“…, betulinic acid, alphitolic acid, ursolic acid, ester derivatives of betulinic acid such as 7β-(4-hydroxy-benzoyloxy)-betulinic acid, 7β-(4-hydro-3-methoxy-benzoyloxy)-betulinic acid and 27-(4-hydroxy-3-methoxy-benzoyloxy)-betulinic acid] (Oliveira et al , 2003; Schuhly et al , 1999) and saponins (Alviano et al , 2008). DXR has been reported to induce micronuclei, chromatid and chromosomal aberrations, and DNA single- and double-strand breaks in vitro and in vivo (Bean et al , 1992; Al-Harbi, 1993; Al-Shabanah, 1993; Delvaeye et al , 1993; Jagetia and Nayak, 1996, 2000; Shan et al , 1996; Dhawan et al , 2003; Jagetia and Aruna, 2000). In addition, the major acute toxicity induced by DXR is bone marrow suppression, while the long-term clinical usefulness is limited by a cumulative, dose-dependent, irreversible, chronic cardiotoxicity that manifests itself as congestive heart failure or cardiomyopathy (Van Acker et al , 1995, 2000).…”