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(718) 218-4791info@briyahealth.comA plain-language guide to Sarapin (pitcher plant) injections for nerve and muscle pain: what they are, how they are used, what the research shows, FDA status, safety, insurance and alternatives.
Medically reviewed by Jonathan Paul Navar, MD, and David Kotlarsky, PA-C, with the Briya Health medical team.
A Sarapin injection is a shot of a liquid distilled from the purple pitcher plant (Sarracenia purpurea). Clinicians inject it near painful nerves or into sore muscles to try to ease nerve or muscle pain. It is usually mixed with a local anesthetic such as lidocaine or bupivacaine.
It is made from the purple pitcher plant, a carnivorous bog plant native to North America. The plant is distilled, and the soluble parts of the vapor are made into a sterile solution. The original product contained 0.75% benzyl alcohol as a preservative.
No. Sarapin contains no corticosteroid. That is why some clinics offer it as a "steroid-free" option. Avoiding steroid side effects is a real advantage. Whether Sarapin itself adds pain relief has not yet been shown in controlled studies.
Sarapin is not an opioid and is not a controlled substance. It is also not a standard numbing medicine. Two studies in horses found it had no numbing (local anesthetic) effect on nerves. Any numbness after a Sarapin injection usually comes from the lidocaine or bupivacaine mixed with it.
No one knows for sure. Old company materials claimed it blocks the small nerve fibers that carry dull, burning pain while sparing the fibers that control movement and touch. That claim rests on a single 1940 animal experiment and has not been confirmed by independent modern research. A 1997 horse study concluded that the way Sarapin might relieve pain is unknown.
The old label listed nerve-related pain: sciatica, intercostal (rib) neuralgia, occipital neuritis (nerve pain at the back of the head), trigeminal neuralgia, lumbar and brachial plexus neuralgia, meralgia paresthetica (thigh numbness and burning) and alcohol-related nerve pain. Clinics also use it for trigger points and back and neck pain. None of these uses has strong evidence.
The evidence is limited. Many patients in published studies improved after nerve blocks that included Sarapin, and some patients and clinicians report good results. However, when researchers compared the same blocks with and without Sarapin, including a double-blind study of 500 patients and 828 treatments and two later randomized trials, they did not find a measurable added benefit. More independent research is needed.
It has not been shown to be better. In Dr. Laxmaiah Manchikanti's facet joint trials, patients who got Sarapin and patients who got steroids had similar results, and Sarapin avoids steroid side effects. However, every group also got a numbing medicine and there was no placebo group, so these trials cannot show how much either Sarapin or the steroid added on its own.
There is no reliable answer. Clinics often say relief lasts days to weeks, and patients report a wide range. Studies have not separated Sarapin's effect from the numbing medicine it is mixed with, so there is no research-based figure for Sarapin alone.
Any quick relief after the injection usually comes from the local anesthetic mixed in, which starts working within minutes. There is no published data showing a separate onset time for Sarapin.
There are no good studies showing Sarapin helps sciatica. One small 2001 study of caudal (tailbone-area) epidural injections in chronic low back pain reported improvement in patients given a local anesthetic with either Sarapin or a steroid, but it had no placebo group and its comparison group was not randomly assigned.
There are no good trials of Sarapin for trigger points. In general, research on trigger point injections finds that no injected drug, including steroids and botulinum toxin, works better than another, and that saline (salt water) often works as well. Stretching, massage and physical therapy are recommended first.
There is no evidence-based schedule. Clinics often suggest a series of injections, but no study has shown that a series of Sarapin injections works better than numbing medicine alone. Ask your clinician what goal you are aiming for and when you would stop if it is not helping.
It appears to have few reported side effects, but its safety has never been formally reviewed by FDA. The old label reported a brief feeling of heaviness, warmth or a short flare of pain at the injection site. Any injection near nerves also carries risks such as bleeding, infection and nerve injury. FDA has also found manufacturing and testing problems with both the original and current makers.
The original label listed temporary heaviness, a feeling of heat, or a brief worsening of symptoms, and advised lying down for 10 to 15 minutes afterward. Other possible problems come from the injection itself, such as soreness, bruising, infection or an allergic reaction. Seek care right away for hives, swelling of the face or throat, or trouble breathing.
Sarapin should not be injected into an infected or inflamed area. People who are allergic to the pitcher plant or to benzyl alcohol should avoid it. Because there is not enough safety information, people who are pregnant or breastfeeding are advised to avoid it. Tell your clinician about blood thinners, bleeding problems, diabetes, and any implanted devices before any injection.
There is not enough information to know if it is safe. WebMD's natural medicines reference advises avoiding pitcher plant products during pregnancy and breastfeeding. The original product also contained benzyl alcohol, which has been linked to a serious reaction in newborns at high doses.
There are no studies of Sarapin in people with diabetes. Sarapin does not contain a steroid, and steroid injections are known to raise blood sugar for a short time. That difference is real, but it does not prove Sarapin is safe or effective. Anyone with diabetes should follow their clinician's advice about injections and infection risk.
In practice it is usually mixed with a local anesthetic, and some clinicians add a steroid. There are no formal drug interaction studies. Tell your clinician about every medicine and supplement you take, especially blood thinners.
No study has set a safe limit. Some clinics say there is "no limit," but that claim is not based on research. Each injection still carries risks from the needle, and there is no proven benefit from repeating them.
Not necessarily. The National Center for Complementary and Integrative Health notes that "natural" does not always mean safe. A plant product injected into the body is a drug, and its safety depends on testing, quality control and evidence, which are limited for Sarapin.
The needle stick and the injection usually cause brief discomfort, similar to other injections. The original label noted that some people feel heaviness, warmth or a short increase in pain afterward. A local anesthetic is often mixed in to reduce discomfort.
No. Sarapin has never been approved by FDA. The original product was listed as an "unapproved drug," and the current maker states its product "has not been reviewed by the FDA for safety or efficacy." Many clinic websites wrongly call it FDA-approved.
Sarapin was first sold in 1935, and FDA has allowed some older unapproved drugs to stay on the market while it focuses enforcement on higher-risk products. Today's version is made by a compounding company that sells it to licensed clinicians. FDA still inspects these makers. In January 2026, FDA recorded seven problems at the current maker, including batches released without required testing.
Some sources say so, but we could not find any FDA document confirming that Sarapin has grandfathered status. The FDA records that do exist list it as an unapproved drug and describe manufacturing violations.
Usually not. Aetna's medical policy lists "Sarapin injections" as experimental, investigational or unproven. UnitedHealthcare and Aetna also treat Sarapin used in prolotherapy as unproven. A Medicare contractor rejected a request to cover Sarapin for trigger point injections, saying botanical-only injections are not supported by peer-reviewed research. Check with your plan before treatment.
There is no reliable public price. Costs depend on the clinic, the type of injection, whether imaging guidance is used and the office visit fee. Because insurance usually does not cover Sarapin, ask for a written cash price for the whole visit before treatment.
Sarapin is given by some pain management practices, chiropractic and integrative clinics, sports medicine clinics and veterinarians. Whoever gives it should be a licensed clinician working within their state's scope of practice who can explain the evidence and risks honestly.
Yes. Some veterinarians inject it for back pain and other pain in horses. Two small controlled horse studies, in 1997 and 2023, did not find a measurable pain-blocking effect when it was given as a nerve block.
Rules vary by organization and change often. The U.S. Equestrian Federation bans any drug that might affect performance and warns that herbal products can cause positive tests. A 2013 Daily Racing Form report described a veterinarian who received a 90-day suspension for illegally giving Sarapin to a horse on race day at Tampa Bay Downs. Check the current rules of your governing body.
It is not named on the 2026 World Anti-Doping Agency (WADA) Prohibited List. However, WADA's "non-approved substances" category bans any drug not covered elsewhere on the List that has no current government approval for human therapeutic use. Athletes should check with their anti-doping organization before any injection.
No. Even clinics that use Sarapin present it as a way to ease pain, not a cure. Long-term improvement in back, neck and muscle pain usually depends on finding the cause and using proven treatments such as exercise, physical therapy and, when needed, other medical care.
For most chronic back, neck and muscle pain, guidelines recommend starting with non-drug treatments: exercise, physical therapy, heat, massage, yoga, tai chi, acupuncture, spinal manipulation and cognitive behavioral therapy. The CDC also recommends non-opioid treatments first for most chronic pain.
Get care right away if back pain comes with loss of bladder or bowel control, numbness in the groin or inner thighs, new leg weakness, fever, a history of cancer, or pain after a serious fall or injury. These can be signs of a condition that needs urgent treatment, not an injection.
Sarapin is an injectable product made from the purple pitcher plant (Sarracenia purpurea). Some clinics inject it near nerves or into sore muscles to treat nerve-related and muscle pain, often as an alternative to steroid shots. It has been sold in the United States since 1935, but it has never been approved by the U.S. Food and Drug Administration (FDA).
Sarapin is a brand name for an injectable solution made from the purple pitcher plant, Sarracenia purpurea. The pitcher plant is a carnivorous plant that grows in bogs in eastern North America, the Great Lakes region and Canada. Its leaves form a tube that fills with water and traps insects.
The original product label described Sarapin as "a sterile aqueous solution of soluble salts of the volatile bases from Sarraceniaceae (Pitcher Plant)" with 0.75% benzyl alcohol as a preservative. In plain terms, the plant is distilled, and the liquid that comes off is made into an injection.
Clinics still call these products "Sarapin," but the product a patient receives today may not be the same as the one used in older studies.
Sarapin is given only by injection, by a licensed clinician. It is rarely used alone. Most often it is mixed with a local anesthetic, and sometimes with a steroid, and given in one of these ways:
A typical visit includes a medical history, an exam to find the painful area, cleaning the skin and the injection itself. Injections near the spine are often guided by X-ray (fluoroscopy) or ultrasound. The original Sarapin label advised keeping the patient lying down for 10 to 15 minutes after the injection. Many clinics schedule a series of injections over several weeks. There is no published research showing that any particular schedule works best.
The original High Chemical Company label listed these uses for "pain of neuralgic origin" (nerve pain):
These were the maker's claims. FDA never reviewed evidence for them.
The way Sarapin might relieve pain has never been established.
The pitcher plant had a long history in folk medicine. Indigenous peoples in eastern Canada used it, and in the 1800s it was promoted as a treatment for smallpox. Sarapin as an injection came later. FDA's drug listing shows the product was first marketed in the United States on January 31, 1935.
In the 1940s, physicians William Bates and Bernard Judovich published papers on treating stubborn nerve pain, and in 1944 the book Segmental Neuralgia in Painful Syndromes. A 2012 review cites their early papers as the first reports that Sarapin relieved pain of nerve origin, more than 70 years ago.
Sarapin is still offered by some pain management, chiropractic, integrative and veterinary practices, often for patients who want to avoid or limit steroid injections. Reviews and insurers generally describe the evidence as insufficient, and opinions among clinicians differ.
Sarapin has never been approved by FDA. FDA's drug listing for the original product used the category "unapproved drug other." The company that now makes the injection states on its website that its product "has not been reviewed by the FDA for safety or efficacy."
FDA explains that unapproved drugs "have not been reviewed by FDA for safety, effectiveness or quality." FDA uses a risk-based approach to these products and has removed many potentially unsafe unapproved drugs from the market since 2006. Being on the market for a long time is not the same as being approved.
Some websites say Sarapin is "grandfathered" because it was sold before modern drug laws. We found no FDA document that says Sarapin has grandfathered status. Treat that claim as unconfirmed.
On July 2, 2019, FDA sent a warning letter to High Chemical Company about its Sarracenia purpurea (Sarapin) distillate, which it sold to compounding pharmacies to make "Sarapin for Injection." FDA found that the company did not test each batch for strength, pesticides or heavy metals, had no stability data to support its 2-year expiration date, and called the ingredient adulterated. The company told FDA it would close by May 31, 2019.
From January 5 to 14, 2026, FDA inspected US Specialty Formulations LLC in Allentown, Pennsylvania, which makes "Sarracenia Purpurea 0.17 g/mL for Injection." FDA's inspection report (Form 483) lists seven observations, including:
A Form 483 lists an inspector's observations. It is not a final FDA ruling, but these findings matter for an injected product, where sterility and consistent strength are important for safety.
The current maker describes its product as made under Section 503B of the federal Food, Drug, and Cosmetic Act, which covers "outsourcing facilities" that compound drugs for clinics. We could not find Sarracenia purpurea on FDA's published lists of bulk substances nominated for use by these facilities. Compounded drugs are not FDA-approved, and FDA does not verify their safety or effectiveness before they are sold.
Health Canada's drug database lists Sarapin (DIN 00226882) as first marketed in 1942 and "cancelled post market" on April 30, 2019.
What patients and clinicians report. Many patients and clinicians who use Sarapin say it helps, especially for nerve-related pain and for people who want to avoid steroids. Some practices have used it for decades. These experiences are real and are one reason the treatment is still offered. They are different from controlled research, though, because pain naturally changes over time, injections are usually combined with a numbing medicine, and expectations can affect how pain feels. Controlled studies are designed to separate these effects.
The published studies. Almost all published human research on Sarapin comes from one research group, led by Dr. Laxmaiah Manchikanti at a pain management center in Kentucky, published between 2001 and 2010. In these studies, Sarapin was added to some nerve blocks and not others.
In 2004, the journal Pain Physician published "A double-blind, controlled evaluation of the value of Sarapin in neural blockade."
This is the most direct test so far of whether Sarapin adds to a nerve block, and it did not find a measurable difference.
A 2001 study compared caudal epidural injections of a local anesthetic plus Sarapin with a local anesthetic plus the steroid betamethasone, and a group treated without injections. Both injection groups improved. However, the comparison group was a "convenience" sample rather than randomly assigned, the reported number of patients does not add up in the abstract (65 vs 70), and there was no placebo group.
The research on Sarapin is limited and mostly comes from one research group. Patients in these studies did improve, but the studies were not designed to show how much of that came from Sarapin itself, and direct comparisons with and without Sarapin did not find a measurable difference. Studies in horses also did not find a pain-blocking effect. Larger, independent, placebo-controlled studies would be needed to settle the question.
The label advised keeping the patient lying down for 10 to 15 minutes after the injection. It also stated that Sarapin was non-toxic and had no side effects other than these. Those statements were the maker's own claims, and they were never reviewed by FDA.
Any injection carries risks, no matter what is injected:
The original product contained 0.75% benzyl alcohol as a preservative. In newborns and low-birth-weight infants, large amounts of benzyl alcohol (more than 99 mg/kg per day) have been linked to "gasping syndrome," a serious and sometimes fatal reaction. This risk applies to infants, not to typical adult injection doses, but it is one reason pregnancy and breastfeeding call for caution.
FDA has found quality problems with both makers of Sarapin: missing batch testing and stability data at the original maker in 2019, and batches released without strength and impurity testing, plus sterility process gaps, at the current maker in 2026. For any injected product, sterility and consistent strength are basic safety requirements.
Call your clinician or seek urgent care for fever, spreading redness, warmth or pus at the injection site, new weakness or numbness that does not go away, a severe headache, chest pain or shortness of breath, or signs of an allergic reaction such as hives, swelling of the lips or throat, or trouble breathing.
Local anesthetics such as lidocaine and bupivacaine temporarily block nerve signals. They are used alone for diagnostic nerve blocks, which help find the source of pain, and as part of most therapeutic injections. If a diagnostic block does not give significant relief, a longer-lasting treatment such as radiofrequency ablation of that nerve is less likely to help. Rare but serious reactions can happen if too much reaches the bloodstream.
Steroid injections reduce inflammation and can relieve pain for weeks to months. Known risks include:
Because risks rise with larger doses and more frequent use, the number of steroid shots is usually limited. Cleveland Clinic advises waiting at least three months between rounds and says most people should not have more than three shots a year. Harvard Health notes that for back pain, the benefit of steroid injections is small to none on average.
In 2014, FDA required warnings on injectable steroids about rare but serious problems after injection into the epidural space of the spine, including loss of vision, stroke, paralysis and death. FDA noted that steroids are not approved for epidural use.
Many patients and clinicians choose Sarapin to avoid these steroid risks. Avoiding steroid side effects is a real advantage. The open question is how much pain relief Sarapin itself adds, which research has not yet shown.
A 2023 review in American Family Physician concluded that routine use of trigger point injections is not supported by clinical trials. No injected drug or mixture has been shown to work better than another, and saline worked as well as drug mixtures in several trials. The review recommends massage and physical therapy first, and injections only when those fail.
Dry needling places a thin needle into a trigger point without injecting any medicine. Studies of dry needling have a high risk of bias, so its benefit is uncertain.
For pain confirmed to come from the facet joints of the spine, radiofrequency ablation uses heat to disrupt the small nerves that carry pain signals. It is usually considered only after diagnostic nerve blocks give significant short-term relief.
Most of the conditions Sarapin is marketed for, such as low back pain, neck pain and muscle pain, have treatments with much stronger evidence.
The American College of Physicians' 2017 guideline recommends starting with non-drug treatments, including:
The National Center for Complementary and Integrative Health reports that yoga gives small to moderate improvements in function, acupuncture has a moderate benefit for chronic low back pain, and spinal manipulation and mobilization are likely to reduce pain and improve function.
Stretching, massage, heat, physical therapy and exercise are first-line treatments for myofascial pain. Myofascial pain usually affects one area or one side of the body. Widespread pain with fatigue and poor sleep may point to fibromyalgia, which is treated differently.
The CDC's 2022 clinical practice guideline states that non-opioid therapies are preferred for subacute and chronic pain, and that clinicians should make the most of non-drug and non-opioid treatments.
In practice, most people pay for Sarapin out of pocket. Always check with your plan and get a written estimate first.
There is no reliable public price for Sarapin injections. Total cost depends on the clinic, the number of injection sites, whether imaging guidance is used and the visit fee. Because a series of injections is often recommended, ask for the total cost of the whole plan, not just one visit.
Some equine veterinarians use Sarapin, often for back pain in sport horses. A product called Sarapin is still marketed for horses outside the United States. As described above, controlled horse studies in 1997 and 2023 found no pain-relieving effect.
The purple pitcher plant has been studied for reasons unrelated to pain:
Do not wait for an injection appointment if back or neck pain comes with:
Some of these can be signs of cauda equina syndrome or another serious condition that needs care right away.
Sarapin is a pitcher plant extract that has been injected for nerve and muscle pain since 1935. It is not a steroid, not an opioid and not FDA-approved. Some patients and clinicians report relief and value it as a steroid-free option, but research is limited, and controlled comparisons have not yet shown a measurable benefit beyond the numbing medicine it is usually mixed with. FDA has documented manufacturing and testing problems with both the original and the current makers, and major insurers consider it experimental.
If you are considering Sarapin, talk with a licensed clinician about the cause of your pain, the evidence, the risks and the full cost, and ask how Sarapin fits with treatments that have stronger evidence, such as exercise and physical therapy.
This guide is for general education only. It is not medical advice and does not replace care from a licensed health professional who knows your history. Do not start, stop or change any treatment based on this guide without talking with your clinician. If you have a medical emergency, call 911 or go to the nearest emergency room.
Last reviewed: October 5, 2026.
This guide draws on FDA records, peer-reviewed studies, clinical guidelines, insurer coverage policies and product information. Manufacturer and clinic claims are labeled as such. Every link was opened and checked on October 5, 2026.