Betel Nut

Scientific Name(s): Areca catechu L.
Common Name(s): Areca nut, Betel nut, Paan, Paan-gutkha pinlang, Pinang, Supari

Medically reviewed by Drugs.com. Last updated on Jan 31, 2022.

Clinical Overview

Use

Limited clinical applications exist, and long-term adverse reactions to betel quid chewing are well documented. A decrease in positive symptoms among men with schizophrenia was attributed to betel nut consumption.

Dosing

Limited clinical trials exist to guide dosage; limited clinical applications exist.

Contraindications

None well documented.

Pregnancy/Lactation

Documented adverse reactions, including teratogenic and fetotoxic effects. Avoid use.

Interactions

None well documented.

Adverse Reactions

Betel nut prevalence data strongly associates consumption with the incidence of metabolic syndrome.

Toxicology

Areca nut and the betel leaf have demonstrated mutagenic, carcinogenic, and genotoxic properties in in vitro and animal experiments. Prevalence studies show a dose- and duration-dependent association of betel quid chewing with precancerous oral submucous fibrosis and oral, pharyngeal, laryngeal, and esophageal cancer.

Scientific Family

• Palmaceae (palms)

Botany

The areca tree is a tropical, feathery palm that grows to approximately 15 m in height and bears fruit year round. It is widely cultivated in tropical India, Bangladesh, Japan, Sri Lanka, south China, the East Indies, the Philippines, and parts of Africa. The nut is approximately 2.5 cm in length and may be used fresh, dried, or cured by boiling, baking, or roasting.1, 2 The quid is a mixture of areca nut, tobacco, and lime wrapped in the leaf of the betel vine (Piper betel L. Family: Piperaceae).

History

The chewing of betel nut quids dates to antiquity. In the 1st century AD, Sanskrit medical writings claimed that betel nut possessed 13 qualities found in the region of heaven. It is pungent, bitter, spicy, sweet, salty, and astringent. It expels wind, kills worms, removes phlegm, subdues bad odors, beautifies the mouth, induces purification, and is said to kindle passion.3

Because of its mild CNS-stimulating effects, betel nut is used in a manner similar to the western use of tobacco or caffeine.4 Arecoline is thought to be responsible for some of the claimed effects of betel quid chewing, such as alertness, increased stamina, a sense of well-being, euphoria, and salivation.5

Chewing the nut stimulates salivary flow, thereby aiding digestion. Betel nut also has been used as an appetite stimulant.2

Extracts of the nut have been used for the management of glaucoma in traditional medicine.6 Arecoline is a basic oily liquid that has been used in veterinary medicine as a cathartic (for horses) and a vermifuge.

Chemistry

The medicinal components are primarily associated with the nut and betel quid. The nuts contain at least 9 structurally related pyridine alkaloids, including arecoline, arecaidine, arecaine, arecolidine, guvacine, isoguvacine, guvacoline, and coniine. However, the most common is the parasympathetic stimulant alkaloid arecoline. The total alkaloid content can reach 0.45%.2, 4, 7, 8

The methyl esters of arecoline and guvacoline are hydrolyzed in the presence of alkali to the respective acids, arecaidine and guvacine. The hydrolysis is catalyzed by lime, wh...