Evidence review
Yohimbe for Erectile Dysfunction
Pausinystalia johimbe
The short answer
Early or mixed evidenceProbably not worth trying. The prescription drug yohimbine hydrochloride beat placebo in a 1998 meta-analysis of seven trials, but the benefit was modest, several trials found no clear effect, and the American Urological Association advised against it in 2005. Yohimbe bark supplements are a different product: they are untested for erectile dysfunction, labels rarely state their yohimbine content, and they can raise blood pressure and heart rate. Get a medical check instead; proven treatments exist.
8 key studies reviewed
Updated October 22, 2026
Key points
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01
The drug was tested, not the bark
Trials used yohimbine hydrochloride, a purified alkaloid, mostly at 15–42 mg a day. Yohimbe bark supplements have essentially no erectile dysfunction trials of their own.
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02
Modest, inconsistent benefit
A 1998 meta-analysis of seven trials favored yohimbine over placebo, but trials in men with physical causes of ED, and one at 100 mg a day, found no clear advantage.
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03
Not recommended by urologists
The American Urological Association advised against yohimbine in 2005. Its current guideline points men to PDE5 inhibitors such as sildenafil and tadalafil and other tested options.
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04
Supplement labels are unreliable
In 49 US yohimbe supplements, yohimbine per serving ranged from none to 12.1 mg. Only 11 labels gave an amount, and those were 23–147% accurate.
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05
Real heart and mental health risks
Yohimbine raises blood pressure and heart rate and can trigger anxiety or panic. Avoid it with heart, kidney, or liver disease, psychiatric conditions, or MAOI or tricyclic antidepressants.
Yohimbe is one of the oldest remedies for erectile dysfunction (ED), but the evidence belongs mostly to a purified drug rather than to the bark sold in supplements. Yohimbine hydrochloride, the bark’s main alkaloid in a standardized prescription form, beat a placebo (dummy pill) in a 1998 meta-analysis of seven randomized trials. The benefit was modest, though, several trials found no clear advantage, and the American Urological Association advised against yohimbine in 2005 once better-tested drugs were available. Yohimbe bark supplements have essentially no trials of their own for ED, their yohimbine content is unpredictable, and they can raise blood pressure and heart rate.
Yohimbe (Pausinystalia johimbe, also listed in plant databases as Corynanthe johimbe) is a West and Central African rainforest tree whose bark contains yohimbine. Yohimbine blocks alpha-2 adrenergic receptors, which normally act as a brake on the release of norepinephrine, the body’s fight-or-flight messenger. That may help blood flow into the penis, and it also explains the stimulant side effects. Before sildenafil (Viagra) and related drugs arrived, yohimbine tablets were among the few oral treatments doctors could offer. In 2013 a few European countries still had yohimbine hydrochloride tablets authorized for ED, and Canada treats yohimbine as a prescription drug, while the European Union has banned yohimbe bark in food and supplements since 2019. In the United States yohimbe is sold as a dietary supplement, but it is illegal to market an over-the-counter yohimbine product for ED without approval from the Food and Drug Administration (FDA).
This page covers what the trials tested and found, including who ran them; why yohimbine pills and yohimbe bark supplements are not interchangeable; how yohimbine fits alongside today’s standard treatments; and who should avoid it. Nothing here is medical advice. ED that keeps happening can be an early warning sign of heart disease or diabetes, so it deserves a medical check before any supplement, and effective treatments, including PDE5 inhibitor medicines such as sildenafil and tadalafil, are available from a clinician.
02 The trials
Key studies
The trials and reviews that carry the most weight for this question, with the product and dose each one tested. Results apply to the preparation studied.
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Ernst and Pittler, 1998
Systematic review and meta-analysis of 7 randomized placebo-controlled trials
- Who
- Men with erectile dysfunction in trials of yohimbine on its own
- What and how much
- Oral yohimbine (prescription alkaloid) as monotherapy
- How long
- Trial lengths not reported in the abstract
Yohimbine was superior to placebo (odds ratio 3.85, 95% CI 2.22 to 6.67). Overall trial quality was judged satisfactory, and serious adverse reactions were infrequent and reversible. The authors called it a reasonable first drug to try, writing at a time when no generally accepted drug treatment for ED existed.
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Reid et al., 1987
Randomized, double-blind, placebo-controlled, partial crossover
- Who
- 48 men with psychogenic erectile dysfunction (no physical cause found)
- What and how much
- Yohimbine 18 mg a day
- How long
- 10 weeks
After the first phase, 62% on yohimbine and 16% on placebo reported some improvement (p < 0.05). Overall, 46% of men who received yohimbine responded. The authors judged it safe and about as effective as sex and marital therapy, a comparison the trial itself did not test.
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Morales et al., 1987
Randomized, placebo-controlled, partial crossover
- Who
- 100 men with organic (physical) erectile dysfunction
- What and how much
- Yohimbine 18 mg a day
- How long
- Two treatment phases; length not given in the abstract
In the first phase, 42.6% responded on yohimbine versus 27.6% on placebo, a difference that was not statistically significant. The authors, largely the same group as the Reid trial, called the response “at best marginal” but still an option for men who declined more invasive treatment.
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Susset et al., 1989
Double-blind, partial crossover study
- Who
- 82 men with erectile dysfunction at a US Veterans Administration medical center, many with diabetes or vascular disease
- What and how much
- Yohimbine hydrochloride, up to 42 mg a day
- How long
- 1 month
14% regained full erections, 20% improved partly, and 65% did not improve; three men responded to placebo. Effects took 2–3 weeks to appear, and side effects were few and mild. The abstract reports no formal statistical comparison with placebo.
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Vogt et al., 1997
Randomized, double-blind, placebo-controlled
- Who
- 86 men with erectile dysfunction and no clearly detectable physical or psychological cause (Munich, Germany)
- What and how much
- Yohimbine hydrochloride 30 mg a day (two 5 mg tablets three times daily)
- How long
- 8 weeks
Response rate 71% on yohimbine versus 45% on placebo, a significant difference, judged on self-reported measures and erection rigidity during sleep. Only 7% rated tolerability fair or poor, and there were no serious adverse events.
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Kunelius et al., 1997
Randomized, double-blind, placebo-controlled crossover
- Who
- 29 men with mixed physical and psychological erectile dysfunction (Oulu, Finland); 27 completed
- What and how much
- High-dose yohimbine hydrochloride, 36 mg a day
- How long
- Two 25-day courses separated by a 14-day washout
44% responded on yohimbine and 48% on placebo, with no statistical difference. Drug-related side effects occurred in 2 men (7%). The authors concluded yohimbine was no better than placebo as a first-line treatment.
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Lebret et al., 2002
Randomized, double-blind, placebo-controlled, three-way crossover pilot; funded by Real 2000 and NitroMed
- Who
- 48 men with mild to moderate erectile dysfunction randomized, 45 analyzed (Hôpital Foch, France)
- What and how much
- L-arginine glutamate 6 g plus yohimbine hydrochloride 6 mg, yohimbine 6 mg alone, or placebo, 1–2 hours before sex
- How long
- Three 2-week periods
Erectile function scores were 17.2 with the combination, 15.4 with yohimbine alone, and 14.1 with placebo; only the combination beat placebo on this main measure (p = 0.006), though patients and investigators rated yohimbine alone better than placebo. One author worked for NitroMed.
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Cohen et al., 2016
Laboratory analysis of supplements, not a clinical trial
- Who
- 49 brands labeled as yohimbe or yohimbine, bought from seven major US retailers
- What and how much
- Yohimbe and yohimbine dietary supplements
- How long
- Single round of chemical testing (published online 2015)
Yohimbine per recommended serving ranged from none detected to 12.1 mg. Only 11 brands stated an amount, and actual content was 23% to 147% of the label. 19 brands lacked the bark’s other alkaloids, suggesting synthetic or highly processed yohimbine. Only 2 gave both an accurate amount and side-effect information.
03 Evidence
What the research shows
Our rating for Yohimbe for Erectile Dysfunction, based on the studies below.
Two meta-analyses (studies that pool the results of earlier trials) from the 1990s form the core of the evidence, and both concern yohimbine itself rather than yohimbe bark. Carey and Johnson (Archives of Sexual Behavior 1996) ran four separate analyses, covering controlled and uncontrolled trials of yohimbine alone and in combination with other drugs, and found a consistent tendency for yohimbine to improve erections compared with placebo, while flagging methodological and reporting problems across much of the literature. Ernst and Pittler (Journal of Urology 1998), at the University of Exeter, found seven randomized, placebo-controlled trials of yohimbine on its own, judged their overall quality satisfactory, and calculated an odds ratio of 3.85 in favor of yohimbine (95% confidence interval, the range in which the true effect probably lies, 2.22 to 6.67). In plain terms, men taking yohimbine had considerably higher odds of reporting improvement than men taking placebo. Serious adverse reactions were infrequent and reversible. The authors concluded that yohimbine was a reasonable first drug to try, but they were writing at a time when, in their words, no generally accepted drug treatment for ED existed. We found no newer meta-analysis focused on yohimbine.
The individual trials show why the overall picture is modest. One research group ran two companion trials at 18 mg a day. In 48 men whose ED had no physical cause (Reid and colleagues, The Lancet 1987), 62% on yohimbine versus 16% on placebo reported some improvement after the first phase, and 46% of all men given yohimbine responded overall. In 100 men with physical (organic) causes (Morales and colleagues, Journal of Urology 1987), 42.6% responded on yohimbine and 27.6% on placebo, a difference that was not statistically significant; the authors called the response “at best marginal.” Mann and colleagues (Archives of Sexual Behavior 1996), giving 15 mg a day for seven weeks to 31 men, likewise found a benefit only in men without a physical cause, and no change in erections measured during sleep. The most favorable trial was by Vogt and colleagues (International Journal of Impotence Research 1997): in 86 men with no clear physical or psychological cause, 30 mg a day for eight weeks produced a response in 71% versus 45% on placebo, with mostly mild side effects. In a Veterans Administration population with high rates of diabetes and vascular disease, Susset and colleagues (Journal of Urology 1989) gave up to 42 mg a day for a month: 14% regained full erections, 20% improved partly, and 65% did not improve.
Trials with higher doses or mixed causes were less encouraging. Kunelius and colleagues (Urology 1997) gave 29 Finnish men with mixed physical and psychological ED 36 mg a day and placebo for 25 days each in a crossover design, in which each man takes both treatments in turn: 44% responded on yohimbine and 48% on placebo, and the authors concluded it was no better than placebo. Telöken and colleagues (Journal of Urology 1998) gave 22 men with organic ED a single 100 mg dose daily for 30 days and found no significant difference from placebo, with anxiety, a faster heart rate, increased urination, and headache as the most common side effects. A 2001 clinical review by Tam and colleagues (Pharmacology and Therapeutics) concluded that relatively few well-designed studies existed and that yohimbine on its own has only modest efficacy; its authors worked for NitroMed, a company that also helped fund a yohimbine combination trial. Taken together, the trials suggest that yohimbine helps some men, with the clearest results in men without an obvious physical cause, but that response is hard to predict and was often close to the placebo response.
Yohimbine has also been tested in combinations, which makes it harder to know what it contributes. In 63 men with psychological ED, Montorsi and colleagues (Urology 1994) found that yohimbine 15 mg plus the antidepressant trazodone 50 mg a day for eight weeks produced complete or partial responses in 71% of those who finished treatment, significantly better than placebo, but there was no yohimbine-only group. Lebret and colleagues (European Urology 2002) compared 6 g of L-arginine glutamate plus 6 mg of yohimbine, 6 mg of yohimbine alone, and placebo, each taken one to two hours before sex for two weeks, in a crossover trial of men with mild to moderate ED. On the main erectile function score, only the combination beat placebo (17.2 versus 14.1), with yohimbine alone in between at 15.4, although patients and investigators rated yohimbine alone better than placebo. It was a pilot study of 45 analyzed men, supported by grants from Real 2000 and NitroMed, with a NitroMed co-author. These were pharmaceutical-grade products at measured doses, and their results cannot be applied to supplement blends that mix yohimbe bark with arginine or other ingredients.
Professional and government bodies now steer men away from yohimbine. The American Urological Association’s 2005 guideline update named PDE5 inhibitors as first-line therapy and listed yohimbine, trazodone, and herbal therapies among treatments it did not recommend for ED. Its 2018 guideline, the current version, centers on informing men about PDE5 inhibitors, vacuum devices, penile injections, and implants, alongside lifestyle change and counseling, and does not include yohimbine. Memorial Sloan Kettering Cancer Center (MSKCC) notes that several research bodies judged the evidence for yohimbine weak. For yohimbe bark supplements the gap is wider: the National Center for Complementary and Integrative Health (NCCIH) says there is not enough research to show they help ED and that a supplement may not work like the prescription medicine. Product testing bears that out. Cohen and colleagues (Drug Testing and Analysis 2016) analyzed 49 US brands labeled as yohimbe or yohimbine and found from none to 12.1 mg of yohimbine per serving; only 11 labels stated an amount, and those were 23% to 147% accurate, while 19 products lacked the bark’s other alkaloids, suggesting synthetic or highly processed yohimbine. A capsule with no yohimbine cannot reproduce the trial results, whatever its label says.
04 In practice
How it was taken in studies
There is no established safe or effective dose of yohimbe bark or yohimbe supplements for ED. Most yohimbine trials used the purified hydrochloride at measured doses of 15–42 mg a day, split through the day, and LiverTox, the US National Institutes of Health liver injury database, gives a usual dose of 5–10 mg three times a day, adding that tolerance may develop. European medicines summarized by the European Food Safety Authority (EFSA) in 2013 were taken at 5–10 mg two or three times a day, up to 30 mg a day, typically for eight weeks. Supplements cannot be matched to those doses. EFSA could not identify any daily intake of yohimbe bark that would not raise health concerns, and estimated that following the labels of the strongest products could supply up to 75 mg of yohimbine a day, well above the highest approved medicinal dose. Where yohimbine is still available as a medicine, as in Canada, it should come from a pharmacy with a stated dose and a prescriber’s supervision.
The more useful first step for ED is a medical assessment. A clinician will usually ask about medicines, supplements, alcohol, smoking, stress, and relationship factors, and may order blood or urine tests for diabetes, heart problems, or low testosterone. Lifestyle changes such as losing excess weight, stopping smoking, exercising daily, eating a healthy diet, and keeping alcohol within recommended limits can help, and counseling or sex therapy is useful when anxiety or relationship strain plays a part. PDE5 inhibitors such as sildenafil and tadalafil are the usual first medicines, and vacuum devices, medicine inserted into or injected into the penis, and implants are options when pills do not work or are unsuitable. ED pills must never be combined with nitrate heart medicines such as nitroglycerin, because the combination can drop blood pressure dangerously.
If you already use a sexual enhancement, pre-workout, or fat-burning product, check the full ingredient list for yohimbe or yohimbine, which often appear alongside caffeine and other stimulants. Avoid products that do not state how much yohimbine they contain, do not take more than one such product at a time, and do not add coffee, energy drinks, or prescription ED medicines on top. The FDA has also found yohimbine hidden, unlisted, in male enhancement pills, including a June 2026 warning about a product called Business Pill, so a “natural” label is no guarantee of what is inside. Stop and seek care for a pounding or irregular heartbeat, chest pain, severe headache, panic, or tremor. And if a product seems to help, tell your doctor anyway, because ED can still signal a heart or blood sugar problem that needs attention.
05 Caution
Before you try yohimbe
Yohimbine’s side effects follow from its stimulant action. MSKCC lists high blood pressure, anxiety, nervousness, nausea, dizziness, rapid and irregular heartbeat, sleeplessness, urinary problems, diarrhea, and psychiatric symptoms, and EFSA cites a study in which doses as low as 5.4 mg significantly raised systolic blood pressure, the top number. In the 100 mg trial, anxiety, a faster heart rate, increased urination, and headache were the most common complaints. At trial doses of the prescription drug most effects were mild, but supplements add uncertainty about the dose. Of 238 adults with symptoms reported to the California Poison Control System after taking yohimbine products from 2000 to 2006, 98.7% had used herbal rather than prescription products, with sexual enhancement the most common reason; 46% had stomach upset, 43% a rapid heartbeat, 33% anxiety or agitation, and 25% high blood pressure, and these cases had nearly six times the odds of a severe outcome compared with the average poison center case. In a 2006 surveillance study, yohimbe products caused 18% of symptomatic supplement cases, second only to caffeine. LiverTox has not linked yohimbine to liver injury, but overdoses have caused seizures and deaths.
Do not use yohimbe or yohimbine if you have heart disease, a heart rhythm problem, or high blood pressure, or if you have kidney or liver disease. Health Canada warns that serious reactions are particularly likely in these groups, and MSKCC lists them as contraindications. MSKCC also advises against it with anxiety, post-traumatic stress disorder, depression, bipolar disorder, mania, or schizophrenia, and with seizures, Parkinson’s disease, thyroid disease, ulcers, or an enlarged prostate. Panic disorder deserves special mention: in a classic study by Charney and colleagues (American Journal of Psychiatry 1987), yohimbine triggered panic attacks in 37 of 68 people with panic disorder or agoraphobia, compared with 1 of 20 healthy volunteers. The FDA warns that yohimbine can cause mania or psychosis in people with schizophrenia. European yohimbine medicines also excluded glaucoma and use in women, NCCIH says yohimbe may be unsafe in pregnancy and breastfeeding, and Health Canada says it should not be used by children.
Several interactions matter. NCCIH advises against yohimbe with monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants, MSKCC warns that it may worsen the side effects of antidepressants and weaken anti-anxiety medicines, and a poison center study recorded a suspected interaction with the antidepressant bupropion. The FDA says risks are greater with stimulants such as caffeine or ephedra and with medicines for attention-deficit/hyperactivity disorder (ADHD), and the same poison center study recorded three cases of yohimbe taken with methamphetamine. Yohimbine may blunt blood pressure medicines. Clonidine, a blood pressure drug, stimulates the same alpha-2 receptors that yohimbine blocks, so the two work against each other; in one emergency case, a 49-year-old man’s severe high blood pressure did not respond to repeated clonidine and intravenous labetalol, and he later admitted taking a yohimbine supplement. There is no good safety evidence for combining yohimbe with PDE5 inhibitors or nitrates, so ask your prescriber before adding any yohimbe product to prescribed medicines.
ED itself can be a warning sign. In 9,457 men aged 55 or older followed in a large US prostate cancer prevention trial, ED was linked to a higher rate of later cardiovascular events, a risk comparable to current smoking or a family history of heart attack, and the authors concluded that ED should prompt a check of cardiovascular risk factors. The American Urological Association likewise advises that men be told ED is a risk marker for cardiovascular disease. See a doctor for ED that persists despite lifestyle changes, began after an injury or prostate surgery, or comes with other symptoms such as back or abdominal pain or a change in urination. Seek emergency care for chest pain, a racing or irregular heartbeat, fainting, severe headache, confusion, or a seizure after taking any yohimbe product, and for any erection that lasts more than four hours.
06 Questions
Frequently Asked Questions
The purified drug yohimbine hydrochloride helped some men in older trials: a 1998 meta-analysis of seven placebo-controlled trials found it beat placebo, but the benefit was modest and several trials, especially in men with physical causes of ED, found no clear effect. Yohimbe bark supplements have not been shown to help, according to NCCIH, and the American Urological Association advised against yohimbine in 2005. Our yohimbe monograph covers the plant, its history, and its chemistry in more detail.
Yohimbe is the African tree and its bark; yohimbine is the bark’s main alkaloid. Yohimbine hydrochloride is a single chemical with a measured dose, usually 5–10 mg, and it is what the ED trials tested. Yohimbe supplements may contain bark, extracts, or added yohimbine, and in a test of 49 US brands the yohimbine content ranged from none to 12.1 mg per serving, with most labels giving no figure. Results from yohimbine drug trials do not automatically apply to bark products.
The yohimbine trials compared it with placebo, not with sildenafil (Viagra) or other PDE5 inhibitors, so there is no head-to-head evidence to cite. What is clear is how guidelines rank them: the American Urological Association named PDE5 inhibitors first-line therapy in 2005 and listed yohimbine among treatments it did not recommend, and its current guideline centers on PDE5 inhibitors and other tested options. PDE5 inhibitors are not suitable for everyone, especially men taking nitrates, so the choice belongs with a clinician.
It carries real risks. NCCIH links yohimbine to irregular heartbeat, blood pressure problems, heart attacks, and seizures, and California poison center cases involving yohimbine products were more severe than average. It can also trigger anxiety and panic attacks. Avoid it if you have high blood pressure, heart, kidney, or liver disease, an anxiety, mood, or psychotic disorder, or seizures, and if you are pregnant or breastfeeding. Our guide to herbs and heart health covers other supplements to be careful with if you have a heart condition.
Avoid these combinations unless a prescriber says otherwise. NCCIH warns against yohimbe with MAOI or tricyclic antidepressants, MSKCC cautions about antidepressants generally, and a poison center study recorded a suspected interaction with bupropion. Yohimbine may blunt blood pressure medicines and works directly against clonidine. The FDA says risks are higher with caffeine, ephedra, and ADHD stimulants. There is no good safety evidence for combining yohimbe with sildenafil or other PDE5 inhibitors, or with nitrates.
It depends on the country. The European Union placed yohimbe under scrutiny in 2015 and, after no one submitted safety data, banned yohimbe bark and its preparations in food and supplements in 2019. Canada treats yohimbine as a prescription drug. In the United States yohimbe is sold as a dietary supplement, but products cannot legally be sold over the counter as a treatment for ED without FDA approval, and the FDA has warned about male enhancement pills with hidden yohimbine.
Ginseng, mainly Asian or Korean red ginseng, has the most research in men with ED, though the gains in trials were small. Tribulus and pine bark (usually tested together with L-arginine) have smaller and less consistent trials, and maca has been studied more for desire than for erections. No herb has been proven to treat ED. Our guide to herbs for libido and sexual health compares the evidence and the safety warnings for each.
07 References
Sources
These references support the claims on this page. They are not an endorsement of any product. The yohimbe monograph carries its own full source list.
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Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials
Journal of Urology (PubMed 9649257), 1998
Ernst and Pittler (University of Exeter): seven placebo-controlled trials of yohimbine monotherapy of satisfactory overall quality; odds ratio 3.85 (95% CI 2.22 to 6.67); serious adverse reactions infrequent and reversible.
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Effectiveness of yohimbine in the treatment of erectile disorder: four meta-analytic integrations
Archives of Sexual Behavior (PubMed 8836468), 1996
Carey and Johnson: four meta-analyses of controlled and uncontrolled trials of yohimbine alone and in combination; consistent tendency to improve erectile function versus placebo; methodological and reporting difficulties noted.
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Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction
Journal of Urology (PubMed 9400452), 1998
Telöken et al.: 22 men with organic ED given 100 mg a day or placebo for 30 days each; no significant difference; anxiety, increased heart rate, increased urine output, and headache most common.
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Effects of yohimbine on sexual experiences and nocturnal penile tumescence and rigidity in erectile dysfunction
Archives of Sexual Behavior (PubMed 8714425), 1996
Mann et al.: 31 men, 15 mg a day for 7 weeks; benefit over placebo only in the nonorganic subgroup; no change in nocturnal erections.
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Effect of yohimbine-trazodone on psychogenic impotence: a randomized, double-blind, placebo-controlled study
Urology (PubMed 7974947), 1994
Montorsi et al.: 63 men with psychogenic ED; yohimbine 15 mg plus trazodone 50 mg a day for 8 weeks; 71% of completers responded, significantly better than placebo; no yohimbine-only arm.
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Yohimbine: a clinical review
Pharmacology and Therapeutics (PubMed 11744068), 2001
Tam, Worcel, and Wyllie (NitroMed): relatively few well-designed studies; yohimbine monotherapy has only modest efficacy; blood pressure rise, anxiety, and urinary frequency at much higher doses.
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Pharmaceutical quantities of yohimbine found in dietary supplements in the USA
Drug Testing and Analysis (PubMed 26391406), 2016
Cohen et al.: 49 brands from seven US retailers; none to 12.1 mg yohimbine per serving; 19 lacked other bark alkaloids; 11 stated an amount, at 23–147% accuracy; only 2 gave accurate content and side-effect information.
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Adverse drug events associated with yohimbine-containing products: a retrospective review of the California Poison Control System reported cases
Annals of Pharmacotherapy (PubMed 20442348), 2010
Kearney et al.: 238 symptomatic adult cases, 2000–2006; 98.7% herbal products; gastrointestinal distress 46%, tachycardia 43%, anxiety or agitation 33%, hypertension 25%; severe outcomes OR 5.81 versus average exposures.
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Dietary supplement adverse events: report of a one-year poison center surveillance project
Journal of Medical Toxicology (PubMed 18570167), 2008
Haller et al.: 2006 California surveillance with FDA; yohimbe products 18% of symptomatic supplement cases, second to caffeine; suspected interactions with bupropion (1) and methamphetamine (3).
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Neurobiological mechanisms of panic anxiety: biochemical and behavioral correlates of yohimbine-induced panic attacks
American Journal of Psychiatry (PubMed 3037926), 1987
Charney et al.: yohimbine produced panic attacks in 37 of 68 patients with panic disorder or agoraphobia with panic attacks and in 1 of 20 healthy subjects.
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AUA Updates Guidelines on Management of Erectile Dysfunction
American Family Physician, 2006
Summary of the 2005 American Urological Association update (Montague et al., Journal of Urology 2005): PDE5 inhibitors first-line; trazodone, testosterone with normal levels, yohimbine, and other herbal therapies not recommended.
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Erectile Dysfunction: AUA Guideline
Journal of Urology (PubMed 29746858), 2018
Burnett et al.: current AUA guideline; men should be informed of PDE5 inhibitors, vacuum devices, intraurethral alprostadil, injections, and implants, and counseled that ED is a risk marker for cardiovascular disease.
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Erectile dysfunction and subsequent cardiovascular disease
JAMA (PubMed 16414947), 2005
Thompson et al.: 9,457 men aged 55 or older in the Prostate Cancer Prevention Trial placebo group; ED associated with later cardiovascular events (HR 1.45 for incident or prevalent ED), comparable to current smoking or family history of heart attack.
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Yohimbe: Usefulness and Safety
National Center for Complementary and Integrative Health (NIH), 2025
Not enough research to show yohimbe supplements help ED; supplements may not work like the prescription medicine; illegal to market OTC yohimbine for ED without FDA approval; avoid with MAOIs or tricyclics; may be unsafe in pregnancy and breastfeeding.
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Yohimbe
Memorial Sloan Kettering Cancer Center, About Herbs, 2021
Current guidelines do not recommend yohimbine for ED; side effects; contraindications including cardiovascular, kidney, liver, and psychiatric conditions; interactions with antidepressants, bupropion, antihypertensives, and opioids.
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Yohimbine
LiverTox, National Institute of Diabetes and Digestive and Kidney Diseases (NIH), 2020
Consistent but limited effect on ED in trials; usual dose 5–10 mg three times a day; tolerance may occur; not linked to liver injury (likelihood score E); overdose deaths described.
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Scientific Opinion on the evaluation of the safety in use of Yohimbe (Pausinystalia yohimbe (K. Schum.) Pierre ex Beille)
EFSA Journal (European Food Safety Authority ANS Panel), 2013
No safe daily intake of yohimbe bark could be set; supplements could supply up to 75 mg yohimbine a day versus up to 30 mg in authorized medicines; medicines dosed 5–10 mg two to three times daily for about 8 weeks; contraindications in product information.
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Commission Regulation (EU) 2019/650 amending Annex III to Regulation (EC) No 1925/2006 as regards Yohimbe (Pausinystalia yohimbe (K. Schum) Pierre ex Beille)
Official Journal of the European Union, via legislation.gov.uk, 2019
Yohimbe placed under Union scrutiny (Annex III Part C) in 2015; after no safety data were submitted, moved to Part A, prohibiting its use in food.
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Business Pill may be harmful due to hidden drug ingredient
U.S. Food and Drug Administration, Medication Health Fraud, 2026
June 10, 2026: undeclared yohimbine in a male enhancement product; yohimbine largely replaced by safer, more effective ED treatments; risks of severe hypertension, arrhythmia, heart attack, seizures, and mania or psychosis, greater with stimulants, ADHD drugs, MAOIs, and some antidepressants.
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Health Canada seized unauthorized sexual enhancement, weight loss and sleep aid products from Vikings Nutrition in Montreal, QC, because the products may pose serious health risks
Health Canada, Recalls and Safety Alerts, 2019
Yohimbine is a prescription drug in Canada; serious reactions particularly in people with high blood pressure or heart, kidney, or liver disease; not for children or pregnant or nursing women.
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Erection problems
MedlinePlus Medical Encyclopedia (NIH), 2025
ED may be a sign of diabetes or heart disease; tests and treatments; never combine ED pills with nitroglycerin; emergency care for an erection over four hours; no herb or supplement proven to treat ED.