Herbs & Botanicals · Amazon tree sap and a diarrhea drug

Dragon's Blood

Croton lechleri · also called Sangre de drago, sangre de grado, sangre de dragón, Amazon dragon's blood

Dragon's blood here means the dark red sap of the South American tree Croton lechleri, used for diarrhea and wounds. One purified part of the sap is an approved prescription drug, crofelemer, for diarrhea in people with HIV. For the raw sap, human evidence is thin: one small wound-cream trial and no trial we could find of sap taken by mouth. Do not confuse it with other resins also sold as dragon's blood, and ask a doctor before using it with any medicine.

General information, not medical advice. Last substantive update October 25, 2026 · Not medically reviewed. A named clinician has not signed off on this page. How this page is made

About Dragon's Blood

Dragon's blood (sangre de drago) is the red sap of Croton lechleri, a South American tree. A purified part of it, crofelemer, is an FDA-approved diarrhea drug. Raw sap, creams and supplements are a different matter: human research is small, and safety data are thin.

What it is

Croton lechleri is a tree in the spurge family from the Amazon region. Cutting its bark releases a dark red latex, called sangre de drago or sangre de grado. Traditional users take it for diarrhea and stomach complaints and put it on wounds.

The same name, dragon's blood, is also used for unrelated red resins from Dracaena, Daemonorops and Pterocarpus. This page covers only Croton lechleri. A purified fraction of its latex, crofelemer, is a mixture of proanthocyanidins that is hardly absorbed into the blood.

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What the research shows

The best evidence is for crofelemer. In a trial of 376 people with HIV on antiretroviral therapy, 17.6% responded versus 8.0% on placebo. A 2002 trial of the purified compound in travelers shortened diarrhea by about 21%. Trials in IBS-D and in diarrhea from cancer treatment missed their main goals.

For the raw sap, there is one small cream trial in which skin-tag wounds healed faster, and a borderline herpes trial that used a purified ointment. We found no human trial of raw sap taken by mouth. Cancer, ulcer, inflammation and germ-fighting effects are lab or animal findings only.

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At a glance

Traditional uses history, not proof

Diarrhea and stomach complaints in Amazon folk medicine
Cuts and wounds, put on the skin as sap
Herpes sores, insect bites and skin problems in traditional use

Studied for research

HIV-associated diarrhea: one large trial of the purified drug, about 18% responders vs 8% on placebo
Traveler's diarrhea: one trial of the purified compound shortened illness by about 21%
IBS-D and cancer-treatment diarrhea: trials missed their main goals
Wound healing: one small cream trial, faster healing of skin-tag wounds
Genital herpes in AIDS: borderline result with a purified ointment
Cancer, ulcers, inflammation: lab and animal findings only

Main compounds

Crofelemer: a mixture of proanthocyanidins (catechin-type polymers)
Taspine (an alkaloid)
Catechin, epicatechin and related building blocks

Common forms

Raw red latex (sap), not standardized
Creams and ointments (as tested in trials)
Purified prescription tablets (crofelemer)

Research links: FDA label: Mytesi (crofelemer) · Memorial Sloan Kettering: Croton lechleri · Review: phytochemistry and pharmacology of Croton lechleri (2025) · Research Library · Genes & Biomarkers Library

The plant and its history

Accepted scientific name: Croton lechleri Müll.Arg.
Naming authority: Accepted in the GBIF backbone (usage key 3057776), checked 2026-10-25. NCBI Taxonomy id 323063.
Common names: Dragon's blood (English); Sangre de drago (Spanish); Sangre de grado (Spanish); Sangre de dragón (Spanish)
Botanical family: Euphorbiaceae (spurge family)
Classification: Plantae > Tracheophyta > Magnoliopsida > Malpighiales > Euphorbiaceae > Croton > Croton lechleri
Native range: South America (Amazon region); MSK says the tree is found in many regions of South America.
Habitat: Not verified in the sources read.
What the plant looks like: Roots: Not verified.; Stems: The bark, when cut, bleeds the dark red latex that gives the name.; Leaves: Not verified.; Flowers: Not verified.; Fruit: Not verified.
Cultivation: Not verified. Sap is wild-harvested in many areas and its chemistry varies (Jones 2003).
Harvest and processing: Latex collected from the trunk; for the drug, a purified proanthocyanidin fraction is made from the red latex (FDA label). Raw sap is not standardized.
Look-alikes and adulterants: Name: Dracaena resins (for example Dracaena cinnabari, Socotra); Note: Unrelated plant family; red resin also called dragon's blood. Chemistry is flavonoid-based. Not covered here.; Name: Daemonorops resins (Jerang); Note: A palm resin also sold as dragon's blood (named in the cream-trial introduction). Not covered here.; Name: Pterocarpus resins (Kino); Note: A legume resin sometimes called dragon's blood (named in the cream-trial introduction). Not covered here.; Name: Other Croton species (for example Croton palanostigma); Note: Also sold as sangre de grado in South America; may differ in chemistry.
Sustainability and conservation: Not assessed in the sources read.

Traditional use and history history, not clinical proof

Tradition or era	Documented use	Source
Amazonian folk medicine	Sap used for diarrhea, wounds, stomach ulcers, herpes, insect bites and tumours, according to a 2003 review.	p14736360
Modern drug development	A proanthocyanidin fraction (SP-303, now crofelemer) was developed as a diarrhea drug and FDA-approved for HIV-associated non-infectious diarrhea; the review calls it the first agent approved specifically for this use.	p23807722
Other dragon's blood traditions	Greek, Roman and Arab use of dragon's blood resin is mentioned in a 2016 trial introduction; these were different resins and the claim was not verified by us.	p26870678

Traditional use shows how a plant was used. It does not show that a supplement works or is safe today.

What is inside, and how it may work

What the plant contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.

Main compounds

Compound	Family	Where it is concentrated	Activity studied	Level of evidence
Crofelemer (SP-303)	Oligomeric proanthocyanidin mixture	Red latex Proanthocyanidins are the most abundant group (Planta Med 2025 review). Average polymer length 5 to 7.5 units (label).	Blocks gut chloride channels; the active ingredient of Mytesi. A mixture, so no single PubChem record exists. ^{24 25}	Human data
Catechin PubChem 9064	Flavan-3-ol (building block)	Red latex Named by the label as a monomer unit of crofelemer.	Building block of the crofelemer polymer. ^{10 24}	Human data
Epicatechin PubChem 72276	Flavan-3-ol (building block)	Red latex Named by the label as a monomer unit.	Building block of the crofelemer polymer. ^{11 24}	Human data
Gallocatechin PubChem 65084	Flavan-3-ol (building block)	Red latex Named by the label as a monomer unit.	Building block of the crofelemer polymer. ^{12 24}	Human data
Epigallocatechin PubChem 72277	Flavan-3-ol (building block)	Red latex Named by the label as a monomer unit.	Building block of the crofelemer polymer. ^{13 24}	Human data
Taspine PubChem 215159	Alkaloid	Red latex Alkaloid content varies by area (Jones 2003).	Promoted wound repair in animal and lab work (MSK); suggested by the cream-trial authors as a possible reason for its effect, not shown. ^{14 9 17}	Animal research

Mechanisms, receptors and pathways

Target or pathway	Gene or receptor	What was found	Level
Intestinal chloride channels (CFTR and calcium-activated)	CFTR; calcium-activated chloride channels	Crofelemer blocks both channels in the gut lining, reducing chloride and water secretion. ^{24 4}	Laboratory research
Clinical antisecretory effect	Not applicable	Fewer watery stools in HIV-associated diarrhea and shorter travelers' diarrhea in randomized trials. ^{8 2}	Human data
Wound repair	Not specified	Taspine promoted fibroblast migration and wound strength in animal work (MSK summary); human cream trial shows faster healing but not the mechanism. ^{9 17}	Animal research
Drug-processing enzymes and transporters	CYP3A4; MRP2; OATP1A2	In vitro potential to inhibit CYP3A4, MRP2 and OATP1A2 at gut concentrations; not P-gp or BCRP. No significant change in midazolam levels in people. ²⁴	Laboratory research
Cancer cell growth	Not specified	Slowed growth of K562 leukemia cells in a dish (IC50 2.5 micrograms per mL); sap was not mutagenic in Ames tests. ²³	Laboratory research

Absorption, metabolism and elimination

Absorption: Minimal. After oral dosing, plasma levels of crofelemer were below the limit of quantitation (50 ng/mL) in healthy adults and HIV-positive patients (label).
Distribution: Not applicable; not measurable in blood.
Metabolism: Not studied because of minimal absorption.
Elimination: Not estimated; half-life and exposure could not be calculated.
Bioavailability: Very low. A high-fat meal did not raise exposure.

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Isolated compounds versus whole extracts

The approved drug is a purified proanthocyanidin fraction. All randomized diarrhea and herpes trials we found used that purified compound (SP-303 / crofelemer); the only trial of a whole extract was the 15% extract cream in 60 people having skin tags removed. Alkaloids such as taspine and other compounds in raw sap are not in the drug, so drug results do not prove the raw sap works and drug safety data do not cover raw sap.

Nutritional composition

Not a food. The red latex is used as a medicine, not a nutrient source. No nutrient content was assessed.

12benefits and uses looked at

25studies and sources checked

Moderate certaintybest evidence rating found

8lab markers tracked in trials

1 moderate certainty5 low certainty6 not enough evidence

What is Dragon's Blood good for?

The main studied uses and how strong the human evidence is for each. The strongest result is for a purified drug, not for the raw sap.

Diarrhea in HIV (purified drug crofelemer)Moderate certaintyOne large trial of 376 people found 17.6% responded versus 8.0% on placebo, so most people did not respond. This is the approved drug, not the raw sap. Traveler's diarrhea (purified SP-303)Low certaintyOne 2002 trial of 184 travelers found diarrhea lasted about 21% less time. It used a purified product for 2 days and has not been repeated. Diarrhea-type irritable bowel (IBS-D)Low certaintyA 240-woman trial missed its main goal; a later look at pain responders favoured crofelemer, but that may be chance. Diarrhea from cancer treatmentLow certaintyA small open-label trial of 51 patients missed its main goal. Severe diarrhea was less common with crofelemer in cycle 2. Diarrhea: raw sapNot enough evidenceA traditional use. Reviews mention positive clinical reports, but we found no trial of raw sap. Wound healing (cream)Low certaintyOne trial of 60 people with skin-tag wounds found faster healing with a 15% extract cream. It was small, from one clinic, and ran up to 20 days. Genital herpes in AIDS (purified ointment)Low certainty41% healed versus 14% on placebo, but the result was borderline (P = 0.053) and MSK says it was no more effective than placebo. Scars and insect bitesNot enough evidenceReported in summaries only. We could not read the studies, and the scar cream also contained pomegranate seed oil. Stomach ulcersNot enough evidenceLab and animal work only. No human trial found. Inflammation, antioxidant and germ-fighting effectsNot enough evidenceSeen in cells and animals. No human trial measured these. Cancer (lab only)Not enough evidenceSlowed some cancer cells in dishes. MSK says it has not been shown to treat cancer in people, and one study found leukemia cells grew better.

Benefits, one by one

Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.

Diarrhea in HIV/AIDS (crofelemer, the purified drug)

Moderate certainty

Crofelemer, purified from the red latex, is an FDA-approved prescription drug for non-infectious diarrhea in adults with HIV on antiretroviral therapy. In the main trial 17.6% of people had a clinical response versus 8.0% on placebo. This is the drug, not the raw sap.

4 studiesPrescription tablets only. Not the raw sap.

Studies, doses and limits

What the trials found

One phase III trial (ADVENT, 376 people, 4 weeks placebo-controlled then 20 weeks open-label) plus an earlier 51-person trial of the same compound that missed its day-4 target but showed a daily-measures benefit. A drug review and the FDA label describe the approval.

Results

ADVENT: 17.6% responders versus 8.0% on placebo (one-sided P = 0.01); fewer watery stools per day and firmer stools. Earlier trial: stool weight fell 451 g per 24 h versus 150 g (P = 0.14 at day 4; P = 0.008 over 4 days of daily measures).

Effect sizes as reported

About 9.6 percentage points more responders than placebo.

Why this rating

One large randomized phase III trial with a consistent but modest effect; one-sided P value, industry-linked, most people did not respond, and only one population was studied. Not rated high because it rests on one pivotal trial.

Form and dose studied

Prescription tablets only. Not the raw sap.

Who was studied

Adults with HIV on stable antiretroviral therapy and non-infectious diarrhea; infection must be ruled out first.

Limits

Does not show that raw sap or supplements work. Only non-infectious diarrhea. Drug maker involvement.

Why researchers looked

Diarrhea is common and hard to treat in people with HIV on antiretroviral therapy, and the latex was a traditional diarrhea remedy in the Amazon.

Traditional use

Used for diarrhea in South American folk medicine (Jones 2003 review).

Proposed mechanism Laboratory research

The drug blocks two chloride channels (CFTR and calcium-activated) in the gut lining, reducing salt and water loss into the bowel. It is hardly absorbed.

A proposed mechanism does not show that the effect happens in people.

See Safety: infection must be ruled out first; common reactions are respiratory infections, cough, gas and raised bilirubin.

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Traveler's diarrhea (purified SP-303)

Low certainty

A 2002 trial of 184 travelers found that SP-303, the purified compound later named crofelemer, shortened diarrhea by about 21% (roughly 8 hours). It was a 2-day trial of a purified product, not raw sap.

3 studiesPurified compound at three strengths, four times a day for 2 days.

Studies, doses and limits

What the trials found

One randomized, double-blind, placebo-controlled trial (Jamaica and Mexico). The review by Jones and the MSK page repeat the result.

Results

Time to last unformed stool: 38.7 h on placebo versus 30.6 h on the lowest strength (P = 0.005). Treatment failures 29.3% on placebo versus 4.3% to 9.8% on the three strengths.

Effect sizes as reported

About 8 hours shorter illness (21%).

Why this rating

A single short trial from 2002 with no repeat; purified product; cause was found in only some people.

Form and dose studied

Purified compound at three strengths, four times a day for 2 days.

Who was studied

US adults travelling in Jamaica or Mexico.

Limits

No trial of raw sap. Not approved for this use.

Why researchers looked

Anti-secretory action suggested it could shorten watery diarrhea from travel bugs.

Traditional use

Sap has long been drunk in the Amazon for watery diarrhea (Jones 2003).

Proposed mechanism Laboratory research

Blocks chloride and water secretion in the gut rather than killing germs.

A proposed mechanism does not show that the effect happens in people.

Well tolerated in the trial; see Safety. The FDA label warns against use in infectious diarrhea.

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Diarrhea-predominant irritable bowel syndrome (IBS-D)

Low certainty

A 12-week trial of 240 women with IBS-D did not reach its main goal (pain-free days). A later, post hoc look at pain responders did favour crofelemer (54.2% vs 42.5%).

2 studiesPurified compound only.

Studies, doses and limits

What the trials found

One randomized phase II trial (women only).

Results

No significant difference in the primary measure. Post hoc pain responders over 3 months 54.2% versus 42.5% (P = 0.037); no stool-consistency difference.

Effect sizes as reported

Primary: none. Post hoc: about 12 percentage points.

Why this rating

Primary endpoint missed; positive signal is post hoc and may be chance.

Form and dose studied

Purified compound only.

Who was studied

Women with IBS-D.

Limits

Women only; not approved for IBS-D.

Why researchers looked

Pain and loose stools in IBS-D might respond to a gut chloride-channel blocker.

Traditional use

None known.

Proposed mechanism Laboratory research

Possible action on gut secretion and pain signalling.

A proposed mechanism does not show that the effect happens in people.

Safety similar to placebo in the trial.

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Diarrhea caused by cancer treatment

Low certainty

HALT-D was a small open-label trial of 51 women having breast-cancer drug treatment. The main result did not differ significantly, though more severe diarrhea was less frequent with crofelemer in cycle 2 (8.0% vs 39.1%).

2 studiesPurified compound only.

Studies, doses and limits

What the trials found

One randomized, open-label phase II study.

Results

Primary endpoint: no statistically significant difference. Diarrhea of grade 2 or worse: 19.2% vs 24.0% (cycle 1) and 8.0% vs 39.1% (cycle 2).

Effect sizes as reported

Secondary results favourable; primary null.

Why this rating

Tiny, open-label, primary endpoint missed, funded by industry. Supportive but not proof.

Form and dose studied

Purified compound only.

Who was studied

Women with HER2-positive breast cancer on trastuzumab, pertuzumab and a taxane.

Limits

Cancer patients should only use it under their oncology team. Note MSK's dacomitinib caution.

Why researchers looked

Targeted breast-cancer drugs often cause diarrhea; a gut-secretion blocker was a logical test.

Traditional use

None known.

Proposed mechanism Laboratory research

Reduced chloride and water secretion in the bowel.

A proposed mechanism does not show that the effect happens in people.

See Safety: possible worsening of diarrhea with dacomitinib (animal data).

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Diarrhea: raw sap and traditional products

Not enough evidence

The red sap itself is a traditional diarrhea remedy. The reviews we read say sap products gave positive results in clinical studies, but we could not read those studies and found no trial of raw sap in our own search.

3 studiesRaw red latex (varies by area, not standardized).

Studies, doses and limits

What the trials found

Review-level statements only. Our search found trials of the purified compound, not of raw sap.

Results

No measured result for raw sap that we could verify.

Effect sizes as reported

None.

Why this rating

Reviews cite clinical studies, but they were not read; sap chemistry varies by area and product.

Form and dose studied

Raw red latex (varies by area, not standardized).

Who was studied

Not applicable.

Limits

Purified-drug results do not carry over to raw sap.

Why researchers looked

Long traditional use in the Amazon.

Traditional use

Used for diarrhea and stomach complaints (Jones 2003).

Proposed mechanism Laboratory research

Proanthocyanidins in the sap are the proposed active part.

A proposed mechanism does not show that the effect happens in people.

Raw-sap safety in people is thin; see Safety.

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Stomach ulcers

Not enough evidence

MSK says lab and animal studies suggest the sap can help gastric ulcers heal. We found no human trial.

2 studiesNot applicable.

Studies, doses and limits

What the trials found

No human trial found.

Results

No human result.

Effect sizes as reported

None.

Why this rating

Lab and animal work only.

Form and dose studied

Not applicable.

Who was studied

Not applicable.

Limits

Not tested in people.

Why researchers looked

Traditional use for stomach complaints.

Traditional use

Folk use for ulcers (Jones 2003).

Proposed mechanism Animal research

Lab and animal work on healing of the stomach lining.

A proposed mechanism does not show that the effect happens in people.

Not applicable.

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Wound healing (cream)

Low certainty

One trial of 60 people having skin tags removed found that a cream with 15% Croton lechleri extract healed small wounds faster than placebo cream. It was small, from one clinic, and ran up to 20 days.

3 studies15% ethanol extract of the resin powder in a lab-made cream.

Studies, doses and limits

What the trials found

One randomized, double-blind, placebo-controlled trial (100 small wounds in 60 people). Reviews (Pona 2019, Planta Med 2025) call wound healing the main clinical finding but note limited research.

Results

Mean healing time shorter with the cream (P = 0.0001). Percent healed: day 3 31.1% vs 4.7%; day 7 77.8% vs 43.9%; day 14 95.7% vs 78.1%.

Effect sizes as reported

Healing faster by several days in tiny surgical wounds.

Why this rating

One small single-centre trial, 20% dropout, small planned wounds; no repeat.

Form and dose studied

15% ethanol extract of the resin powder in a lab-made cream.

Who was studied

People aged 14 to 65 having skin tags removed.

Limits

Not tested in burns, ulcers or infected wounds.

Why researchers looked

The sap is traditionally put on cuts and sores, and the alkaloid taspine promoted wound repair in animal work.

Traditional use

Used on wounds across the Amazon (Jones 2003; Pona 2019).

Proposed mechanism Animal research

Taspine and proanthocyanidins are proposed to draw skin-repair cells to the wound.

A proposed mechanism does not show that the effect happens in people.

No irritation in the treated group; one wound infection in the placebo group.

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Genital and anal herpes sores in AIDS (purified ointment)

Low certainty

A 45-person trial of a 15% ointment of SP-303 (purified compound) found healing in 41% versus 14% on placebo, but the result missed the usual cut-off (P = 0.053). MSK says it was no more effective than placebo.

2 studies15% ointment of the purified compound, applied three times daily for …

Studies, doses and limits

What the trials found

One randomized, double-blind phase II trial.

Results

Complete healing 9 of 22 (41%) vs 3 of 21 (14%), P = 0.053; culture-negative 50% vs 19%, P = 0.06.

Effect sizes as reported

A trend, not statistically significant.

Why this rating

Small, borderline and not repeated; purified compound.

Form and dose studied

15% ointment of the purified compound, applied three times daily for 21 days.

Who was studied

People with AIDS and recurrent herpes sores.

Limits

Not raw sap. Not a proven herpes treatment.

Why researchers looked

Lab work showed antiviral activity against herpes viruses.

Traditional use

Sap used on sores and viral skin conditions (Jones 2003).

Proposed mechanism Laboratory research

Antiviral activity in cell cultures.

A proposed mechanism does not show that the effect happens in people.

Not reported in the abstract.

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Scars and insect bites

Not enough evidence

MSK mentions a cream containing the resin plus pomegranate seed oil that was reported useful for scarring, and Jones says clinical studies reported better insect-bite symptoms. We could not read those studies.

2 studiesCombination cream (resin plus pomegranate seed oil) for scars.

Studies, doses and limits

What the trials found

Summary-only statements. Not verified by us.

Results

No numbers we could verify.

Effect sizes as reported

None.

Why this rating

Summary statements without the primary studies; the scar cream was a combination product.

Form and dose studied

Combination cream (resin plus pomegranate seed oil) for scars.

Who was studied

Not applicable.

Limits

Combination product; primary papers not read.

Why researchers looked

Traditional skin and bite remedy.

Traditional use

Used for insect bites and skin (Jones 2003).

Proposed mechanism Laboratory research

Possible anti-inflammatory and itch-calming action in the lab.

A proposed mechanism does not show that the effect happens in people.

Not reported.

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Inflammation and antioxidant effects (lab)

Not enough evidence

Reviews describe anti-inflammatory and antioxidant effects in cells and animals. No human trial measured these.

2 studiesNot applicable.

Studies, doses and limits

What the trials found

No human trial.

Results

No human result.

Effect sizes as reported

None.

Why this rating

Lab and animal work only.

Form and dose studied

Not applicable.

Who was studied

Not applicable.

Limits

Test-tube effects often do not carry over to people.

Why researchers looked

Proanthocyanidins and other polyphenols are antioxidant in test tubes.

Traditional use

None specific.

Proposed mechanism Laboratory research

Cell and animal studies of inflammation signals and oxidative stress.

A proposed mechanism does not show that the effect happens in people.

Not applicable.

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Germs: antibacterial and antiviral effects (lab)

Not enough evidence

Reviews describe antimicrobial effects in the lab. A 2025 study (not read) paired the sap with blue light. None of this has been tested as a treatment for infection in people, beyond the herpes trial above.

2 studiesNot applicable.

Studies, doses and limits

What the trials found

No human trial of sap for infection.

Results

No human result.

Effect sizes as reported

None.

Why this rating

Lab work only.

Form and dose studied

Not applicable.

Who was studied

Not applicable.

Limits

Not a substitute for treating infected wounds.

Why researchers looked

Traditional use on wounds suggests an antiseptic action.

Traditional use

Sap used on wounds.

Proposed mechanism Laboratory research

Lab studies show activity against some microbes.

A proposed mechanism does not show that the effect happens in people.

Not applicable.

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Cancer (lab findings only)

Not enough evidence

Lab studies show the sap and its alkaloid taspine can slow cancer cells growing in dishes. MSK says it has not been shown to treat cancer in people, and in one study it increased the viability of leukemia cells.

3 studiesNot applicable.

Studies, doses and limits

What the trials found

No human trial.

Results

Lab only: K562 leukemia cells IC50 2.5 micrograms per mL in one test.

Effect sizes as reported

None.

Why this rating

Lab only; one study went the other way.

Form and dose studied

Not applicable.

Who was studied

Not applicable.

Limits

Never use in place of cancer treatment.

Why researchers looked

Cell studies reported anti-tumour activity.

Traditional use

Traditional use for tumours (Jones 2003).

Proposed mechanism Laboratory research

Cell-culture growth inhibition. The leukemia-cell increase is reported by MSK (original study not read).

A proposed mechanism does not show that the effect happens in people.

See Safety: ask the cancer team about any herb.

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Connections to the rest of health

How Dragon's Blood connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.

Explore every connection: goals, body systems, organs, symptoms, genes

Kind of connection Connected to Search

A. Wellness goals

Connected to	Kind of connection	Evidence status	Context	Studies
Digestive Support		Moderate certainty	Diarrhea in HIV/AIDS (crofelemer, the purified drug): Crofelemer, purified from the red latex, is an FDA-approved prescription drug for non-infectious diarrhea in adults with HIV on antiretroviral therapy. In the main trial 17.6% of people had a clinical response versus 8.0% on placebo. This is the drug, not the raw sap.	^{8 6 4 24}
Digestive Support	Potential benefit	Low certainty	Traveler's diarrhea (purified SP-303): A 2002 trial of 184 travelers found that SP-303, the purified compound later named crofelemer, shortened diarrhea by about 21% (roughly 8 hours). It was a 2-day trial of a purified product, not raw sap. Diarrhea-predominant irritable bowel syndrome (IBS-D): A 12-week trial of 240 women with IBS-D did not reach its main goal (pain-free days). A later, post hoc look at pain responders did favour crofelemer (54.2% vs 42.5%).	^{2 7 9 19 21}
Digestive Support	Traditional use	Not enough evidence	Diarrhea: raw sap and traditional products: The red sap itself is a traditional diarrhea remedy. The reviews we read say sap products gave positive results in clinical studies, but we could not read those studies and found no trial of raw sap in our own search.	^{7 25 9}
Gut Health		Not enough evidence	Stomach ulcers: MSK says lab and animal studies suggest the sap can help gastric ulcers heal. We found no human trial.	^{9 7}
Healthy Skin	Potential benefit	Low certainty	Wound healing (cream): One trial of 60 people having skin tags removed found that a cream with 15% Croton lechleri extract healed small wounds faster than placebo cream. It was small, from one clinic, and ran up to 20 days.	^{17 22 25}
Immune Support	Potential benefit	Low certainty	Genital and anal herpes sores in AIDS (purified ointment): A 45-person trial of a 15% ointment of SP-303 (purified compound) found healing in 41% versus 14% on placebo, but the result missed the usual cut-off (P = 0.053). MSK says it was no more effective than placebo.	^{20 9}
Healthy Skin	Traditional use	Not enough evidence	Scars and insect bites: MSK mentions a cream containing the resin plus pomegranate seed oil that was reported useful for scarring, and Jones says clinical studies reported better insect-bite symptoms. We could not read those studies.	^{9 7}
Healthy Aging		Not enough evidence	Inflammation and antioxidant effects (lab): Reviews describe anti-inflammatory and antioxidant effects in cells and animals. No human trial measured these.	^{25 22}
Immune Support		Not enough evidence	Germs: antibacterial and antiviral effects (lab): Reviews describe antimicrobial effects in the lab. A 2025 study (not read) paired the sap with blue light. None of this has been tested as a treatment for infection in people, beyond the herpes trial above.	^{22 25}
Cellular Protection		Not enough evidence	Cancer (lab findings only): Lab studies show the sap and its alkaloid taspine can slow cancer cells growing in dishes. MSK says it has not been shown to treat cancer in people, and in one study it increased the viability of leukemia cells.	^{9 23 25}

B. Body systems

Connected to	Kind of connection	Evidence status	Context	Studies
Digestive system	Adverse effect or risk	Documented	Gas, nausea and belly swelling at a few percent; infection must be ruled out first. Preparation or compound: Crofelemer	²⁴
Liver	Adverse effect or risk	Documented	Occasional bilirubin and ALT rises; no clinically apparent liver injury linked (LiverTox). Preparation or compound: Crofelemer	^{18 24}
Reproductive system	Contraindication	Not enough evidence	Avoid raw sap in pregnancy and breastfeeding; the drug label says mothers should not breastfeed on it. Preparation or compound: Crofelemer / raw sap	²⁴
Digestive System	Biological association	Moderate certainty	Studied for: Diarrhea in HIV/AIDS (crofelemer, the purified drug) Studied for: Traveler's diarrhea (purified SP-303)	^{8 6 4 24 2 7 9 19 21 25}
Skin Hair Beauty	Biological association	Low certainty	Studied for: Wound healing (cream) Studied for: Scars and insect bites	^{17 22 25 9 7}
Immune System	Biological association	Low certainty	Studied for: Genital and anal herpes sores in AIDS (purified ointment) Studied for: Inflammation and antioxidant effects (lab)	^{20 9 25 22 23}

G. Root causes and contributing factors

Connected to	Kind of connection	Evidence status	Context	Studies
Medication side effects	Drug or supplement interaction	Not enough evidence	Dacomitinib caution (animal data). Preparation or compound: Crofelemer	⁹

I. Biomarkers

Connected to	Kind of connection	Evidence status	Context	Studies
Watery stools per day or week	Biological association	Moderate certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{8 6}
Stool weight	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	⁶
Time to last unformed stool	Biological association	Low certainty	Measured in trials: shortened. A lab change is not the same as a health benefit.	²
Abdominal pain-free days	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	¹⁹
Grade 2 or worse chemotherapy diarrhea	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	²¹
Wound healed (percent of surface)	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	¹⁷
Complete healing of herpes lesions	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	²⁰
Herpes virus culture turned negative	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	²⁰

K. Biological pathways

Connected to	Kind of connection	Evidence status	Context	Studies
	Preliminary mechanism	In vitro		²⁴

L. Active compounds

Connected to	Kind of connection	Evidence status	Context	Studies
Crofelemer (SP-303)	Biological association	Human	Blocks gut chloride channels; the active ingredient of Mytesi. A mixture, so no single PubChem record exists. Preparation or compound: Red latex	^{24 25}
Catechin	Biological association	Human	Building block of the crofelemer polymer. Preparation or compound: Red latex	^{10 24}
Epicatechin	Biological association	Human	Building block of the crofelemer polymer. Preparation or compound: Red latex	^{11 24}
Gallocatechin	Biological association	Human	Building block of the crofelemer polymer. Preparation or compound: Red latex	^{12 24}
Epigallocatechin	Biological association	Human	Building block of the crofelemer polymer. Preparation or compound: Red latex	^{13 24}
Taspine	Biological association	Animal	Promoted wound repair in animal and lab work (MSK); suggested by the cream-trial authors as a possible reason for its effect, not shown. Preparation or compound: Red latex	^{14 9 17}

Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).

Evidence at a glance: what changed in 7 lab markers

Tap a number to show only those markers. Counts are markers, not people.

Other34

The evidence

The research centre for Dragon's Blood. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.

Evidence by outcome

Diarrhea in HIV/AIDS (crofelemer, the purified drug) 4 studies · 427 people in trials Moderate certainty Traveler's diarrhea (purified SP-303) 3 studies · 184 people in trials Low certainty Diarrhea-predominant irritable bowel syndrome (IBS-D) 2 studies · 240 people in trials Low certainty Diarrhea caused by cancer treatment 2 studies · 51 people in trials Low certainty Diarrhea: raw sap and traditional products 3 studies Not enough evidence Stomach ulcers 2 studies Not enough evidence Wound healing (cream) 3 studies · 60 people in trials Low certainty Genital and anal herpes sores in AIDS (purified ointment) 2 studies · 45 people in trials Low certainty Scars and insect bites 2 studies Not enough evidence Inflammation and antioxidant effects (lab) 2 studies Not enough evidence Germs: antibacterial and antiviral effects (lab) 2 studies Not enough evidence Cancer (lab findings only) 3 studies Not enough evidence

Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).

How we rate evidence

High certainty

Several well-run trials or reviews agree; further research is unlikely to change the picture much.

Moderate certainty

Good trials point the same way, but some doubt remains.

Low certainty

Small, short or inconsistent trials. The finding could change with better research.

Very low certainty

Very little or very weak human data. Treat as a possibility only.

Mixed findings

Trials or reviews disagree with each other.

Not enough evidence

Not enough human research to say either way.

Evidence against

Good research found no benefit, or found harm.

We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We started from our existing dragon's blood summary, searched PubMed, and read the abstract of every PubMed study cited, the full FDA label for Mytesi, the Memorial Sloan Kettering page and the full text of the wound-cream trial. Plant names were checked in GBIF and NCBI Taxonomy and compounds in PubChem. Not verified: EMA, WHO and LactMed could not be confirmed, no NCCIH page was found, and the LiverTox page was read as an abstract only. Several clinical studies named in reviews were not read. Certainty ratings are the compiler's reading.

Study library: every study we checked 25

Design Research type Plant part Year from Search

Study	Design	People	Product, dose, length	Result
Al-Awthan 2021 Phytochemistry and Pharmacological Activities of Dracaena cinnabari Resin. BioMed Research International · PMID 34337055 · DOI	Narrative review	Review of a different dragon's blood (Dracaena cinnabari, Socotra)	Dracaena cinnabari resin, a different species Resin Not applicable Not applicable · vs Not applicable	States that deep red resin from different plant species is commonly known as dragon's blood, and that the Dracaena resin contains biflavonoids such as cinnabarone, chalcones and sterols. Included here to show that the name covers unrelated plants. Context only (None) Methods, limits and funding Outcomes: Identity of the plant source and its chemistry Limitations: About a different plant; says nothing about Croton lechleri safety or benefit. Funding and conflicts: Not stated in the abstract. Read: abstract
DiCesare 2002 A double blind, randomized, placebo-controlled study of SP-303 (Provir) in the symptomatic treatment of acute diarrhea among travelers to Jamaica and Mexico. American Journal of Gastroenterology · PMID 12385443 · DOI	Controlled trial	184 US travelers with acute diarrhea in Jamaica or Mexico	SP-303 (Provir), the purified proanthocyanidin, not raw sap Latex (purified) Three strengths four times a day (125, 250 or 500 mg) 2 days of treatment, 3 days of visits · vs Placebo	Time to last unformed stool: 38.7 hours on placebo versus 30.6 hours on 125 mg (P = 0.005), 30.3 hours on 250 mg, 32.6 hours on 500 mg (P = 0.01). Treatment failures 29.3% on placebo versus 7.3%, 4.3% and 9.8%. Authors described a 21% shorter illness. Well tolerated. About 8 hours shorter diarrhea (21%) (None) Methods, limits and funding Outcomes: Time from first dose to last unformed stool (TLUS48); treatment failures Limitations: One short trial; purified product; cause was mostly not found (enterotoxigenic E. coli in 19%); no trial of raw sap. Funding and conflicts: Not stated in the abstract. Read: abstract
European Medicines Agency 2026 EMA herbal medicines search for Croton lechleri EMA website, accessed 2026-10-25 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	The search page returned HTTP 401 to our request, so we could not check whether an HMPC monograph or assessment exists. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: Not verified. We make no claim either way about an EMA/HMPC document. Funding and conflicts: Public record or reference page Read: abstract
Frampton 2013 Crofelemer: a review of its use in the management of non-infectious diarrhoea in adult patients with HIV/AIDS on antiretroviral therapy. Drugs · PMID 23807722 · DOI	Narrative review	Adults with HIV/AIDS on antiretroviral therapy (review)	Crofelemer (purified oligomeric proanthocyanidin from Croton lechleri latex), not raw sap Latex (purified drug) Not applicable Not applicable · vs Not applicable	Describes crofelemer as an oligomeric proanthocyanidin from the stem bark latex of Croton lechleri with minimal systemic absorption that blocks two chloride channels in the gut lining. It was the first agent FDA-approved for this use, based on ADVENT (376 randomized). Infections and gut disorders were the most common adverse events; overall rates were similar to placebo in the 4-week phase. No appreciable effect on viral load or CD4 counts. Review of the drug only (None) Methods, limits and funding Outcomes: Description, absorption, mechanism, trials and tolerability of crofelemer Limitations: Single-drug review by a drug-information author; not a pooled analysis. Funding and conflicts: Not stated in the abstract. Read: abstract
GBIF Secretariat 2026 GBIF backbone match: Croton lechleri Müll.Arg. GBIF API (species/match), checked 2026-10-25 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	Exact match, status ACCEPTED, usage key 3057776, no synonym; family Euphorbiaceae, order Malpighiales, class Magnoliopsida, phylum Tracheophyta. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: Taxonomy only. Funding and conflicts: Public record or reference page Read: full-text
Holodniy 1999 A double blind, randomized, placebo-controlled phase II study to assess the safety and efficacy of orally administered SP-303 for the symptomatic treatment of diarrhea in patients with AIDS. American Journal of Gastroenterology · PMID 10566728 · DOI	Controlled trial	51 Hospitalized adults with AIDS and diarrhea	SP-303 (the purified proanthocyanidin later named crofelemer), not raw sap Latex (purified) 500 mg every 6 hours 4 days, follow-up at 1 week · vs Placebo	26 people on SP-303, 25 on placebo. Stool weight fell by 451 g per 24 hours versus 150 g on placebo on day 4 (P = 0.14); abnormal stools fell by 3 versus 2 (P = 0.30). Daily-measures analysis over 4 days was significant for stool weight (P = 0.008) and frequency (P = 0.04). No serious adverse events or lab abnormalities. Day-4 comparison not significant; daily-measures analysis significant (None) Methods, limits and funding Outcomes: Change in stool weight and abnormal stool frequency Limitations: Small; 4 days; the headline day-4 result was not significant. Funding and conflicts: Not stated in the abstract; research support from US public health service and non-government sources listed. Read: abstract
Jones 2003 Review of sangre de drago (Croton lechleri)--a South American tree sap in the treatment of diarrhea, inflammation, insect bites, viral infections, and wounds: traditional uses to clinical research. Journal of Alternative and Complementary Medicine · PMID 14736360	Narrative review	Review of traditional use, lab, animal and clinical work	Sangre de drago sap and sap-derived products Latex (bark sap) Not applicable Not applicable · vs Not applicable	Says lab and animal studies largely support traditional uses. Clinical studies reported positive results in traveler's and watery diarrhea and insect-bite symptoms. Says the sap showed low toxicity and preparations in clinical studies were well tolerated. Warns that sap chemistry differs between areas, including alkaloid types, so clinical materials must be standardized. Narrative summary (None) Methods, limits and funding Outcomes: Pharmacologic and clinical evidence for traditional uses Limitations: Narrative review from 2003 by an author linked to a botanical research company; the clinical studies it cites were not individually read by us. Funding and conflicts: Not stated in the abstract. Read: abstract
MacArthur 2013 Efficacy and safety of crofelemer for noninfectious diarrhea in HIV-seropositive individuals (ADVENT trial): a randomized, double-blind, placebo-controlled, two-stage study. HIV Clinical Trials · PMID 24334179 · DOI	Controlled trial	376 Adults with HIV on stable antiretroviral therapy and chronic non-infectious diarrhea	Crofelemer (purified oligomeric proanthocyanidin from Croton lechleri latex), not raw sap Latex (purified drug) Stage I tested 125, 250 and 500 mg twice daily; stage II used 125 mg twice daily 4 weeks placebo-controlled, then 20-week open-label extension · vs Placebo	196 people in stage I and 180 in stage II. Responders: 17.6% on crofelemer 125 mg versus 8.0% on placebo (one-sided P = 0.01). Watery stools per day and stool consistency also improved (P = 0.04, P = 0.02). In the open-label extension 40% to 56% of people were weekly responders. Minimally absorbed; safety similar to placebo; no effect on immune measures. About 9.6 percentage points more responders than placebo; most people did not respond (None) Methods, limits and funding Outcomes: Clinical response: 2 or fewer watery stools a week in at least 2 of the 4 weeks Limitations: One-sided P value; most people did not respond; open-label extension has no placebo group; HIV-specific. Funding and conflicts: Not stated in the abstract. The FDA label names Napo Pharmaceuticals as the drug's maker. Read: abstract
Memorial Sloan Kettering Cancer Center 2019 Croton lechleri (Sangre de Drago) MSK About Herbs, last updated 2019-03-27 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	Summary page. Says crofelemer was FDA-approved for diarrhea in AIDS patients on antiretroviral therapy; a proanthocyanidin mixture helped traveler's and AIDS-related diarrhea; supplementary analysis suggests less abdominal pain in women with IBS-D; crofelemer was no more effective than placebo in AIDS patients with recurrent genital herpes; a cream with C. lechleri resin and pomegranate seed oil was reported useful for scarring; cancer-cell effects are lab findings and the sap also increased viability of leukemic cells in one study. Taspine, an alkaloid from the sap, helped wounds in animal work. Only listed contraindication: dacomitinib (animal studies suggest crofelemer may worsen dacomitinib-induced diarrhea; clinical relevance unknown). Reference list includes a sangre de grado study on Croton palanostigma. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: Cancer-centre summary; the underlying studies were not individually read by us. No adverse-effect or pregnancy section was found. Funding and conflicts: Public record or reference page Read: full-text
NCBI PubChem 2026 PubChem compound record: Catechin PubChem PUG REST, checked 2026-10-25 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	CID 9064, formula C15H14O6. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: Identity only. Funding and conflicts: Public record or reference page Read: full-text
NCBI PubChem 2026 PubChem compound record: Epicatechin PubChem PUG REST, checked 2026-10-25 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	CID 72276, formula C15H14O6. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: Identity only. Funding and conflicts: Public record or reference page Read: full-text
NCBI PubChem 2026 PubChem compound record: Gallocatechin PubChem PUG REST, checked 2026-10-25 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	CID 65084, formula C15H14O7. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: Identity only. Funding and conflicts: Public record or reference page Read: full-text
NCBI PubChem 2026 PubChem compound record: Epigallocatechin PubChem PUG REST, checked 2026-10-25 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	CID 72277, formula C15H14O7. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: Identity only. Funding and conflicts: Public record or reference page Read: full-text
NCBI PubChem 2026 PubChem compound record: Taspine PubChem PUG REST, checked 2026-10-25 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	CID 215159, formula C20H19NO6, molecular weight 369.4. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: Identity only. Funding and conflicts: Public record or reference page Read: full-text
NCCIH 2026 NCCIH herb page for dragon's blood (not found) NCCIH website, accessed 2026-10-25 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	The address nccih.nih.gov/health/dragons-blood returned HTTP 404; no NCCIH fact sheet was found. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: Absence of a page we guessed at is not proof that NCCIH has nothing; only that we found none. Funding and conflicts: Public record or reference page Read: abstract
NIH / 2026 LactMed record for crofelemer (not found) PubMed and Bookshelf search, 2026-10-25 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	A PubMed search for crofelemer with lactation or breastfeeding terms returned nothing, and the Bookshelf pages were blocked by a bot check. No LactMed record was confirmed. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: Not verified. No claim either way about LactMed. Funding and conflicts: Public record or reference page Read: abstract
Namjoyan 2016 Efficacy of Dragon's blood cream on wound healing: A randomized, double-blind, placebo-controlled clinical trial. Journal of Traditional and Complementary Medicine · PMID 26870678	Controlled trial	60 People aged 14 to 65 having skin tags removed (100 wounds); Ahvaz, Iran	15% ethanol extract of Croton lechleri resin powder in a cream Resin (powder bought from a Dutch herb supplier) Applied to the wound as a cream (amount per application not recorded here) Up to 20 days, visits on days 3, 5, 7, 10, 14 and 20 · vs Placebo cream	Healing was faster with the cream (P = 0.0001 for mean healing time). Mean percent healed: day 3 31.1% vs 4.7%; day 7 77.8% vs 43.9%; day 14 95.7% vs 78.1%. 12 people (17 wounds) dropped out because of poor compliance. No irritation in the treated group; one infection in the placebo group. Faster healing of small surgical wounds (None) Methods, limits and funding Outcomes: Wound surface healed and mean healing time Limitations: Small; one centre; 20% dropout; tiny planned wounds, not chronic wounds or burns; product made by the authors. Funding and conflicts: Not stated in the abstract or the part of the full text we read. Read: abstract
National Institute of Diabetes and Digestive and Kidney Diseases 2012 Crofelemer (LiverTox: Clinical and Research Information on Drug-Induced Liver Injury). LiverTox, NCBI Bookshelf (NBK548325) · PMID 31643647	Authoritative guidance	Drug-induced liver injury record	Crofelemer (purified oligomeric proanthocyanidin from Croton lechleri latex), not raw sap Latex (purified drug) Not applicable Not applicable · vs Not applicable	The record's abstract says crofelemer is associated with occasional serum enzyme elevations during therapy but has not been linked to cases of clinically apparent acute liver injury. No clinically apparent liver injury linked (None) Methods, limits and funding Outcomes: Liver safety Limitations: Only the abstract could be read (the full page was blocked by a bot check). Drug record, not raw sap. Funding and conflicts: Public record. Read: abstract
Nee 2019 Randomized Clinical Trial: Crofelemer Treatment in Women With Diarrhea-Predominant Irritable Bowel Syndrome. Clinical and Translational Gastroenterology · PMID 31800542 · DOI	Controlled trial	240 Women with IBS with diarrhea	Crofelemer (purified oligomeric proanthocyanidin from Croton lechleri latex), not raw sap Latex (purified drug) 125 mg twice daily 12 weeks · vs Placebo	No significant difference in the primary measure. In a post hoc analysis, abdominal pain responders were more likely on crofelemer over the 3 months (54.2% vs 42.5%, P = 0.037). No difference in stool consistency responders or the combined measure. Safety similar to placebo. Primary result null; post hoc pain signal (None) Methods, limits and funding Outcomes: Percentage of abdominal pain/discomfort-free days (primary); FDA-style monthly responders (post hoc) Limitations: Primary endpoint missed; the pain result is post hoc and can be a chance finding; women only. Funding and conflicts: Not stated in the abstract. Read: abstract
Orozco-Topete 1997 Safety and efficacy of Virend for topical treatment of genital and anal herpes simplex lesions in patients with AIDS. Antiviral Research · PMID 9217246 · DOI	Controlled trial	45 People with AIDS and recurrent genital or anal herpes lesions	Virend (SP-303), a purified proanthocyanidin, 15% ointment Latex (purified) Ointment three times a day 21 days · vs Placebo ointment	24 on Virend, 21 on placebo. Complete healing in 9 of 22 (41%) on Virend versus 3 of 21 (14%) on placebo (P = 0.053, not below the usual 0.05 cut-off). Culture-negative: 50% vs 19% (P = 0.06). Trend, not statistically significant (None) Methods, limits and funding Outcomes: Complete healing of lesions; time to healing; viral culture Limitations: Small; borderline result; purified compound in an ointment, not raw sap; HIV-specific. Funding and conflicts: Not stated in the abstract. Read: abstract
Pohlmann 2022 HALT-D: a randomized open-label phase II study of crofelemer for the prevention of chemotherapy-induced diarrhea in patients with HER2-positive breast cancer receiving trastuzumab, pertuzumab, and a taxane. Breast Cancer Research and Treatment · PMID 36280642 · DOI	Controlled trial	51 Women with HER2-positive breast cancer on trastuzumab, pertuzumab and a taxane	Crofelemer (purified oligomeric proanthocyanidin from Croton lechleri latex), not raw sap Latex (purified drug) 125 mg twice daily during chemotherapy cycles 1 and 2 2 chemotherapy cycles · vs No preventive medicine (open-label)	26 on crofelemer, 25 controls. No significant difference in the primary endpoint. Diarrhea of grade 2 or worse: 19.2% vs 24.0% in cycle 1 and 8.0% vs 39.1% in cycle 2. Diarrhea resolved 1.8 times more often; less watery diarrhea. Primary result null; secondary results favourable (None) Methods, limits and funding Outcomes: Any-grade chemotherapy-induced diarrhea for 2 or more consecutive days (primary) Limitations: Open-label; only 51 people; primary endpoint missed and secondary results are less certain. Funding and conflicts: Industry-linked: funded by Genentech; Napo Pharmaceuticals supplied the drug, and several authors report ties to Napo or Genentech. Read: abstract
Pona 2019 Review of future insights of Dragon's Blood in dermatology. Dermatologic Therapy · PMID 30556246 · DOI	Narrative review	Review of Croton lechleri in dermatology	Croton lechleri sap Latex Not applicable Not applicable · vs Not applicable	Preclinical work shows anti-inflammatory, antioxidant, antimicrobial, antifungal and antineoplastic effects. Clinical studies reflect wound-healing and antiviral properties. Concludes that dragon's blood offers limited use in dermatology and more research is needed. Narrative summary (None) Methods, limits and funding Outcomes: Preclinical and clinical dermatology evidence Limitations: PubMed-keyword search review; abstract only. Funding and conflicts: Not stated in the abstract. Read: abstract
Rossi 2003 Evaluation of the mutagenic, antimutagenic and antiproliferative potential of Croton lechleri (Muell. Arg.) latex. Phytomedicine · PMID 12725567 · DOI	Laboratory research in-vitro	Bacteria (Ames test) and human leukemia cells in the lab	Croton lechleri latex (sap) Latex Not applicable Not applicable · vs Untreated controls	No mutagenic activity in two Salmonella strains, with or without liver-enzyme mix (S9). The sap reduced the mutagenicity of 2-aminoanthracene when S9 was present and gave moderate protection against two direct mutagens. The authors suggest the sap interacts with enzymes in the S9 mix. Antiproliferative effect on K562 cells (IC50 2.5 micrograms per mL). Lab only (None) Methods, limits and funding Outcomes: Mutagenicity, protection against mutagens, and effect on K562 leukemia cells Limitations: Bacteria and cells; not evidence for people. The enzyme hint is a lab suggestion. Funding and conflicts: Not stated in the abstract. Read: abstract
US FDA / Napo Pharmaceuticals via DailyMed 2020 MYTESI (crofelemer) delayed-release tablets, prescribing information DailyMed label, revised 11/2020 · Source	Authoritative guidance	Not applicable	Croton lechleri latex and crofelemer Latex Not applicable Not applicable · vs Not applicable	Indicated for symptomatic relief of non-infectious diarrhea in adults with HIV/AIDS on antiretroviral therapy. No contraindications. The label warns to rule out infectious diarrhea first. Common reactions at 3% or more: upper respiratory infection, bronchitis, cough, flatulence, increased bilirubin; also nausea, increased ALT, nephrolithiasis (1% to 2%). Description: oligomeric proanthocyanidin from the red latex of Croton lechleri, average polymer length 5 to 7.5 units of catechin, epicatechin, gallocatechin and epigallocatechin. Mechanism: blocks the CFTR and calcium-activated chloride channels in the gut lining. Plasma levels were below the limit of detection (50 ng/mL). In vitro: potential to inhibit CYP3A4 at gut concentrations, and the transporters MRP2 and OATP1A2, but not P-gp or BCRP. In healthy people, 4 times the recommended amount for 6 days did not significantly change midazolam levels. No clinically relevant interaction with nelfinavir or zidovudine; lamivudine exposure fell about 20%, judged not clinically important. Pregnancy: human data not available; minimal absorption, rat studies without fetal harm, rabbit fetal losses at 96 times the clinical dose possibly from maternal toxicity. Breastfeeding: no data; mothers told not to breastfeed (also because of HIV). Children: not established. Not carcinogenic or mutagenic in animal and lab tests. None (None) Methods, limits and funding Outcomes: Identity, regulatory status or safety record Limitations: A drug label for the purified drug in one narrow population. Does not cover raw sap. Wording dated 11/2020; a newer version may exist. Funding and conflicts: Public record or reference page Read: full-text
de Albuquerque RDDG 2025 A Review on Phytochemistry and Recent Pharmacology of Dragon's Blood (Croton lechleri), a Multifunctional Ethnomedicinal Resource from the Amazon Forest. Planta Medica · PMID 40043740 · DOI	Narrative review	Review of 33 articles	Croton lechleri resin and extracts Latex / resin Not applicable Not applicable · vs Not applicable	Based on 33 articles. Proanthocyanidins are the most abundant group; alkaloids, diterpenoids, phytosteroids, saponins and phenolics are also present. Reports wound-healing, antitumor, anti-inflammatory and gut effects, mostly with the resin; the authors call for continued investigation. Narrative summary (None) Methods, limits and funding Outcomes: Phytochemistry and pharmacology of the species Limitations: Mostly lab and animal work; search of Scopus and Google Scholar only. Funding and conflicts: The authors declare no conflict of interest. Read: abstract

What we do not know yet

No randomized trial of raw Croton lechleri sap taken by mouth was found; the diarrhea and herpes trials used the purified compound.
The wound trial is one small trial of skin-tag wounds; no chronic wounds or burns.
Trials in traveler's diarrhea (2002) and herpes (1997) were never repeated.
Scar, insect-bite and ulcer claims rest on summaries or lab work.
No safety data for raw sap in pregnancy, breastfeeding, children or long-term use.
EMA/HMPC and WHO not verified; no NCCIH or LactMed record found.

How new research is added

New studies are found by a saved PubMed search and placed in a review queue. A person reads each one before it changes any rating or safety wording.

Lab markers

What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".

Other 8

▼

Watery stools per day or week

Lowered in trials

How many loose, watery bowel movements a person has.

Moderate certainty

Results and what it means

Why it was measured

The main symptom in secretory diarrhea.

Statistical vs. clinical meaning

Statistically significant in the large trial; modest absolute effect.

Safety implication

Common reactions listed on the label: infections, cough, gas, bilirubin rise.

Study	Result	People	Product
⁸	Fewer daily watery bowel movements than placebo (P = 0.04); responders 17.6% vs 8.0%.	376 adults with HIV and non-infectious diarrhea	Crofelemer, 4 weeks
⁶	Abnormal stool frequency fell by 3 versus 2 per 24 h at day 4 (P = 0.30); daily-measures analysis P = 0.04.	51 hospitalized adults with AIDS and diarrhea	SP-303, 4 days

^{8 6}

▼

Stool weight

Lowered in trials

Weight of stool passed in 24 hours.

Low certainty

Results and what it means

Why it was measured

An objective measure of fluid loss.

Statistical vs. clinical meaning

Day-4 result not significant; daily-measures analysis was.

Safety implication

No serious events or lab changes in the trial.

Study	Result	People	Product
⁶	Fell 451 g vs 150 g per 24 h at day 4 (P = 0.14); significant over daily measures (P = 0.008).	51 adults with AIDS	SP-303, 4 days

⁶

●

Time to last unformed stool

Shortened in trials

Hours from the first dose until the last loose stool.

Low certainty

Results and what it means

Why it was measured

How long the illness lasts.

Statistical vs. clinical meaning

One trial; about 21% shorter.

Safety implication

Well tolerated.

Study	Result	People	Product
²	38.7 h on placebo vs 30.6 h at the lowest strength (P = 0.005).	184 travelers with acute diarrhea	SP-303, 2 days

▲

Abdominal pain-free days

Raised in trials

Share of days without belly pain or discomfort.

Low certainty

Results and what it means

Why it was measured

A key symptom of IBS-D.

Statistical vs. clinical meaning

Primary result null; post hoc signal.

Safety implication

Safety similar to placebo.

Study	Result	People	Product
¹⁹	No significant difference overall; post hoc pain responders 54.2% vs 42.5% (P = 0.037).	240 women with IBS-D	Crofelemer, 12 weeks

¹⁹

▼

Grade 2 or worse chemotherapy diarrhea

Lowered in trials

How often diarrhea becomes moderate or severe during chemotherapy.

Low certainty

Results and what it means

Why it was measured

Severe diarrhea can lead to dose cuts.

Statistical vs. clinical meaning

Secondary result in a small open-label trial.

Safety implication

Cancer patients: ask the oncology team.

Study	Result	People	Product
²¹	19.2% vs 24.0% in cycle 1 and 8.0% vs 39.1% in cycle 2 (primary endpoint not significant).	51 women with HER2-positive breast cancer	Crofelemer, cycles 1 and 2

²¹

▲

Wound healed (percent of surface)

Raised in trials

How much of the original wound surface has closed.

Low certainty

Results and what it means

Why it was measured

Direct measure of healing speed.

Statistical vs. clinical meaning

Significant on every day; one small trial.

Safety implication

No irritation in the treated group.

Study	Result	People	Product
¹⁷	Day 3 31.1% vs 4.7%; day 7 77.8% vs 43.9%; day 14 95.7% vs 78.1%.	60 people, 100 skin-tag wounds	Cream with 15% extract, up to 20 days

¹⁷

▲

Complete healing of herpes lesions

Raised in trials

Share of people whose sores healed fully.

Low certainty

Results and what it means

Why it was measured

The main clinical goal.

Statistical vs. clinical meaning

Not significant at the usual cut-off.

Safety implication

Not reported.

Study	Result	People	Product
²⁰	41% vs 14% (P = 0.053).	45 people with AIDS and recurrent herpes	15% ointment of SP-303, 21 days

²⁰

▲

Herpes virus culture turned negative

Raised in trials

Whether the virus could still be grown from the sore.

Low certainty

Results and what it means

Why it was measured

A lab sign of the virus being cleared.

Statistical vs. clinical meaning

Not significant; lab marker.

Safety implication

Not reported.

Study	Result	People	Product
²⁰	50% vs 19% (P = 0.06).	45 people with AIDS and recurrent herpes	15% ointment of SP-303, 21 days

²⁰

Safety

What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.

Main points to know 4

Most safety data are for the purified drug, not the raw sap. Crofelemer (Mytesi) is a purified extract with a full FDA label. It is hardly absorbed into the blood. Raw red latex and creams have almost no formal human safety data. One cream trial reported no irritation in the treated group, and reviews call the sap low in toxicity, but these are weak sources. Authoritative guidance ^{24 7 17}
Rule out infection before treating diarrhea. The FDA label warns that treating infectious diarrhea with the drug could be wrong and could worsen disease, so infection should be ruled out first. The label lists no contraindications. Authoritative guidance ²⁴
Do not take it with dacomitinib. Memorial Sloan Kettering says animal studies suggest crofelemer may worsen diarrhea caused by the cancer drug dacomitinib. Clinical relevance is unknown. Animal research ⁹
Look-alike resins and variable sap. Several unrelated plants are sold as dragon's blood, and the chemistry of Croton lechleri sap varies by area. Results for one product do not carry over to another. Narrative review ^{1 7}

Side effects 6

Effect	How often	Severity and recovery	Evidence
Respiratory infections (upper respiratory infection, bronchitis), cough Drug trials in people with HIV; the group also has more infections at baseline.	Upper respiratory infection 6% vs 2% on placebo; bronchitis 4% vs 0%; cough 4% vs 1% (label, 229 on the drug vs 274 on placebo)	mild to moderate Not stated	Controlled trial ²⁴
Gas, nausea, belly swelling Gut effects of the purified drug.	Flatulence 3% vs 1%; nausea 3% vs 2%; abdominal distension 2% vs under 1%	mild Not stated	Controlled trial ²⁴
Raised bilirubin and ALT (blood tests) See liver section.	Bilirubin 3% vs 1%; ALT 2% vs 1%	lab change Not stated	Controlled trial ^{24 18}
Kidney stones (nephrolithiasis) Listed as less common; causal link not established.	Listed in the 1% to 2% group on the label	not stated Not stated	Authoritative guidance ²⁴
Few side effects in the ADVENT trial Crofelemer was minimally absorbed and did not reduce CD4 counts or raise viral load.	Overall adverse event rates were similar to placebo in the 4-week phase	not serious Not applicable	Controlled trial ^{8 4}
Skin irritation from creams or raw sap One small trial is not enough to rule out irritation or allergy; no patch-test guidance was found.	None reported in the treated group of one 60-person cream trial	none reported Not applicable	Controlled trial ¹⁷

Liver

LiverTox's record for crofelemer says it is linked to occasional serum enzyme elevations but not to clinically apparent acute liver injury. The FDA label lists raised bilirubin and ALT as reactions in a few percent of people. No liver-injury case report for raw Croton lechleri sap was found. ^{18 24}

How often. Bilirubin 3% vs 1% and ALT 2% vs 1% in the label's pooled trials. Not finding raw-sap reports is not proof of safety.

Monitoring. No agency monitoring advice for raw sap was found. People with liver disease should ask their clinician before use.

This is a safety connection. It is not evidence that Dragon's Blood supports liver health.

Medicines and supplements 5

With	Why it matters	Importance	Evidence	What to do
Dacomitinib (cancer drug) drug	Animal studies suggest crofelemer may worsen dacomitinib-induced diarrhea (reported by MSK; original study not read).	Clinical relevance unknown.	Animal research Low certainty ⁹	Avoid the combination unless your cancer team says otherwise.
CYP3A4 drug-processing enzyme (for example midazolam) drug	The label says crofelemer has the potential to inhibit CYP3A4 in vitro at the concentrations expected in the gut. In healthy people, 4 times the recommended amount for 6 days did not significantly change midazolam or its metabolite levels.	No significant effect in the human test; label says other CYP enzymes are unlikely to be affected systemically because of minimal absorption.	Controlled trial Moderate certainty ²⁴	Ask a pharmacist if you take drugs that depend on gut CYP3A4. This applies to the drug; raw sap was not tested.
P-glycoprotein (P-gp) and BCRP transporters drug	The label says in vitro studies showed crofelemer does NOT inhibit P-gp or BCRP at gut concentrations, but may inhibit MRP2 and OATP1A2.	Unknown; no human study of MRP2 or OATP1A2 effects was found.	Laboratory research Low certainty ²⁴	No P-gp warning is given on the label. Drugs carried by MRP2 or OATP1A2 are a theoretical concern only.
HIV drugs: nelfinavir, zidovudine, lamivudine drug	A crossover study in healthy people found no effect on nelfinavir or zidovudine exposure, and about a 20% fall in lamivudine exposure.	The label judges these not clinically relevant.	Controlled trial Moderate certainty ²⁴	Tested at much higher than usual amounts of crofelemer; other HIV drugs not tested in this study.
Raw sap with prescription drugs in general drug	A lab test found the sap interacted with enzymes in a liver-enzyme mix (S9) used in the Ames test, a lab hint of enzyme effects.	No human interaction study of raw sap was found.	Laboratory research Not enough evidence ²³	Tell your pharmacist you use it, especially with narrow-range drugs such as blood thinners or transplant drugs (a general precaution, not a documented interaction).

Who should check first 4

Situation	Advice	Evidence
Infectious diarrhea (the drug)	Do not use the drug until infection is ruled out (label warning). The label itself lists no formal contraindication.	Authoritative guidance ²⁴
Taking dacomitinib	Avoid the combination (MSK).	Animal research ⁹
Pregnancy and breastfeeding	Avoid raw sap and creams as a precaution. For the drug, the label says human pregnancy data are unavailable and mothers should not breastfeed on it.	Authoritative guidance ²⁴
Children	The label says safety and effectiveness of the drug are not established in children. No data for raw sap.	Authoritative guidance ²⁴

Overdose, product quality and regulators

Summary. The drug was not carcinogenic or mutagenic in animal and lab tests (label). The raw sap was not mutagenic in a lab Ames test. Reviews call the sap low in toxicity, but no formal human toxicity study of raw sap was found.

Animal. Crofelemer: no tumours in a 6-month transgenic mouse study or 2-year rat study; not teratogenic in rats at very high amounts; rabbits had fetal losses at 96 times the clinical amount, possibly from maternal toxicity. Reduced survival in male rats at the highest carcinogenicity amounts led to reduced amounts.

Human doses studied. Trials of the purified drug lasted up to 24 weeks (ADVENT, with a 48-week open-label safety study described in a review). The cream trial lasted up to 20 days.

High dose or long term signals. No long-term human safety data for raw sap.

Overdose response. No overdose report found.

Genotoxicity. Crofelemer was negative in bacterial, chromosome and rat bone-marrow tests (label). Sap was not mutagenic in Salmonella (Rossi 2003).

Toxic plant parts. The used part is the red latex from the bark. No toxic plant part was described in the sources read.

The name 'dragon's blood' covers resins from unrelated plants (Croton, Dracaena, Daemonorops, Pterocarpus), and sap chemistry varies by area. No lab survey of retail products for adulteration or contaminants was found.

Different plants sold under one name. A review of Dracaena cinnabari resin and the wound-cream trial both note that deep red resins from several plant families are called dragon's blood. Their chemistry and effects differ. ^{1 17}

Variable sap chemistry. Jones (2003) says the chemistry of the sap changes from one geographic area to another, including alkaloid types, so products used clinically must be standardized. ⁷

Other Croton species. A study listed in MSK's references used the related Croton palanostigma, also sold as sangre de grado (title seen only in MSK's reference list). ⁹

Raw sap versus the drug. Mytesi is a defined, tested product with a set polymer length. Raw sap and supplements are not standardized and carry no such guarantee. ²⁴

Body	Action	Date
US FDA (United States)	Crofelemer (Mytesi; called Fulyzaq in a 2013 review) is an approved prescription drug for symptomatic relief of non-infectious diarrhea in adults with HIV/AIDS on antiretroviral therapy. Raw sap and supplements are not approved drugs. source	Label revised 11/2020
LiverTox (United States)	Crofelemer record: occasional enzyme elevations; no clinically apparent acute liver injury linked. source	2012
Memorial Sloan Kettering (United States)	Patient herb page: summarizes the approved drug and lab findings; lists dacomitinib as the contraindication. source	2019-03-27

When to get medical help

Blood in the stool, high fever, severe belly pain or diarrhea lasting more than a few days: this may be an infection that needs a doctor, not a herb.
Signs of dehydration (very dark urine, dizziness, no urine for many hours), especially in children and older adults.
Hives, facial swelling or trouble breathing after taking it or putting it on skin.
Yellow skin or eyes, dark urine or severe pain in the side or back (liver or kidney stone concern).

Stop the supplement and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.

General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.

Frequently asked questions

Is dragon's blood the same as crofelemer?

No. Crofelemer is a purified proanthocyanidin fraction of Croton lechleri latex, made into a prescription tablet. Raw sap is a variable plant product with different, and much thinner, evidence.

^{24 4}

Does it work for diarrhea?

The purified drug modestly helps non-infectious diarrhea in HIV: 17.6% responded versus 8.0% on placebo. We found no trial of raw sap taken by mouth.

^{8 7}

Is it the same as other dragon's blood resins?

No. Resins from Dracaena, Daemonorops and Pterocarpus come from unrelated plants and have different chemistry. Evidence on one does not apply to another.

^{1 17}

Does it heal wounds?

One small trial of 60 people found faster healing of skin-tag wounds with a 15% extract cream. It has not been tested in chronic wounds or burns, so the evidence is weak.

^{17 22}

Does it treat herpes?

Not proven. A purified ointment healed 41% of sores versus 14% on placebo in people with AIDS, but the result was borderline and MSK says it was no more effective than placebo.

^{20 9}

Can it fight cancer?

Not in people. Cancer-cell effects are lab findings, and one study found leukemia cells grew better. Never use it in place of cancer treatment.

^{9 23}

What are the side effects?

Of the drug: respiratory infections, cough, gas, nausea and slightly raised bilirubin or liver enzymes. In the one cream trial, there was no irritation in the treated group. Raw-sap side effects are not well studied.

^{24 17}

Does it affect the liver?

LiverTox links crofelemer to occasional enzyme rises but not to clinically apparent liver injury. We found no raw-sap liver case reports, which is not proof of safety.

^{18 24}

Does it interact with other medicines?

The label notes lab potential to inhibit CYP3A4 but no significant change in a human midazolam test, and no P-gp inhibition. MSK advises against dacomitinib. Raw sap has no interaction studies, so ask a pharmacist.

^{24 9}

Is it safe in pregnancy or breastfeeding?

Unknown. The drug label says human pregnancy data are lacking and mothers should not breastfeed on it. Raw sap has no data, so avoid it.

²⁴

Should it be used for infectious diarrhea?

No. The label warns that infection should be ruled out first. See a doctor for fever, blood in the stool or diarrhea lasting more than a few days.

²⁴

Is there an official EMA or NCCIH opinion?

We could not verify one. The EMA site gave an access error and no NCCIH page was found. The FDA approved the purified drug.

^{3 15 24}

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Editorial transparency

Written by: AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records.
Medical review: None. This page has not been reviewed by a physician or pharmacist.
First published: 2026-10-25
Last substantive update: 2026-10-25
How we research: We started from our existing dragon's blood summary, searched PubMed, and read the abstract of every PubMed study cited, the full FDA label for Mytesi, the Memorial Sloan Kettering page and the full text of the wound-cream trial. Plant names were checked in GBIF and NCBI Taxonomy and compounds in PubChem. Not verified: EMA, WHO and LactMed could not be confirmed, no NCCIH page was found, and the LiverTox page was read as an abstract only. Several clinical studies named in reviews were not read. Certainty ratings are the compiler's reading.
How we rate evidence: See "How we rate evidence" in the Evidence tab.
Independence: No product is promoted on this page. No affiliate links are shown.

Sources 25

Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.

Al-Awthan YS, Bahattab OS. Phytochemistry and Pharmacological Activities of Dracaena cinnabari Resin.. BioMed Research International. 2021. PMID 34337055. DOI 10.1155/2021/8561696. (abstract)
DiCesare D, DuPont HL, Mathewson JJ, et al.. A double blind, randomized, placebo-controlled study of SP-303 (Provir) in the symptomatic treatment of acute diarrhea among travelers to Jamaica and Mexico.. American Journal of Gastroenterology. 2002. PMID 12385443. DOI 10.1111/j.1572-0241.2002.06027.x. (abstract)
European Medicines Agency. EMA herbal medicines search for Croton lechleri. EMA website, accessed 2026-10-25. 2026. (abstract)
Frampton JE. Crofelemer: a review of its use in the management of non-infectious diarrhoea in adult patients with HIV/AIDS on antiretroviral therapy.. Drugs. 2013. PMID 23807722. DOI 10.1007/s40265-013-0083-6. (abstract)
GBIF Secretariat. GBIF backbone match: Croton lechleri Müll.Arg.. GBIF API (species/match), checked 2026-10-25. 2026. (full-text)
Holodniy M, Koch J, Mistal M, et al.. A double blind, randomized, placebo-controlled phase II study to assess the safety and efficacy of orally administered SP-303 for the symptomatic treatment of diarrhea in patients with AIDS.. American Journal of Gastroenterology. 1999. PMID 10566728. DOI 10.1111/j.1572-0241.1999.01535.x. (abstract)
Jones K. Review of sangre de drago (Croton lechleri)--a South American tree sap in the treatment of diarrhea, inflammation, insect bites, viral infections, and wounds: traditional uses to clinical research.. Journal of Alternative and Complementary Medicine. 2003. PMID 14736360. (abstract)
MacArthur RD, Hawkins TN, Brown SJ, et al.. Efficacy and safety of crofelemer for noninfectious diarrhea in HIV-seropositive individuals (ADVENT trial): a randomized, double-blind, placebo-controlled, two-stage study.. HIV Clinical Trials. 2013. PMID 24334179. DOI 10.1310/hct1406-261. (abstract)
Memorial Sloan Kettering Cancer Center. Croton lechleri (Sangre de Drago). MSK About Herbs, last updated 2019-03-27. 2019. (full-text)
NCBI PubChem. PubChem compound record: Catechin. PubChem PUG REST, checked 2026-10-25. 2026. (full-text)
NCBI PubChem. PubChem compound record: Epicatechin. PubChem PUG REST, checked 2026-10-25. 2026. (full-text)
NCBI PubChem. PubChem compound record: Gallocatechin. PubChem PUG REST, checked 2026-10-25. 2026. (full-text)
NCBI PubChem. PubChem compound record: Epigallocatechin. PubChem PUG REST, checked 2026-10-25. 2026. (full-text)
NCBI PubChem. PubChem compound record: Taspine. PubChem PUG REST, checked 2026-10-25. 2026. (full-text)
NCCIH. NCCIH herb page for dragon's blood (not found). NCCIH website, accessed 2026-10-25. 2026. (abstract)
NIH / NLM. LactMed record for crofelemer (not found). PubMed and Bookshelf search, 2026-10-25. 2026. (abstract)
Namjoyan F, Kiashi F, Moosavi ZB, et al.. Efficacy of Dragon's blood cream on wound healing: A randomized, double-blind, placebo-controlled clinical trial.. Journal of Traditional and Complementary Medicine. 2016. PMID 26870678. (abstract)
National Institute of Diabetes and Digestive and Kidney Diseases. Crofelemer (LiverTox: Clinical and Research Information on Drug-Induced Liver Injury).. LiverTox, NCBI Bookshelf (NBK548325). 2012. PMID 31643647. (abstract)
Nee J, Salley K, Ludwig AG, et al.. Randomized Clinical Trial: Crofelemer Treatment in Women With Diarrhea-Predominant Irritable Bowel Syndrome.. Clinical and Translational Gastroenterology. 2019. PMID 31800542. DOI 10.14309/ctg.0000000000000110. (abstract)
Orozco-Topete R, Sierra-Madero J, Cano-Dominguez C, et al.. Safety and efficacy of Virend for topical treatment of genital and anal herpes simplex lesions in patients with AIDS.. Antiviral Research. 1997. PMID 9217246. DOI 10.1016/s0166-3542(97)00015-6. (abstract)
Pohlmann PR, Graham D, Wu T, et al.. HALT-D: a randomized open-label phase II study of crofelemer for the prevention of chemotherapy-induced diarrhea in patients with HER2-positive breast cancer receiving trastuzumab, pertuzumab, and a taxane.. Breast Cancer Research and Treatment. 2022. PMID 36280642. DOI 10.1007/s10549-022-06743-9. (abstract)
Pona A, Cline A, Kolli SS, et al.. Review of future insights of Dragon's Blood in dermatology.. Dermatologic Therapy. 2019. PMID 30556246. DOI 10.1111/dth.12786. (abstract)
Rossi D, Bruni R, Bianchi N, et al.. Evaluation of the mutagenic, antimutagenic and antiproliferative potential of Croton lechleri (Muell. Arg.) latex.. Phytomedicine. 2003. PMID 12725567. DOI 10.1078/094471103321659843. (abstract)
US FDA / Napo Pharmaceuticals via DailyMed. MYTESI (crofelemer) delayed-release tablets, prescribing information. DailyMed label, revised 11/2020. 2020. (full-text)
de Albuquerque RDDG, Leon-Vargas FR, Carrasco-Montanez DD, et al.. A Review on Phytochemistry and Recent Pharmacology of Dragon's Blood (Croton lechleri), a Multifunctional Ethnomedicinal Resource from the Amazon Forest.. Planta Medica. 2025. PMID 40043740. DOI 10.1055/a-2551-5681. (abstract)

Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.