Sanguinaria canadensis: Traditional Medicine, Phytochemical Composition, Biological Activities and Current Uses

Int J Mol Sci. 2016 Aug 27;17(9):1414. doi: 10.3390/ijms17091414.


Sanguinaria canadensis, also known as bloodroot, is a traditional medicine used by Native Americans to treat a diverse range of clinical conditions. The plants rhizome contains several alkaloids that individually target multiple molecular processes. These bioactive compounds, mechanistically correlate with the plant's history of ethnobotanical use. Despite their identification over 50 years ago, the alkaloids of S. canadensis have not been developed into successful therapeutic agents. Instead, they have been associated with clinical toxicities ranging from mouthwash induced leukoplakia to cancer salve necrosis and treatment failure. This review explores the historical use of S. canadensis, the molecular actions of the benzophenanthridine and protopin alkaloids it contains, and explores natural alkaloid variation as a possible rationale for the inconsistent efficacy and toxicities encountered by S. canadensis therapies. Current veterinary and medicinal uses of the plant are studied with an assessment of obstacles to the pharmaceutical development of S. canadensis alkaloid based therapeutics.

Keywords: Sanguinaria canadensis; alkaloid; black salve; bloodroot; escharotic; herbal; sanguinarine; skin cancer.

Publication types

  • Review

MeSH terms

  • Alkaloids / chemistry
  • Alkaloids / therapeutic use
  • Animals
  • Antineoplastic Agents / chemistry
  • Antineoplastic Agents / therapeutic use
  • Benzophenanthridines / chemistry
  • Benzophenanthridines / therapeutic use
  • Humans
  • Medicine, Traditional / methods*
  • Phytotherapy / methods
  • Plant Extracts / chemistry
  • Plant Extracts / therapeutic use
  • Sanguinaria / chemistry*


  • Alkaloids
  • Antineoplastic Agents
  • Benzophenanthridines
  • Plant Extracts