IngredientsChuchuhuasi belongs to the family Celastraceae and the genus Maytenus Molina, a large and botanically diverse group: four hundred different species of the genus Maytenus Molina have been identified. The taxonomy of the plant sold and used under the common name "chuchuhuasi" is exceptionally complex, and multiple scientific names have been applied to the same or closely related trees across different publications and regions.
Although M. macrocarpa is the most widely accepted scientific name, Celastrus macrocarpus Ruiz & Pav., Haenkea macrocarpa (Ruiz & Pav.) Steud., Haenkea multiflora Ruiz & Pav., M. multiflora (Ruiz & Pav.) Loes., and M. tarapotensis Briq. also refer to the same species. The situation is complicated further by the use of similar vernacular names for distinct species: "chuchuhuasha" is a vernacular name for M. macrocarpa, even though M. chuchuhuasha actually refers to another species — M. krukovii A.C. Sm. Another used vernacular name, "chuchuhuasi," may refer to one or both of the species M. macrocarpa and M. amazonica Mart. ex Reissek. Other vernacular names in use are chuchuasi, chuchuasha, chuchuwasha, chuchuwasha blanca, chuchuhuasca, and chichtá or xixuá.
Several botanical names have been given to this species of tree; it is referenced as Maytenus krukovii, M. ebenifolia, M. laevis, and M. macrocarpa, with all botanical names referring to the same tree. It should not be confused with Heisteria pallida, which is sometimes referred to as chuchuhuasha or chuchuwasi. Some secondary sources cite Maytenus ilicifolia as chuchuhuasi; however, expert opinion indicates that this species should not be associated with chuchuhuasi.
Chuchuhuasi is an enormous canopy tree of the Amazon rainforest that grows to 30 m high. It has large leaves (10–30 cm), small, white flowers, and extremely tough, heavy, reddish-brown bark. Chuchuhuasi is indigenous to the tropical rainforests of Bolivia, Colombia, Ecuador, and Peru. It is distributed in tropical lowland rainforests, with some exceptions growing up to 2,000 m above sea level.
Its roots, leaves, bark, and combinations of these are used in traditional medicine, mainly to treat rheumatism, and to a lesser extent to heal wounds and to combat bronchitis and diarrhea. The bark is commonly prepared as a decoction (boiled tea) or macerated in alcohol to produce the traditional "chuchuhuasi tonic" known throughout South America; the bark, root, and leaves all contain bioactive compounds, though the bark is the primary part used in traditional herbal supplements.
Modern commercial preparations include standardized capsules, liquid tinctures, bark powders, and pre-made alcoholic infusions. Sections of bark are commonly sold in herbal markets, and many fluid preparations can be found; chuchuhuasi liquors, from wines to distilled alcohols, appear in grocery stores and airport gift shops throughout the Peruvian Amazon. The name itself carries descriptive weight: its Peruvian name, chuchuhuasi, means "trembling back," which refers to its long-standing use for arthritis, rheumatism, and back pain.
Indigenous people of the Amazon rainforest have been using the bark of chuchuhuasi medicinally for centuries. Chuchuhuasi, a towering tree native to the Amazon rainforest, has long held a prominent place in the traditional medicine of indigenous peoples in Peru, Ecuador, and Brazil. For centuries, its reddish bark has been prized for its potent therapeutic properties. Traditionally, chuchuhuasi bark is soaked in alcohol or water to create tinctures and decoctions, which are then consumed or applied topically. Among its most celebrated uses are remedies for arthritis, rheumatism, and muscle pain, as the bark is believed to have strong anti-inflammatory and analgesic effects.
Traditionally, chuchuhuasi is used to relieve pain and inflammation, to treat arthritis, rheumatism and back pain, to restore vigor after a debilitating disease, as a general tonic, and for relieving menstrual pain and enhancing libido. Other uses vary in different regions. Ethnopharmacological studies showed that M. macrocarpa possesses aphrodisiac and anti-diarrheic effects and can also be used as a health and postpartum tonic and to enhance healing.
The Shipibo, Quijos Quichua, and other Amazonian clans have relied on the bark of this tree as a general tonic and herbal remedy for generations. The Siona Indians of Colombia have a documented preparation method: indigenous Peruvian communities, including the Siona Indians of Colombia and the Bora-Bora people of Loreto, have traditionally prepared the chuchuhuasi remedy by boiling bark in water for extended periods.
The most common use in the western Amazon is for rheumatism. To prepare the herb for pain, the bark is soaked overnight in cane liquor, and the resulting tincture is drunk. In Peru, it remains one of the most popular natural remedies after cat's claw, and it is a key ingredient in many Peruvian aphrodisiac blends.
Several indigenous groups have distinct traditions surrounding chuchuhuasi. The Quijos Quichua use it not only for physical ailments but also for spiritual protection and to enhance vitality. The Siona people are known to utilize chuchuhuasi to strengthen the spirit and promote emotional balance.
Maytenus krukovii is respected as a plant teacher in Peruvian shamanism for the strength and protection it confers. It is one of the palos (trees) included in la dieta, the shamanic diet that forms the basis of shamanic training in the Ucayali region of Peru. Chuchuhuasi is one of many additional ingredients which can be added to the ayahuasca brew.
Chuchuhuasi is used for joint and back pain, diarrhea, complications after childbirth, and sexual arousal. As a food, chuchuhuasi is used as a flavoring agent. The bark imparts a distinctive bitter, spicy, and woody profile to fermented or distilled alcoholic beverages, a practice that has crossed from indigenous tradition into contemporary commercial production.
To date, mainly triterpenes and dihydro-β-agarofuran sesquiterpenes have been isolated from M. macrocarpa. Extracts and selected pure compounds isolated from the leaves, roots, and stem bark showed antibacterial, antiviral, antiparasitic, anti-inflammatory, and cytotoxic activities in vitro.
The triterpenoids are a much better explored group of compounds isolated from M. macrocarpa. Several studies described the presence of mainly tetracyclic dammarane and pentacyclic friedelane triterpenes, and to a lesser extent quinonmethide, lupane, and oleane-derived compounds. Another very interesting group of compounds obtained from M. macrocarpa consists of dihydro-β-agarofuran sesquiterpenes.
Maytenus species are known to contain a diverse group of triterpenoids, flavonoids, tannins, lignans, dihydro-β-agarofurans, and sesquiterpene pyridine alkaloids that display remarkable structural diversities and cytotoxicity, as well as insecticidal, antitumor-promoting, MDR-reverting, antitubercular, neuroprotective, immunosuppressive, anti-HIV, anti-inflammatory, and other medicinal properties.
The full chemical profile of chuchuhuasi is extensive. The main plant chemicals found in chuchuhuasi include: 6β,8β,15-triacetoxy-1α,9α-dibenzoyloxy-4β-hydroxy-β-dihydroagarofuran, dammarane triterpenes, lupeol, friedelin, canophyllol, catechin tannins, scutione, tingenones, pristimerin, tingenone, celastrol, epifriedelanol, maniladiol, macrocarpine A–D, macrocarpoic acid A and B, maytansine, mayteine, maytenin, phenoldienones, laevisine alkaloids, ebenifoline alkaloids, dulcitol, and proanthocyanidins.
Phytochemical screening has confirmed the presence of alkaloids, flavonoids, coumarins, steroids, phenols, quinones, saponins, and catechins.
Key compounds and their proposed activities are as follows:
Research on chuchuhuasi spans multiple decades but remains predominantly preclinical — that is, conducted in cell culture systems and animal models. As of the available literature, there are no published randomized controlled trials in human subjects evaluating chuchuhuasi for any indication. All clinical evidence discussed below is therefore derived from in vitro or animal studies, and evidence strength is characterized accordingly.
Evidence level: Preclinical only (animal and in vitro models). No human clinical trials identified.
This is the most extensively investigated area and the one most directly corresponding to chuchuhuasi's principal traditional use. Chuchuhuasi has long been employed in Peru as a traditional alternative therapy for several diseases including cancer, arthritis, and diarrhea. Recent studies show that several species of Maytenus have effects on nociceptive and inflammatory signaling, as well as toxic effects on behavioral neuronal pathways.
One experimental study published in Pharmacognosy Journal used the carrageenan paw edema test in mice to assess anti-inflammatory activity: M. macrocarpa displayed anti-inflammatory effects in a non-significant dose-dependent trend. At 1,250 mg/kg, anti-inflammatory effects were higher in comparison with diclofenac (74.14% vs. 58.62%; one-way ANOVA, p<0.05). This same study also noted neurobehavioral adverse effects, discussed in the safety section.
A separate study investigating central analgesic activity used the tail-flick model in mice: researchers explored the central analgesic activity of M. macrocarpa leaves in mice using the tail-flick model. Fifty albino mice (25 g average weight) were divided into five groups and administered by oral route: M. macrocarpa at 1,000 and 1,500 mg/kg, tramadol at 10 mg/kg, distilled water as placebo, and a control group. Pain was evaluated by estimating average latency period after six measurements at 30-minute intervals. Percent maximum possible effect (% MPE) was also determined. Baseline time for chuchuhuasi 1,000 mg/kg was 2.781 seconds vs. 4.135 seconds at 120 minutes, indicating a significant increase in pain threshold.
Another rodent study reported: sedation and stereotypies were observed at 4,000 mg/kg, and death occurred at 12,000 and 14,000 mg/kg without determination of the lethal dose (LD50). At 500–2,250 mg/kg, antinociceptive effects were found by inhibition of abdominal contractions, being more effective than diclofenac (ANOVA, p<0.05).
Research has shown that the ethanolic extract from chuchuhuasi leaves has anti-inflammatory activity, with studies demonstrating up to 18.1% inhibition of inflammation at certain doses. A pharmacological synergistic interaction was also demonstrated between chuchuhuasi at a dose of 1,000 mg/kg and prednisone at 3 mg/kg.
Collectively, these studies provide proof-of-concept for anti-inflammatory and analgesic activity in rodent models. The doses used (500–2,250 mg/kg in rodents) are extremely high relative to human equivalents and have not been translated into validated human dosing protocols. All evidence remains preclinical.
Evidence level: In vitro (cell line studies) only. No animal tumor models or human trials identified for the whole plant extract.
M. macrocarpa was examined as a potential source of cytotoxic substances. Pristimerin inhibited DNA synthesis and triggered apoptosis in human HL-60 cells (promyelocytic leukemia cell line). It inhibited topoisomerase II, but did not influence topoisomerase I. Pristimerin also showed activity against K-562 (chronic myelocytic leukemia), SF-295 (glioblastoma), HCT-8 (colon carcinoma), and MDA/MB-435 (melanoma) cell lines with IC50 values ranging from 0.55 µM to 3.20 µM.
Several friedelane triterpenoids and sesquiterpene pyridine alkaloids isolated from the genus Maytenus have also showed good anti-tumor and anti-bacterial characteristics. These findings are preliminary and derived entirely from cell culture models. They do not constitute evidence of clinical efficacy or safety in human cancer treatment.
Evidence level: In vitro only. No controlled human studies identified.
Extracts and selected pure compounds isolated from the leaves, roots, and stem bark showed antibacterial, antiviral, antiparasitic, anti-inflammatory, and cytotoxic activities in vitro.
Antileishmanial activity has been specifically examined: the Leishmania major strain used in a brief antileishmanial-activity screening of an extract obtained from M. macrocarpa bark showed relatively strong inhibitory activity at doses lower than 10 µg/mL. Unfortunately, no strains of local clinically isolated Leishmania parasites were available for this study, and only the promastigote form of Leishmania was used in the assay. The predictive value of the test is therefore limited, and more experiments should be carried out to confirm the effect.
Three triterpene compounds derived from Maytenus showed antibiotic activities against B. subtilis, with minimal inhibitory concentrations (MICs) of 12–14, 35–39, and 25 µg/mL, respectively. 6-Oxo-tingenol was also active against Staphylococcus aureus with a MIC of 40–50 µg/mL. These are in vitro findings and their clinical relevance has not been established.
Evidence level: Preclinical (rodent) only.
A study examining cardiovascular pharmacodynamics in conscious rats found significant effects at high doses: Maytenus macrocarpa showed depressing effects on cardiac frequency, being more effective at 1,500 mg/kg doses (average 308.6 bpm), with higher negative inotropic effect at 1,500 mg/kg. Severe bradypnea was shown at 1,500 mg/kg (average RF 51.6 rpm), as well as hypothermia (average T° 31.84 °C). The conclusion was that Maytenus macrocarpa demonstrated bradycardic as well as depressing effects on respiratory frequency and body temperature. A separate rodent study recorded hypotensive and bradycardic effects with Maytenus krukovii at 1,000 mg/kg by the oral route. These cardiovascular findings in rodents are relevant to safety profiling but have not been evaluated in human subjects.
Evidence level: Preclinical (rodent) only.
Its roots, leaves, bark, and combinations of these are used in traditional medicine, and to a lesser extent, to combat diarrhea. Rodent studies in the broader Maytenus genus have demonstrated intestinal motility modulation. Studies in rodents treated with M. macrocarpa showed activity on intestinal motility. Traditional healers in Peru have also cited gastrointestinal uses: the main indications for consumption of chuchuhuasi reported by traditional healers included respiratory problems (80%) and osteotendinous conditions.
Evidence level: In vitro only.
Chuchuhuasi contains chemicals that have antioxidant effects. The polyphenol content and antioxidant capacity of bark extracts have been studied using optimized extraction methods. Catechin tannins, proanthocyanidins, and flavonoids present in the bark are known antioxidant compound classes, but in vitro antioxidant findings cannot be directly extrapolated to in vivo benefit.
Evidence level: Preclinical (rodent and macrophage cell models). Older research (1960s) noted reticuloendothelial stimulation.
Early research documented immune-stimulating properties. Studies from the 1960s examined the ability of Maytenus laevis extracts to stimulate the reticuloendothelial system (RES) and protect mice against gram-positive bacterial challenge. These older findings are of historical importance but do not meet modern standards for establishing immunostimulant activity in humans.
Evidence level: Traditional use only; no controlled scientific studies identified.
Local people and villagers along the Amazon believe that Maytenus macrocarpa is an aphrodisiac and tonic, and it continues to be used by those who trek through the jungle to give stamina and vitality. No animal or human studies specifically addressing libido, sexual function, or testosterone have been identified in the peer-reviewed literature.
Evidence level: Preclinical (rodent) only. Notable for safety implications.
Santoyo et al. (2015) demonstrated antipsychotic effect and behavior-modifying effect in a study using the Maytenus macrocarpa ethanolic extract. Importantly, the anti-inflammatory study in the Pharmacognosy Journal also noted neurobehavioral adverse effects alongside the anti-inflammatory results, emphasizing that higher doses produced observable excitatory and motor effects in mice.
There is no standardized, clinically validated dosage for chuchuhuasi in humans. In research studies, chuchuhuasi extract has been used at doses of 1,000 mg/kg and 1,500 mg/kg in animal models, with the 1,000 mg/kg dose proving more effective than the higher dose. However, there is not enough scientific information to determine an appropriate range of doses for human use.
The following dosage forms have been reported in the ethnographic and research literature:
There is no proven safe or effective dose for chuchuhuasi in children.
When taken by mouth, there is not enough reliable information to know if chuchuhuasi is safe or what the side effects might be. There is insufficient scientific evidence to rate the effectiveness for most of the uses for which chuchuhuasi is employed.
Rodent acute toxicity studies establish important safety signals. In rodent studies, sedation and stereotypies were observed at 4,000 mg/kg, and death occurred at 12,000 and 14,000 mg/kg without determination of the lethal dose (LD50). The anti-inflammatory rodent study also identified significant neurobehavioral toxicity at higher doses, including excitation, abnormal gait, cramps, and piloerection. These findings suggest a meaningful margin between effective and toxic doses in animal models, but no human pharmacokinetic or toxicology studies have been conducted.
At doses of 1,500 mg/kg in rodents, Maytenus macrocarpa showed depressing effects on cardiac frequency, severe bradypnea, and hypothermia, demonstrating bradycardic as well as depressing effects on respiratory frequency and body temperature. Traditional healers in Lima contraindicated chuchuhuasi in pregnancy, hypertension, and diabetes.
Chuchuhuasi should be avoided in pregnant women, as Maytenus macrocarpa has been used traditionally for birth control and to induce abortion. Chuchuhuasi is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.
Chuchuhuasi may interact with antibiotics, anticancer agents, antifungals, anti-inflammatory agents, and antiprotozoals. Due to its potential interactions with anti-inflammatory medications, caution should be exercised when using chuchuhuasi alongside conventional anti-inflammatory drugs. A pharmacological synergistic interaction has been demonstrated between chuchuhuasi at 1,000 mg/kg and prednisone at 3 mg/kg in animal models, which raises concerns about additive effects when co-administered with corticosteroids or other anti-inflammatory drugs. Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods; the interactions listed are based on reports in scientific publications, laboratory experiments, or traditional use.
Maytansine, a cytotoxic alkaloid present in chuchuhuasi, has been investigated for its antitumor potential; however, it is highly toxic and is not used clinically. The presence of this compound in the plant is an important consideration when evaluating the safety of whole-bark preparations, particularly at higher doses or in vulnerable populations.
People with liver disease should avoid using chuchuhuasi as it may worsen their condition. This caution is based on the metabolic burden of its alkaloid and triterpene constituents, though no specific hepatotoxicity studies in humans have been identified.
It is necessary to continue developing phytochemical and pharmacological studies as well as chemotaxonomic identification techniques of the species, in order to avoid confusion that may influence the efficacy and safety in its use as a complementary therapy. Given the multiple species — and even unrelated genera — sold under the chuchuhuasi name, misidentification is a practical safety concern with commercial products.
The aim of the primary systematic review in this field is to summarize the available ethnobotanical, phytochemical, and pharmacological information about this traditional Amazonian medicinal tree, as well as to attract the attention of phytochemists and pharmacognosists to this potentially interesting source of ethnopharmaceuticals.
Chuchuhuasi occupies an important niche in Amazonian ethnomedicine with a centuries-long history of use for pain, inflammation, and general vitality. A meaningful body of preclinical research — predominantly from Peruvian, Colombian, and European laboratories — supports the presence of pharmacologically active compounds and demonstrates relevant bioactivity in animal and cell-based systems. However, as of the current literature, no randomized controlled clinical trials, systematic reviews of human studies, or pharmacokinetic studies in humans have been published. There is no good scientific evidence to support chuchuhuasi's use for any condition in humans.
The most robust signals from preclinical research include anti-inflammatory and analgesic activity (via rodent models), in vitro cytotoxicity (particularly pristimerin against leukemia and other tumor cell lines), and in vitro antimicrobial effects. These findings warrant properly designed human studies but do not, by themselves, constitute evidence of clinical efficacy or safety.
Health conditions that Chuchuhuasi may help support.
Body systems that Chuchuhuasi may help support.
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