Pawpaw

Scientific Name(s): Asimina triloba (L.) Dunal.
Common Name(s): Custard apple, Indiana banana, Kentucky banana, Pawpaw, Poor man's banana

Medically reviewed by Drugs.com. Last updated on Mar 22, 2022.

Clinical Overview

Use

A. triloba has been used medicinally, as well as for food and as a material in fishing nets. Although it exhibits cytotoxic and pesticidal activity, published clinical trials are lacking to support its use for any indication.

Dosing

Clinical trials are lacking to provide guidance on dosing, and concerns of toxicity persist.

Contraindications

None identified; however, concerns of neurotoxicity persist.

Pregnancy/Lactation

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

May cause contact dermatitis.

Toxicology

Pawpaw fruit contains the neurotoxins annonacin and squamocin, and has been linked to Parkinsonism in some reports; however, case studies are lacking.

Scientific Family

• Annonaceae (Custard apple)

Botany

A. triloba, commonly known as "pawpaw," is from the custard-apple family and should not be confused with Carica papaya from the papaya family (see Papaya monograph).1, 2

A. triloba is a small, North American tree that grows approximately 3 to 12 meters tall. It is common in the temperate woodlands of the eastern United States and is an orchard crop in several states.3 Its large, drooping leaves give the plant a tropical appearance. The dark brown, velvety flowers, which can bloom for up to 6 weeks, are approximately 5 cm across and grow in umbrella-like whorls similar to those of some magnolia species. The fruit is smooth-skinned and yellow to greenish-brown in color, measures from approximately 8 to 15 cm long, and can reach up to 0.45 kg in weight. It resembles a short, thick banana and is similar in nutrient value but has a very short shelf life, which currently limits culinary and commercial uses.3 The yellow, soft, custard-like pulp is edible but sickly sweet in flavor and contains dark seeds.4, 5, 6

History

Pawpaw bark has been used medicinally due its useful alkaloid content. It has also been used as food by American Indians and the thin, fibrous, inner bark has been used to make fishing nets.4

The seeds of several Annonaceous species have an emetic properties, and in 1898 Eli Lilly Inc. sold an A. triloba extract for inducing emesis.6 Topical preparations exploit the pesticidal properties of the plant. An ointment for use in oral herpes is commercially available.7, 8

Chemistry

The bark, roots, twigs, and seeds of A. triloba contain acetogenins, long-chain, aliphatic compounds with 35 to 39 carbon atoms ending with a gamma-lactone, cyclized in tetrahydrofuran rings. Acetogenins are polyketide-derived molecules and are unique to the Annonaceae family. About 400 acetogenins from Asimina and other genera have been identified.7, 8, 9, 10, 11, 12, 13, 14

A variety of essential oils and other extracts from the leaf of the pawpaw plant have been described, with sesqui...