Avoid in individuals with a known allergy or hypersensitivity to muira puama (Ptychopetalum olacoides), any of its constituents, or any related members of the Olacaceae family.

Muira puama is generally considered by experts to be a safe herb, and no serious adverse effects have been reported in the available scientific literature.

Muira puama may raise blood pressure and CNS (central nervous system) stimulation, which may alter blood pressure, heart functions, and CNS effects on heart tissue. Muira puama may also have proposed testosterone-like proprieties, which may cause anabolic side effects, such as increases in energy, aggression, or appetite, changes in voice, or enlargement of genitalia.

Use cautiously in patients taking steroidal drug therapy or in patients with hormone-sensitive conditions (e.g., breast cancer, endometriosis, ovarian cancer, prostate cancer).

Use cautiously in patients with hypertension (high blood pressure) or cardiac disease, as muira puama may exacerbate these conditions.

Use cautiously in patients taking CNS-acting medications, as muira puama may stimulate the CNS.

Avoid use during pregnancy due to reported idiosyncratic motor/sacral stimulant properties. Muira puama is not recommended in breastfeeding women due to a lack of available scientific data.

There is no proven effective dose for muira puama. However, for erectile dysfunction, up to 2,580 milligrams of Herbal vY® daily for two weeks has been used with minimal side effects.

There is no proven effective dose for muira puama in children.

Although not well studied in humans, cross-tolerance with opioids may occur. Caution is advised when taking muira puama with other pain relieving (analgesic) agents.

Due to coumarin constituents of muira puama, actions of warfarin, other anticoagulant and anti-platelet drugs may be potentiated. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Muira puama may increase blood pressure and central nervous system (CNS) stimulation, which may alter blood pressure, cardiac functions and CNS effects on cardiac tissue.

The combined use of muira puama with monoamine oxidase inhibitors (MAOIs) may potentiate the potential risk for hypertensive crisis.

Due to serotonergic effects of muira puama, actions of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may be altered.

Due to proposed testosterone-like effects as well as positive or negative estrogenic effects, use of muira puama with testosterone or estrogen may result in additive or diminished effects.

Combination use with sympathomimetics may lead to potentiation of sympathomimetic effects.

Although not well studied in humans, cross-tolerance with opioids may occur. Caution is advised when taking muira puama with other pain relieving (analgesic) herbs or supplements.

Due to coumarin constituents of muira puama, actions of anticoagulants and anti-platelets may be altered. Caution is advised in patients with bleeding disorders or taking herbs or supplements that may increase the risk of bleeding. Dosing adjustments may be necessary.

Due to proposed serotonergic effects of muira puama, actions of antidepressant herbs may be altered.

Muira puama may increase blood pressure and central nervous system (CNS) stimulation, which may alter blood pressure, cardiac functions and CNS effects on cardiac tissue.

The combined use of muira puama with monoamine oxidase inhibitors (MAOIs) may potentiate the potential risk for hypertensive crisis.

Due to proposed testosterone-like effects of muira puama as well as positive or negative estrogenic effects, use of muira puama with testosterone or estrogen-like herbs may result in additive or diminished effects.

Combination of muira puama with stimulant herbs may lead to potentiation of sympathomimetic effects.

Hydroalcoholic extract of muira puama may potentiate yohimbine-induced toxicity