Guarana is an herb belonging to the maple family. Guarana is used as a dietary supplement, which is twice as potent as coffee in yielding stimulation. However, since guarana also contains twice the amount of caffeine in coffee, it also produces guarana side effects related to this high caffeine content.

The guarana plant has a lot of uses. The most commonly used part is the fruit, which is like the coffee bean. The seeds of the fruit are pounded into powder to make a tea. Food supplements containing guarana also use the seeds to benefit from its uses. Guarana contains various components such as adenine, choline, fat, guanine, protein, starch, saponin, theophylline, theobromine, xanthine and the most popular is caffeine. Guarana is considered Generally Recognized as Safe (GRAS) by the Food and Drug Administration of the United States.

Guarana is used as a sweetener for carbonated soft drinks, energy drinks and a major ingredient for herbal teas. Other medical uses of guarana include:

• CNS stimulant to increase alertness, mood and memory
• Weight loss remedy by increasing the body’s feeling of fullness
• Reduces platelet aggregation to prevent risk of ischemic stroke and heart attacks
• Increase blood pressure in hypotension
• Increase endurance to exercise
• Increase power and performance in chronic fatigue syndrome
• Reduces fluid retention through its diuretic effect
• Prevention of malaria and diarrhea through its antibacterial effect

Guarana Side effects

Along with its vast uses, it may also have various guarana side effects as a result of the various mechanism of action of the herb. Guarana side effects may include:

1. Insomnia

Since guarana contains high amounts of caffeine that act as a CNS stimulant, it may lead to insomnia when taken at night. In order to prevent this, be sure to take guarana containing products and supplements in the morning to prevent CNS stimulation at night.

2. Anxiety

People with anxiety disorders may have intensified feelings of anxiety when guarana is taken because of CNS stimulation.

3. Anorexia

One of the beneficial effects of guarana for those who want to lose weight is anorexia. This effect results from the action of guarana in inducing early satiety. In people taking guarana not for weight loss, anorexia may be an adverse guarana side effect.

4. Bleeding tendencies

Since guarana reduces platelet aggregation, there may be increased risk for bleeding. When taking guarana, make sure to watch out for signs of bleeding such as dark stools, nose bleeding and easy bruising. In this line, never take guarana products when under other blood thinning medications.

5. Tachycardia

Guarana contains theopylline, theobromine and other xanthine compounds that are potent cardiac stimulants. Because of this, the heart rate may increase leading to palpitations.

6. Hypertension

Due to its cardiac stimulant effect, guarana may also lead to increased blood pressure. This may be beneficial to those suffering from low blood pressure such as those experiencing antihypertensive medication side effects such as Atacand side effects. However, people who have hypertension should be alert for possible hypertensive crisis.

7. Glaucoma

The increased pressure in the blood vessels may also increase the pressure in the intraocular space leading to glaucoma. People with this eye condition should be cautious in order to prevent this guarana side effect.

8. Increased frequency of urination

The increased myocardial contraction increases the cardiac output and blood flow to the kidneys. As a result, there is increased urine production leading to diuresis.

9. Hypoglycemia

Caffeine may also reduce blood sugar levels. In patients having diabetes, it is important to monitor the blood sugar regularly in order to prevent severe hypoglycemia states especially when under insulin therapy.

10. Worsening of diarrhea

The caffeine in guarana may intensify diarrhea because of being an intestinal irritant. In addition, the diuresis may also worsen dehydration associated with diarrhea.

11. Osteoporosis

Caffeine flushes calcium in the kidneys. Because of too much caffeine contained in guarana, it may lead to osteoporosis as a serious guarana side effect. Osteoporosis may be prevented by taking less than 300 mg of caffeine per day only along with intake of calcium supplements.

Because of these various guarana side-effects, it is recommended to take guarana in minimal amounts. Also, never take guarana when you have other underlying conditions that may be worsened by guarana use.

Terbinafine is an antifungal medication. It is a synthetic allylamine medication that is highly lipophilic or binds to lipids. It accumulates in the fatty tissues, nails and skin where fungus are usually found. Terbinafine works by stopping the growth of the fungus by altering its cell membrane synthesis leading to lysis of the fungus. Despite its beneficial effects in inhibiting fungi, it may also produce terbinafine side-effects along with any other medication that may yield various side-effects and adverse reactions. Terbinafine hydrochloride is the specific active component of the drug and it is sold in the brand names Lamisil, Corbinal, Terbisil and Zabel.

Terbinafine is available in oral and topical preparations. All of these preparations have the potential to produce terbinafine side effects. Indications of terbinafine include:

• Tinea Cruris or jock itch
• Tiea pedis or athlete’s foot
• Tinea corporis or ring worm
• Tinea capitis or ringworm of the scalp in children
• Onychomycosis of the finger nails and toe nail
• Other forms of fungal infections caused by dermatophytes

 Side effects of Terbinafine

There have been a lot of terbinafine side effects that have been reported. These terbinafine side effects may be induced by its extensive biodistribution meaning that it is circulated in different areas of the body. It is also taken by people with fungal infections in extended durations of up to 2 months; hence various terbinafine side effects may occur. The following are the various side-effects of the drug:

1. Gastrointestinal Side effects

The man side effect of terbinafine is related to gastrointestinal problems. These terbinafine side effects may be related to the action of the drug on the normal flora of the GIT that may lead to nausea, constipation or diarrhea, abdominal pain, fullness, indigestion, gastritis, flatulence, dyspepsia, and abdominal cramps. The color of the stool may also be altered may be due to hepatic affectation.

2. Hepatic Side effects

Terbinafine is known to be a hepatotoxic drug. Prolonged and excessive use of the drug may lead to liver inflammation, jaundice, increased liver enzymes, liver damage and subsequently liver failure when it is not detected early.

3. Neurologic Side effects

Terbinafine may also cause terbinafine side effects involving the CNS. Because of being lipophilic, it easily crosses the blood brain barrier leading to side effects such as headache, vertigo, dizziness, paresthesia or abnormal sensations in the extremities, decreased concentration and light headedness.

4. Immune System Side effects

Terbinafine also may affect the blood cell production by the bone marrow leading to decreased blood cell counts such as luekopenia (decreased WBC), anemia (decreased RBC), thrombocytopenia (decreased platelets), neutropenia (decreased neutrophils), agranulocytosis (decreased agranulocytes, which is a type of white blood cells) and pancytopenia (reduction of most blood cells). There have also been cases of systemic lupus erythematosus following terbinafine use. Those who suffer from autoimmune diseases should avoid the use of terbinafine.

5. Cognitive and affective Side effects

Terbinafine may also affect the emotions and cognition of the person. It may produce terbinafine side effects such as insomnia, anxiety, depression, and unusual dreaming.

6. Sensory Side effects

Terbinafine may also cause problems in the senses such as in the vision and taste. Terbinafine have caused double vision and blurred vision in patients taking it possibly due to affectation of the optic nerve. In addition, it also may cause taste problems such as metallic taste in the mouth, dysgeusia or distorted taste, hypogeusia or decreased taste and ageusia or complete loss of taste. Some patients also experienced dry mouth following intake of the drug.

7. Dermatologic Side effects

These terbinafine side effects are commonly seen in topical administration of the drug, rarely, it may also be caused by oral administration. Skin problems may include hives, rash, itching, and Stevens-Johnson syndrome. These may result from allergic reactions that can also be experienced with the use of other drugs such as side effects of citalopram, penicillin and other medications.

Since terbinafine may cause various side effects, it is commonly a prescription drug. Also, report immediately the development of these terbinafine side effects in order to prevent more serious complications such as organ damage. Despite these, terbinafine is still considered a potent antifungal medication that is more effective than other antifungal medications.