Dragon's Blood

Scientific Name(s): Croton lechleri Muell. -Arg.
Common Name(s): Blood of the dragon, Crofelemer, Drago, Dragon's blood, Sangre de drago, Sangre de grado, SP-303

Medically reviewed by Drugs.com. Last updated on Jun 21, 2021.

Clinical Overview

Use

A variety of traditional uses are associated with dragon's blood as C. lechleri sap, such as bleeding control, wound healing, and treatment of GI problems and cancer. However, evidence from clinical trials is insufficient to support these uses. Crofelemer (Fulyzaq) has been approved by the US Food and Drug Administration (FDA) for symptomatic relief of noninfectious diarrhea in patients with HIV/AIDS who are receiving antiretroviral therapy.

Dosing

The traditional oral dosage is 5 to 10 drops of the sap in water, once to twice per day for 5 days. For HIV/AIDS-related diarrhea, crofelemer 125 mg twice daily in adults. Safety and efficacy in children have not been established.

Pharmacokinetic data indicate that systemic absorption of oral crofelemer is minimal, regardless of concomitant food intake.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

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

Interactions

None well documented.

Adverse Reactions

No major toxic effects have been reported from consumption of C. lechleri extract. Systemic absorption of crofelemer is minimal, and studies report low levels of GI-related adverse effects (eg, abdominal pain, flatulence, dyspepsia).

Toxicology

Weak to no mutagenicity has been reported for the sap of C. lechleri; however, the chemical constituent taspine is considered cytotoxic.

Scientific Family

• Euphorbiaceae (spurge)

Botany

The genus Croton comprises approximately 750 species of trees and shrubs commonly found in tropical and subtropical regions. The C. lechleri tree stands 10 to 20 m high, and the trunk is covered with smooth, mottled bark. When the bark is cut or damaged, it oozes a red, sap-like resin, which makes the tree appear to be bleeding. The plant bears heart-shaped leaves 15 to 30 cm in size, as well as 3-celled fruits from small flowers borne on tall, thin spikes.1, 2

A number of other sources of "dragon's blood" are documented, including the genera Dracaena, Daemonorops, and Pterocarpus, as well as mercury sulfide.3 Synonyms include Oxydectes lechleri and Croton draco.

History

Dragon's blood is mentioned in early Greek, Roman, and Arabic records; however, the source of the preparation varies. As "sangre de grado" (blood of the dragon), its recorded use has been extensive among Latin American countries since the 1600s: both the bark and resin have been used internally and externally to stop bleeding, heal wounds, and treat GI problems (including piles and hemorrhoids).3, 4 The sap has also been used in childbirth and as a remedy for cancer.3, 5, 6, 7

Chemistry

Reviews of the chemical constituents of C. lechleri have been published.2, 3

Among other alkaloids, taspine has been isolated from C. lechleri sap, and sinoacutine has been isolated from the leaves.2, 8, 9 Proanthocyanidins (or oligomers) and flavonols are the major phenolic constituents of the sap of C. lechleri, ...