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Reserpine is an indole alkaloid extracted from Rauwolfia serpentine roots, an Indian climbing shrub. Reserpine has FDA approval since 1955 and is one of the first agents developed to treat hypertension in clinical practice. Reserpine can be prescribed alone or in combination with a vasodilator or thiazide diuretic, such as reserpine-hydrochlorothiazide, as commonly used in China for over 40 years. Reserpine was utilized as a first-line antihypertensive therapy when initially introduced but is currently considered second-line treatment.