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Caudatin is derived from plants of the genus Cynanchum and has been found to have strong anticancer efficacy by modulating Wnt/-catenin, NF-B, and PI3K/AKT pathways, inducing ROS-mediated apoptosis, and inhibiting metastasis through the inhibition of epithelial to mesenchymal transitions

R 5 is a substituted or unsubstituted C2-16 alkylene, substituted or unsubstituted C2-16 alkenylene, substituted or unsubstituted C1-12 alkyl(arylene) [e.g., substituted or unsubstituted C1-12 alkyl(phenylene)], or substituted or unsubstituted aryl(Ci-i2 alkylene) [e.g., substituted or unsubstituted phenyl(Ci-i2 alkylene)]

Diarrhea is the least unique of these, but it leads to a vicious cycle of worsening status of niacin and other nutrients