Background

• Nicosanâ„¢ is an antisickling drug used for prevention of symptoms and pain management in patients with sickle cell disease (SCD). It is prepared from a mixture of four Nigerian plant materials: the seeds of Piper guineense, the stems of Pterocarpus osun, the fruits of Eugenia caryophyllum, and the leaves of Sorghum bicolor.
• Nicosanâ„¢ was developed at the Nigerian National Institute for Pharmaceutical Research and Development (NIPRD). It had been produced by Xechem International, Inc., an American-based company that filed for bankruptcy. It is unclear when production will resume.
• Although the evidence supporting the use of Nicosanâ„¢ for SCD is promising, it should be noted that most of these studies were carried out by the Nigerian government, which has a vested interest in the drug's success. Further large-scale, randomized, controlled studies need to be performed before conclusions may be drawn.

References

1. Adzu B, Garba M, Haruna A, et al. Effect of niprisan on single oral dose pharmacokinetics of paracetamol in rats. Eur J Drug Metab Pharmacokinet. 2001;26(3):201-204. View Abstract
2. Ataga KI. Novel therapies in sickle cell disease. Hematology Am Soc Hematol Educ Program. 2009:54-61. Review. View Abstract
3. Awodgan AO, Wambebe C, Gamaniel K, et al. Acute and short-term toxicity of NIPRISAN® in rats I: a biochemical study. J Pharm Res Dev 1996;1(1):39-45.
4. Babalola OE, Wambebe CO. When should children and young adults with sickle cell disease be referred for eye assessment? Afr J Med Med Sci 2001;30(4):261-263. View Abstract
5. Cordeiro NJ, Oniyangi O. Phytomedicines (medicines derived from plants) for sickle cell disease. Cochrane Database Syst Rev 2004;(3):CD004448. View Abstract
6. Gamaniel K, Amos A, Akah PA, et al. Pharmacological Profile of NIPRD 94/002/1-0: A Novel Herbal Antisickling Agent. Journal of Pharmaceutical Research 1998;3(2):39-45.
7. Fawibe AE. Managing acute chest syndrome of sickle cell disease in an African setting. Trans R Soc Trop Med Hyg 2008;102(6):526-531. View Abstract
8. Iyamu EW, Turner EA, Asakura T. Niprisan (Nix-0699) improves the survival rates of transgenic sickle cell mice under acute severe hypoxic conditions. Br J Haematol 2003;122(6):1001-1008. View Abstract
9. Iyamu EW, Turner EA, Asakura T. In vitro effects of NIPRISAN (Nix-0699): a naturally occurring, potent antisickling agent. Br J Haematol 2002;118(1):337-343. View Abstract
10. Okpala, I. Investigational agents for sickle cell disease. Expert Opin Investig Drugs 2006;15(8):833-842. View Abstract
11. Wambebe CO, Bamgboye EA, Badru BO, et al. Efficacy of niprisan in the prophylactic management of patients with sickle cell disease. Current Therapeutic Research, Clinical & Experimental 2001;62(1):26-34.
12. Wambebe C, Khamofu H, Momoh JA, et al. Double-blind, placebo-controlled, randomised cross-over clinical trial of NIPRISAN in patients with Sickle Cell Disorder. Phytomedicine 2001;8(4):252-261. View Abstract