Synonyms/Common Names/Related Substances:

• Amaska, Areca catechu, areca quid, areca nut, arecoline, arequier, betal, betel quid, betelnusspalme, chavica etal, gutkha, hmarg, maag, marg, mava, mawa, paan, Palmaceae (family), pan, pan masala, pan parag, pinang, pinlang, Piper betel Linn. (leaf of vine used to wrap betel nuts), pugua, quid, ripe areca nut without husk, Sting® (Tantric Corporation), supai, ugam.

Clinical Bottom Line/Effectiveness

Brief Background:

• Betel nut or betel quid use refers to a combination of three ingredients: the nut of the betel palm (Areca catechu), part of the Piper betel vine, and lime. Anecdotal reports have indicated that small doses generally lead to euphoria and increased flow of energy while large doses often result in sedation. Although all three ingredients may contribute to these effects, most experts attribute the psychoactive effects to the alkaloids found in betel nuts.
• Betel nut is reportedly used by a substantial portion, approximately 10% of the world's population, as a recreational drug due to its CNS stimulant activity; it is the fourth most commonly used addictive substance in the world (1;​2;​3;​4). Found originally in tropical Southern Asia, betel nut has been introduced to the communities of East Africa, Madagascar, and the West Indies. There is little evidence from adequately controlled studies to support the clinical use of betel, but the constituents have demonstrated pharmacological actions. The main active component, the alkaloid arecoline, has potent cholinergic activity.
• Constituents of areca are potentially carcinogenic. Long-term use has been associated with oral submucous fibrosis (OSF), pre-cancerous oral lesions, and squamous cell carcinoma. Acute effects of betel chewing include asthma exacerbation, hypotension, and tachycardia.

Dosing/Toxicology

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Precautions/Contraindications

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Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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Mechanism of Action

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History

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Evidence Table

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Evidence Discussion

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Products Studied

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Author Information

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References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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