Clinical Summary

Graviola, a tree prevalent in the rain forests of Africa, South America, and Southeast Asia, has been used in traditional medicine in many countries.

Extracts of graviola show antiviral (1), antiparasitic, antirheumatic, astringent, emetic (2), antileishmanial and cytotoxic (3) (4), antinociceptive, anti-inflammatory (9), antihyperglycemic (10) and anticancer effects (5)(12) (13) in vitro and in vivo.

Purported Uses

Cancer treatment
Parasitic infections



Quinolines and isoquinolines
Coreximine and reticuline 
(6) (7)  


Mechanism of Action

Annonaceous acetogenins, phytochemicals isolated from the leaves, bark and twigs of graviola, are thought to be the active ingredients. 

The ethanolic extract of Annona muricata was found to inhibit the Herpes simplex virus (1) and effective against Leishmania braziliensis, L. panamensis promastigotes, and the cancer cell line U 937 (3) and hepatoma cell lines (8) in vitro.


Graviola extracts were shown to be lethal to the fresh-water mollusk Biomphalaria glabrata, which acts as a host for the parasitic worm, Schistosoma mansoni (2).

Alkaloids from graviola are detrimental to the survival of dopaminergic nerve cells in vitro. This may result in neuronal dysfunction and degeneration. 
Graviola-induced cell death was inhibited by glucose supplementation suggesting that cell death may have been caused by energy depletion (6).  
Graviola has also been shown to stimulate serotonine receptors (7).

Graviola extracts were effective against the growth of Adriamycin-resistant human mammary adenocarcinoma (MCF-7/Adr) by blocking access of cancer cells to ATP and by inhibiting the actions of plasma membrane glycoprotein (5).

They also inhibited expression of HIF-1α, NF-κB, glucose transporters, and glycolytic enzymes resulting in decreased glucose uptake and ATP production in pancreatic cancer cells (12); and downregulated EGFR expression in another study (13).