Therapeutic potentials of reserpine formulations: Recent progress and challenges

Reserpine is an indole alkaloid related to the class of rauwolfia alkaloids used as an alternative drug to manage and treat high blood pressure (hypertension) via acting as an adrenergic uptake inhibitor. Moreover, severe agitation in patients with mental disorders can be treated by this metabolite. Reserpine can slow down the heartbeat and relax the blood vessels. Reserpine can hinder planktonic and biofilm forms of bacteria. Reserpine can block Gram-positive bacterial and mammalian efflux. This alkaloid leads to apoptosis and cell cycle arrest through inhibition of DNA ladder formation, DNA synthesis, an increase in calcium influx, and destabilization of mitochondrial membrane potential. The clinical utility of reserpine is limited due to its neurotoxicity. Low bioavailability and adverse side effects have been reported for this bioactive compound. Therefore, looking for novel strategies for loading and encapsulation of reserpine is needed. This mini-review has tried to present the results of new investigations to finding effective formulations of reserpine in monotherapy and combination therapy.