Rauwolfia vomitoria (Apocynaceae): A comprehensive insight into its botany, ethnomedicinal uses, pharmacology, phytochemistry, and clinical trials

Rauvolfia vomitoria (Afzel.) is a famous indigenous medicinal plant in Africa and Asia that belongs to the Apocynaceae family. It is extensively used in both traditional and conventional medicine to treat various ailments. The current review provides an up-to-date report on available findings on the botany, geographical distribution, traditional use, pharmacology, phytochemistry, and clinical trials of R. vomitoria. Relevant information on R. vomitoria published from 1955 until March 2025 was collected from several popular databases such as PubMed, Google Scholar, Web of Science, African Journal Online, Scopus, and Semantic Scholar, using a combination of various meaningful keywords. All parts of R. vomitoria are used in traditional medicine in many African countries to treat various human ailments. The plant can be prepared by maceration, decoction, infusion, or powder form. Several in vitro and in vivo studies demonstrated various pharmacological properties of R. vomitoria, including antimicrobial, anticancer, antidiarrheal, aphrodisiac, antidiabetic, cardioprotective, hepatoprotective, anticonvulsant, and antidepressant. Phytochemical investigations identified over a hundred active secondary metabolites from R. vomitoria, including alkaloids, steroids, terpenoids, saponins, and tannins. The bioactive effects of R. vomitoria have been mainly ascribed to its indole alkaloids, such as reserpine, yohimbine, serpentine, reserpiline, and rauvomine. Clinical studies have shown that reserpine is effective in the treatment of chronic psychiatric conditions; it is also an approved cardiovascular medicine with an antihypertensive effect. The present systematic review highlights R. vomitoria as a rich source of naturally active principles for developing new drugs. This exhaustive analysis offers the opportunity to explore the potential of R. vomitoria bioactive compounds as next-generation therapies for various ailments. However, intensive investigations regarding the safety of its bioactive principles and their mechanism of action are needed before their incorporation into therapeutic practices.