YUNNAN BAIYAO

Yunnan Baiyao is a proprietary Chinese formula marketed as having medicinal properties. Proprietary is a fancy word for secret.  This is not in and of itself bad. Think Coca Cola®. However, this famous beverage does make broad therapeutic claims, so knowledge of its ingredients is not critical to public health.

Although the formula is heavily guarded by the state run Yunnan Baiyao manufacturer in the Yunnan province of China, Yunnan Baiyao is thought to be a combination of mostly plant derived ingredients including notoginseng, Chinese yam root and progesterone, just to name a few suspected ingredients. 

Yunnan Baiyao has been used for over 100 years in China and eastern Asia. It became widely known to Americans during the Vietnam War when we discovered that Vietnamese soldiers carried the product on their person and used it to stop or slow bleeding after being wounded in battle.

There have been a few promising studies in human medicine to support it’s use in the preoperative period to reduce the need for blood products during surgery and to aid in the treatment of ulcerative disease (e.g. ulcerative colitis). 1,2,3,4 As it is the case in most areas of medicine, there have been studies to show no efficacy as well.

Adverse reactions seem to be very rare in people but can include nausea, vomiting, diarrhea, stomach discomfort, gastro-esophageal reflux and rash. 5

In veterinary medicine Yunnan Baiyao has been shown to increase blood coagulation in 8 healthy research beagle dogs, and 18 client-owned, healthy dogs of various breeds that weighed less than 30 pounds.6,7 In clinical practice however, we do not use Yunnan Baiyao in healthy dogs nor do we often find ourselves treating dogs wounded in battle. 

Instead, Yunnan Baiyao is often employed to decrease the frequency and severity of bleeding episodes associated with several types of canine cancers; but most often with a type of cancer called hemangiosarcoma. We admittedly do this with little to no data to support efficacy in this specific group of patients. In fact, there is one published report of the use of Yunnan Baiyao in dogs with right atrial masses (presumed, but not known, to be hemangiosarcoma) and pericardial effusion in which the treated dogs did not seem to benefit compared to the control population.8

So why do we still sometimes suggest it’s use?  Great question. It’s probably because, like you, we want to do everything we can for our patients – especially those with terminal cancer. And in this case there is a small amount of evidence to suggest it may help with coagulation in healthy dogs and it appears to be safe even for dogs with cancer. However, due to a lack of evidence of it’s efficacy specifically for dogs with cancer, if you find yourself forcing your pet to take this pill, we do not recommend continuing.  

  1. Tang, Z.-L., et al. Effects of the preoperative administration of Yunnan Baiyao capsules on the intraoperative blood loss in bimaxillary orthognathic surgery: A prospective, randomized, double-blind, placebo-controlled study. Int J Oral Maxillofac Surg. 2009; 38(3) 261-266.
  2. LI, NC., et al. The effect of Yunnan Baiyao on reduction of intra-operative bleeding of the patients undergoing transurethral resection of prostate. Zhonghua Yi Xue Za Zhi.  2007; 87(15): 1017-1020.
  3. Pan, SF., et al. Effects of Yunnan Baiyao on peri-operative bleeding of patients undergoing cervical open-door laminoplasty: a multi-center randomized double-blind placebo-control trial. Zhonghua Yi Xue Za Zhi.  2006; 86(27): 1888-1890.
  4. Yang, B., et al. The efficacy of Yunnan Baiyao on haemostasis and antiulcer: a systematic review and meta-analysis of randomized controlled trials. Int J Clin Exp Med.  2004; 7(3): 461-482. 
  5. Li, B., et al. Adverse drug reactions of Yunnan Baiyao capsule: a multi-center intensive monitoring study in China. Ann Transl Med.  2019; 7(6): 118-129.
  6. Frederick, J., et al. The effects of oral administration of Yunnan Baiyao on blood coagulation in beagle dogs as measured by kaolin-activated thromboelastography and buccal mucosal bleeding time. Can J Vet Res.  2017; 81(1): 41-45.
  7. Tansey, C., et al. A prospective evaluation of oral Yunnan Baiyao therapy on thromboleastographic parameters in apparently healthy dogs. J Vet Emerg and Crit Care. 2018; 28(3): 221-225.
  8. Murphy, L.A., et al. Use of Yunnan Baiyao and epsilon aminocaproic acid in dogs with right atrial masses and pericardial effusion.  J Vet Emerg and Crit Care. 2017; 27(1): 121-126.

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