the effects of these medications and possibly the dose needed for treatment. Use with caution. [33]

These drugs include nitroglycerin (various dosage forms), isosorbide mononitrate, isosorbide dinitrate, amyl nitrate, isoxsuprine, hydralazine, minoxidil, papaverine, tolazoline, epoprostenol, ethaverine, nesiritide, bosentan

Antihypertensive medications

Studies report that vinpocetine may act in the body like some of these medications, which may alter the effects of these medications and possibly the dose needed for treatment. Use with caution. [18][33]

These drugs include amlodipine, bepridil, diltiazem, felodipine, isradipine, nicardipine, nifedipine, nimodipine, nisoldipine, verapamil, benazepril, captopril, enalapril, lisinopril, fosinopril,moexipril, quinapril, ramipril, trandolapril, perindopril erbumine, atenolol, esmolol, betaxolol, penbutolol, carteolol, bisoprolol, pindolol, metoprolol, timolol, sotalol, acebutolol, nadolol, propranolol, labetalol, carvedilol, methyldopa, clonidine, guanfacine, guanabenz, brimonidine tartrate, dipiprazole, levobunolol, levobetaxolol, metipranolol, reserpine, prazosin, terazosin, doxazosin meylate, guanadrel, guanethidine, isosorbide monohydrate, isosorbide dinitrate, nitroglycerin, hydralazine, minoxidil, papaverine, isoxsuprine, losartan, valsartan, eprosartan mesylate, telmisartan, candesartan cilexetil, irbesartan

Anticoagulant medications

Studies have reported that vinpocetine affects the blood's clotting ability and may alter the effects of these medications and possibly the dose needed for treatment. Use with caution. [36][37]

These drugs include warfarin, heparin, dalteparin, tinzaparin, enoxaparin, danaparoid sodium, antithrombin III, lipirudin, argatroban, bivalirudin,

Antiplatelet medications

Studies have reported that vinpocetine affects the blood's clotting ability and may alter the effects of these medications and possibly the dose needed for treatment. Use with caution. [36][37]

These drugs include aspirin, dipyridamole, anagrelide, cilostazol, clopidogrel, ticlopidine, abciximab, tirofiban, eptifibatide

Interaction with other Herbs

No documentation.

Contraindications

No documentation.

Dosage

No documentation.

Poisonous Management

No documentation.

Line drawing

No documentation.

References

  1. The Plant List. Ver1.1. Vinca minor L. [homepage on the Internet]. c2013 [updated 2012 Mar 23; cited 2016 Aug 10]. Available from: http://www.theplantlist.org/tpl1.1/record/kew-213172
  2. Quattrocchi U. CRC world dictionary of medicinal and poisonous plants: Common names, scientific names, eponyms, synonyms, and etymology. Volume V R-Z. Boca Raton, Florida: CRC Press, 2012; p. 745.
  3. Burtsev EM, Savkov VS, Shprakh VV, Burtsev ME. 10-year experience with using Cavinton in cerebrovascular disorders. Zh Nevropatol Psikhiatr Im S S Korsakova. 1992;92(1):56-60.
  4. Domzal T, Kozłowski P, Zaleska B. Cavinton in the treatment of ischemic cerebral stroke. Clinical and computerized-tomographic evaluation. Neurol Neurochir Pol. 1986;20(3):234-240.
  5. Kovacs L. Cavinton in the treatment of acute stroke. Ther Hung. 1985;33(1):50-57.
  6. Kakihana M, Suno M, Shibota M, Hamajo K, Nagaoka A. [Protective effect of vinpocetine on experimental brain ischemia]. Nippon Yakurigaku Zasshi. 1982;80(3):225-229. Japanese.
  7. Tretter L, Adam-Vizi V. The neuroprotective drug vinpocetine prevents veratridine-induced [Na+]i and [Ca2+]i rise in synaptosomes. Neuroreport. 1998;9(8):1849-1853.
  8. Rischke R, Krieglstein J. Protective effect of vinpocetine against brain damage caused by ischemia. Jpn J Pharmacol. 1991;56(3):349-356.
  9. Bonoczk P, Gulyas B, Adam-Vizi V, et al. Role of sodium channel inhibition in neuroprotection: Effect of vinpocetine. Brain Res Bull. 2000;53(3):245-254.
  10. Santos MS, Duarte AI, Moreira PI, Oliveira CR. Synaptosomal response to oxidative stress: Effect of vinpocetine. Free Radic Res. 2000;32(1):57-66.
  11. Deshmukh R, Sharma V, Mehan S, Sharma N, Bedi KL. Amelioration of intracerebroventricular streptozotocin induced cognitive dysfunction and oxidative stress by vinpocetine -- a PDE1 inhibitor. Eur J Pharmacol.  2009;620(1-3):49-56.
  12. Molnár P, Erdö SL. Vinpocetine is as potent as phenytoin to block voltage-gated Na+ channels in rat cortical neurons. Eur J Pharmacol. 1995;273(3):303-306.
  13. Nekrassov V, Sitges M. Vinpocetine protects from aminoglycoside antibiotic-induced hearing loss in guinea pig in vivo. Brain Res. 2000;868(2):222-229.
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  16. Vaizova OE, Vengerovskiĭ AI, Alifirova VM. [An effect of vinpocetine (cavinton) on endothelium function in patients with chronic cerebral ischemia]. Zh Nevrol Psikhiatr Im S S Korsakova. 2006;Suppl 16:46-50. Russian.
  17. Sitges M, Nekrassov V. Vinpocetine selectively inhibits neurotransmitter release triggered by sodium channel activation. Neurochem Res. 1999;24(12):1585-1591.
  18. Ishchenko MM, Shkrobot SI, Borak VT. [Effect of cavinton and sulfocamphocain on systemic and cerebral hemodynamics in patients with early forms of cerebrovascular diseases]. Zh Nevropatol Psikhiatr Im S S Korsakova. 1987;87(8):1160-1164. Russian.
  19. Balestreri R, Fontana L, Astengo F. A double-blind placebo controlled evaluation of the safety and efficacy of Vinpocetine in the treatment of patients with chronic vascular senile cerebral dysfunction. J Am Geriatr Soc. 1987;35(5):425-430.
  20. Hindmarch I, Fuchs HH, Erzigkeit H. Efficacy and tolerance of vinpocetine in ambulant patients suffering from mild to moderate organic psychosyndromes. Int Clin Psychopharmacol. 1991;6(1):31-43.
  21. Nicholson CD. Pharmacology of nootropics and metabolically active compounds in relation to their use in dementia. Psychopharmacology. (Berl). 1990;101(2):147-159.
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  23. Tohgi H, Sasaki K, Chiba K, Nozaki Y. Effect of vinpocetine on oxygen release of hemoglobin and erythrocyte organic polyphosphate concentrations in patients with vascular dementia of the Binswanger type. Arzneimittelforschung. 1990;40(6):640-643.
  24. Kidd PM. A review of nutrients and botanicals in the integrative management of cognitive dysfunction. Altern Med Rev. 1999;4(3):144-161.
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  28. Ueyoshi A, Ota K. Clinical appraisal of vinpocetine for the removal of intractable tumoral calcinosis in haemodialysis patients with renal failure. J Int Med Res. 1992;20(5):435-443.
  29. Afon'kin VIu, Dobretsov KG, Sipkin AV. [The new scheme of cavinton application to the treatment of chronic neurosensory loss of hearing]. Vestn Otorinolaringol. 2009;(6):69-70. Russian.
  30. Ribári O, Zelen B, Kollár B. Ethyl apovincaminate in the treatment of sensorineural impairment of hearing. Arzneimittelforschung. 1976;26(10a):1977-1980.
  31. Szakáll S, Boros I, Balkay L, et al. Cerebral effects of a single dose of intravenous vinpocetine in chronic stroke patients: A PET study. J Neuroimaging. 1998;8(4):197-204.
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  33. Tamaki N, Kusunoki T, Matsumoto S. The effect of Vinpocetine on cerebral blood flow in patients with cerebrovascular disorders. Ther Hung. 1985;33(1):13-21.
  34. Osawa M, Maruyama S. Effects of TCV-3B (Vinpocetine) on blood viscosity in ischemic cerebrovascular diseases. Ther Hung. 1985;33(1):7-12.
  35. Bayer R, Plewa S, Borcescu E, et al. Filterability of human erythrocytes - drug induced prevention of aging in vitro. Arzneimittelforschung. 1988;38(12):1765-1767.
  36. Kuzuya F. Effects of Vinpocetine on platelet aggregability and erythrocyte deformability. Ther Hung. 1985;33(1):22-34.
  37. Hayakawa M. Effect of Vinpocetine on red blood cell deformability in stroke patients. Arzneimittelforschung. 1992;42(4):425-427.
  38. Hayakawa M. Comparative efficacy of vinpocetine, pentoxifylline and nicergoline on red blood cell deformability. Arzneimittelforschung. 1992;42(2):108-110.