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Bloodroot (Sanguinaria canadensis)

Bloodroot (Sanguinaria canadensis) Image
Synonyms / Common Names / Related Terms
Alkaloids, B. homochelidonine, benzylisoquinoline alkaloids, berbine, blood root, chelerythrine, chelilutine, chelirubine, coon root, Papaveraceae (family), paucon, pauson, protopine, pseudochelerythrine, puccoon, puccoon-root, red Indian paint, red puccoon, red resin, red root, redroot, SaE, Sangrovit®, sanguilutine, Sanguinaria canadensis, sanguinaria dentifrice, sanguinaria extract, sanguinarin, sanguinarine, sanguinarine chloride, sanguinarine hydroxide, sanguinarine nitrate, sanguinarine sulfate, sanguinarium, sanguiritrin, sanguirubine, sangvinarin, snakebite, sweet slumber, tetterwort, white puccoon.

Combination products (examples): Veadent® (sanguinarine, zinc), Viadent® (sanguinarine, zinc).

Note: This monograph also discusses sanguinarine, an alkaloid of bloodroot, which is also found in other plants such as Mexican prickly poppy (Argemone mexicana), Chelidonium majus, and Macleaya cordata. However, Mexican sanguinaria extract (Polygonum aviculare L.) is not included, as it is not known to contain sanguinarine or other major constituents of bloodroot.

Mechanism of Action


  • Constituents: Bloodroot (Sanguinaria canadensis) contains several alkaloids, primarily in the rhizome; the major alkaloids include sanguinarine, chelerythrine, chelirubine, sanguirubine, chelilutine, the opium alkaloid protopine, and sanguilutine.1,7,2 The rhizomes contain approximately 3-7% total alkaloid. The chief benzylisoquinoline alkaloid is sanguinarine, which is attributed with most of bloodroot's antibacterial and anti-inflammatory properties.8 The root also contains red resin and a large quantity of starch.
  • Anti- H. pylori effects: In an in vitro study, methanol extracts of Sanguinaria canadensis rhizomes inhibited the growth of Helicobacter pylori, with a MIC50 range of 12.5-50.0mcg/mL.1 Protopine also inhibited the growth of the bacterium, with a MIC50 of 100mcg/mL.
  • Antimicrobial effects: Sanguinarine has demonstrated antibacterial activity against both Gram-positive and Gram-negative bacteria, antifungal activity against Candida and dermatophytes, and antiprotozoal against Trichomonas.3,4,5,6 The proposed antibacterial mechanism of action is sanguinarine's ability to react with nucleophiles.9 Sanguinarine may also kill animal cells by blocking the action of Na+/K+-ATPase transmembrane proteins. There is particular interest in sanguinarium's effects on oral bacterial and fungal populations.10,11 In a clinical split-mouth study, a seven day treatment with 5% sanguinarium led to significant microbiota changes, such as decreases in antibiotic-resistant bacteria and yeast in periodontal sites as well as in the saliva.12 The reduction in bacteria may be due to sanguinarine's inhibition of bacterial adherence and plaque formation, as it induces bacteria to aggregate and become morphologically irregular in vitro.8,13,11
  • Antimycobacterial activity: In an in vitro screening, sanguinarine and chelerythrine from the roots of Sanguinaria canadensis inhibited Mycobacterium aurum and Mycobacterium smegmatis.2 Of the two, chelerythrine was more active with IC50=29.0mcg/mL (75.56mcM), while sanguinarine's IC50=7.30mcg/mL (19.02mcM).


  • For most species of plaque bacteria, sanguinarine's minimum inhibitory concentration (MIC) is between 1 and 32mcg/mL.8
  • Metabolism: CYP80B1 may be involved in the metabolism of sanguinarine.


  1. Mahady, G. B., Pendland, S. L., Stoia, A., and Chadwick, L. R. In vitro susceptibility of Helicobacter pylori to isoquinoline alkaloids from Sanguinaria canadensis and Hydrastis canadensis. Phytother Res  2003;17(3):217-221. 12672149
  2. Newton, S. M., Lau, C., Gurcha, S. S., Besra, G. S., and Wright, C. W. The evaluation of forty-three plant species for in vitro antimycobacterial activities; isolation of active constituents from Psoralea corylifolia and Sanguinaria canadensis. J Ethnopharmacol  2002;79(1):57-67. 11744296
  3. Vichkanova, S. A., Rubinchik, M. A., Adgina, V. V., and Fedorchenko, T. S. A study of the chemotherapeutic action of Sanguinarine. Farmakol Toksokol (Moscow) 1969;32:325-328.
  4. Vichkanova, S. A. and Adgina, V. V. The antifungal properties of Sanguinarine. Antibiotiki (Moscow) 1971;16:609-612.
  5. Stickl, O. Die bactericide wirkung der extrakte und alkaloide des schollkrautes auf grampositive pathogene mikroorganisme. Z Hyg infektionskr 1928;108:801-867.
  6. JOHNSON, C. C., JOHNSON, G., and POE, C. F. Toxicity of alkaloids to certain bacteria. II. Berberine, physostigmine, and sanguinarine. Acta Pharmacol Toxicol (Copenh) 1952;8(1):71-78. 14933116
  7. Harkrader, R. J., Reinhart, P. C., Rogers, J. A., Jones, R. R., Wylie, R. E., Lowe, B. K., and McEvoy, R. M. The history, chemistry and pharmacokinetics of Sanguinaria extract. J Can Dent Assoc  1990;56(7 Suppl):7-12. 2207856
  8. Godowski, K. C. Antimicrobial action of sanguinarine. J Clin Dent  1989;1(4):96-101. 2700895
  9. Vichkanova, S. A. and Tolkachev, O. N. Dependence of antimicrobial activity on the structure and reactivity of natural quaternary heteroaromatic compounds and their analogues. Farmatsiya (Mosc) 1978;27:38.
  10. Walker, C. Effects of sanguinarine and Sanguinaria extract on the microbiota associated with the oral cavity. J Can Dent Assoc  1990;56(7 Suppl):13-30. 2207850
  11. Babu, J. P., Waring, M. B., Lyne, S. M., and Dabbous, M. K. Antiplaque activity of a sanguinaria-containing oral rinse: an in vitro study. Compend Contin Educ Dent  1986;Suppl 7:S209-S211. 3459627
  12. Godowski, K. C., Wolff, E. D., Thompson, D. M., Housley, C. J., Polson, A. M., Dunn, R. L., Duke, S. P., Stoller, N. H., and Southard, G. L. Whole mouth microbiota effects following subgingival delivery of sanguinarium. J Periodontol  1995;66(10):870-877. 8537870
  13. Rau, I. and Bossmann, K. [Effects of dequalinium chloride and sanguinarine on the ultrastructure of early supragingival plaque]. Oralprophylaxe  1991;13(4):133-141. 1818603

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