Carduus marianus 3x • Cynara 3x • Solidago 3x • Taraxacum 3x • Benzoicum ac. 15x • Berberis vulgaris 15x • Bryonia 15x • Cantharis 15x • Carduus benedictus 15x • Ceanothus 15x • Chelidonium majus 15x • Cinchona bark extract 15x • Dioscorea 15x • Dolichos 15x • Iris versicolor 15x • Juniperus communis 15x • Nux vomica 15x • Ptelea 15x • Taraxacum 15x • Uricum acidum 15x. Inactive Ingredients: USP verified Water, USP gluten-free, non-GMO organic Cane Alcohol 20%.
Brand name products often contain multiple ingredients. To read detailed information about each ingredient, click on the link for the individual ingredient shown above.
This is a homeopathic preparation. Homeopathy is a system of medicine established in the 19th century by a German physician named Samuel Hahnemann. Its basic principles are that "like treats like" and "potentiation through dilution." For example, in homeopathy, diarrhea would be treated with an extreme dilution of a substance that normally causes diarrhea when taken in high doses.
Practitioners of homeopathy believe that more dilute preparations are more potent. Many homeopathic preparations are so diluted that they contain little or no active ingredient. Therefore, most homeopathic products are not expected to have any pharmacological effects, drug interactions, or other harmful effects. Any beneficial effects are controversial and cannot be explained by current scientific methods.
Dilutions of 1 to 10 are designated by an "X." So a 1X dilution = 1:10, 3X=1:1000; 6X=1:1,000,000. Dilutions of 1 to 100 are designated by a "C." So a 1C dilution = 1:100; 3C = 1:1,000,000. Dilutions of 24X or 12C or more contain zero molecules of the original active ingredient.
Homeopathic products are permitted for sale in the US due to legislation passed in 1938 sponsored by a homeopathic physician who was also a Senator. The law still requires that the FDA allow the sale of products listed in the Homeopathic Pharmacopeia of the United States. However, homeopathic preparations are not held to the same safety and effectiveness standards as conventional medicines. For more information, see the Homeopathy monograph.
Below is general information about the effectiveness of the known ingredients contained in the product Drainage. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of bryonia.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of juniper.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
Below is general information about the safety of the known ingredients contained in the product Drainage. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
LIKELY SAFE ...when used orally in amounts commonly found in foods. Artichoke has Generally Recognized As Safe status (GRAS) for use in foods in the US (4912).
POSSIBLY SAFE ...when used orally and appropriately in medicinal amounts. Artichoke extract has been used with apparent safety at doses up to 3200 mg daily for up to 12 weeks (6282,15204,52235,91475,91478,100934). Artichoke leaf powder has been used with apparent safety at a dose of 1000 mg daily for up to 8 weeks (104133). Cynarin, a constituent in artichoke extract, has been used with apparent safety at daily doses of 750 mg daily for up to 3 months or 60 mg daily for up to 7 months (1423,1424,52222,52223,52236).
PREGNANCY AND LACTATION:
There is insufficient reliable information available about the safety of artichoke when used in medicinal amounts during pregnancy or lactation; avoid amounts greater than those found in foods.
LIKELY SAFE ...when used orally in amounts commonly found in foods. Blessed thistle has Generally Recognized As Safe (GRAS) status in the US (4912). There is insufficient reliable information available about the safety of blessed thistle when used in medicinal amounts.
PREGNANCY: LIKELY UNSAFE
when used orally (4,12); avoid using.
LACTATION:
Insufficient reliable information available; avoid using.
LIKELY UNSAFE ...when the root or berries are used orally (2,18). Consuming 40 berries might be fatal (18).
CHILDREN: LIKELY UNSAFE
when the root or berries are used orally (2,18).
Consuming as few as 15 berries can be fatal in children (18).
PREGNANCY: UNSAFE
when the root is used orally.
Bryonia root might have abortifacient effects (2). ...when the berries are used orally (2).
LACTATION: LIKELY UNSAFE
when the root or berries are used orally (2).
LIKELY SAFE ...when used orally as a flavoring in tonic water and alcoholic beverages. The US Code of Federal Regulations allows not more than 83 parts per million (ppm) of total cinchona alkaloids in finished beverages (93229).
POSSIBLY UNSAFE ...when used orally in medicinal amounts. Cinchona derivatives marketed as over-the-counter (OTC) medicines are required to carry the warning, "Caution - discontinue use if ringing in the ears, deafness, skin rash, or visual disturbances occur" (93231). Cinchona contains the alkaloid quinine that was previously available OTC in the US for treatment and prevention of nocturnal leg muscle cramps. In 1994 the US Food and Drug Administration (FDA) determined that quinine was not generally recognized as safe and effective for this indication, citing serious adverse reactions and its narrow therapeutic index (93232,93233). A final ban on marketing of OTC quinine products was implemented by the FDA in 2007, and a Risk Evaluation and Mitigation Strategy (REMS) to reduce off-label use of prescription quinine products for night-time leg cramps was introduced in 2010 (93232).
LIKELY UNSAFE ...when excessive amounts are used orally. Cinchona contains the alkaloids quinine and quinidine, which are used as prescription medicines and have been associated with significant adverse effects at doses of 2 grams per day or more (505). The amount of these constituents in cinchona products is variable (13).
PREGNANCY: LIKELY UNSAFE
when used orally.
Cinchona is reported to have uterine stimulant and abortifacient activity, and to be fetotoxic and teratogenic, causing visual and auditory defects (12,19). Avoid using.
LACTATION: POSSIBLY UNSAFE
when used orally.
The cinchona alkaloids quinine and quinidine are reported to be excreted in breast milk and may be toxic to infants (19).
LIKELY SAFE ...when used orally in amounts commonly found in foods. Dandelion has Generally Recognized As Safe (GRAS) status in the US (4912).
POSSIBLY SAFE ...when used orally and appropriately in medicinal amounts (12).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using amounts greater than those in foods.
LIKELY SAFE ...when the fruit is consumed orally in food amounts (13527). There is insufficient reliable information available about the safety of European barberry when used orally in medicinal amounts or when used topically.
CHILDREN: LIKELY UNSAFE
when used orally in newborns.
The berberine constituent of European barberry can cause kernicterus in newborns, particularly preterm neonates with hyperbilirubinemia (2589). There is insufficient reliable information available about the safety of European barberry when used orally in older children.
PREGNANCY: LIKELY UNSAFE
when used orally.
Berberine is thought to cross the placenta and may cause harm to the fetus. Kernicterus has developed in newborn infants exposed to berberine (2589).
LACTATION: LIKELY UNSAFE
when used orally.
Berberine and other harmful constituents can be transferred to the infant through breast milk (2589).
POSSIBLY UNSAFE ...when used orally. Greater celandine has been implicated in dozens of cases of liver damage, primarily in European countries including Germany (363,13410,16839,41412,53502,53504,53506,53507,53510). There is insufficient reliable information available about the safety of greater celandine when used topically or when derivatives of greater celandine constituents are used intravenously.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally in amounts commonly found in foods. Juniper, juniper berry, and juniper extract have Generally Recognized as Safe (GRAS) status in the US (4912).
POSSIBLY SAFE ...when used topically on limited areas of skin (12230). ...when the oil is used by inhalation and appropriately as aromatherapy (7107). There is insufficient reliable information available about the safety of juniper when used orally in doses of less than 10 grams of berries or 100 mg of oil daily, short-term. Juniper oil and berry have a long history of traditional use (12,103759).
LIKELY UNSAFE ...when used orally in excessive amounts or long-term. Use of daily doses greater than 10 grams of juniper berries (about 60 berries) or 100 mg of juniper essential oil, or prolonged oral use longer than 4 weeks, have been reported to increase the risk of severe adverse effects such as convulsions or kidney damage (8,19,103759).
PREGNANCY: UNSAFE
when used orally.
Juniper can increase uterine tone, interfere with fertility and implantation, and cause abortion (4,19).
LACTATION:
Insufficient reliable information available; avoid using.
UNSAFE ...when used orally (2,13,18,505). Nux vomica in doses of 30-50 mg contains approximately 5 mg of strychnine, and can cause severe adverse effects. 1-2 grams of nux vomica contains 60-90 mg of strychnine, and can be fatal (13,18,65345). Chronic ingestion of lesser amounts can cause death after a period of weeks (18).
PREGNANCY AND LACTATION: UNSAFE
when used orally (2,13,18,505); avoid using.
POSSIBLY SAFE ...when used orally. A dose of 50 mg (containing 8 mg diosgenin) has been used with apparent safety for 12 weeks (12,96724). ...when used topically. A wild yam cream has been used with apparent safety for 3 months (10989).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
Below is general information about the interactions of the known ingredients contained in the product Drainage. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Theoretically, artichoke leaf extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.
Details
A meta-analysis of small clinical studies shows that taking artichoke leaf extract for 8-12 weeks can modestly reduce fasting plasma glucose when compared with placebo (105768).
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Theoretically, artichoke leaf extract may increase the risk of hypotension when taken with antihypertensive drugs.
Details
A meta-analysis of small clinical studies in patients with hypertension shows that taking artichoke can reduce systolic blood pressure by around 3 mmHg and diastolic blood pressure by around 2 mmHg when compared with placebo (105767).
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Theoretically, artichoke might increase serum levels of drugs metabolized by CYP2B6.
Details
In vitro research shows that artichoke leaf extract inhibits CYP2B6 activity (97717). However, this interaction has not been reported in humans.
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Theoretically, artichoke might increase serum levels of drugs metabolized by CYP2C19.
Details
In vitro research shows that artichoke leaf extract inhibits CYP2C19 activity (97717). However, this interaction has not been reported in humans.
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Theoretically, blessed thistle might decrease the effectiveness of antacids.
Details
There are reports that blessed thistle increases stomach acid (19).
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Theoretically, blessed thistle might decrease the effectiveness of H2-blockers.
Details
There are reports that blessed thistle increases stomach acid (19).
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Theoretically, blessed thistle might decrease the effectiveness of PPIs.
Details
There are reports that blessed thistle increases stomach acid (19).
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Theoretically, taking cinchona might decrease the effectiveness of antacids. Theoretically, taking antacids might also increase the risk of adverse effects from cinchona.
Details
Some research shows that taking cinchona lowers stomach acid pH (19). In addition, some research shows that taking antacids might increase urinary pH. Theoretically, this may increase the amount of quinidine, a constituent of cinchona, reabsorbed in the renal tubules and increase the risk of quinidine toxicity (3046).
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Theoretically, taking cinchona might increase the drug effects and risk of bleeding with anticoagulant and antiplatelet drugs.
Details
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Theoretically, taking cinchona might increase the adverse effects of carbamazepine.
Details
Clinical research shows that taking quinine, a constituent of cinchona, increases the peak plasma concentration and area under the curve of carbamazepine (11016).
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Theoretically, taking cinchona might inhibit cytochrome P450 2D6 (CYP2D6) and increase levels of drugs metabolized by this enzyme.
Details
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Theoretically, taking cinchona might increase serum levels of digoxin.
Details
Quinine and quinidine, which are constituents of cinchona, decrease clearance of digoxin and increase serum digoxin levels in humans (3046).
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Theoretically, taking cinchona might decrease the effectiveness of H2-blockers.
Details
Some research shows that taking cinchona lowers stomach acid pH (19).
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Theoretically, taking cinchona might increase the adverse effects of phenobarbital.
Details
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Theoretically, taking cinchona might decrease the effectiveness of PPIs.
Details
Some research shows that taking cinchona lowers stomach acid pH (19).
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Theoretically, taking cinchona with other QT interval-prolonging drugs might cause an additive effect and increase the risk of ventricular arrhythmias.
Details
Quinidine and quinine, which are constituents of cinchona, prolong the QT interval (3046).
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Theoretically, taking cinchona might increase plasma levels and adverse effects of quinidine.
Details
Cinchona contains quinidine (505).
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Theoretically, taking cinchona might increase plasma levels and adverse effects of quinine.
Details
Cinchona contains quinine (505).
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Theoretically, taking dandelion root along with anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding.
Details
In vitro research suggests that dandelion root inhibits platelet aggregation (18291).
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Theoretically, dandelion might increase the risk for hypoglycemia when used with antidiabetes drugs.
Details
Laboratory research suggests that dandelion extract may have moderate alpha-glucosidase inhibitor activity and might also increase insulin secretion (13474,90926). Also, in a case report, a 58-year-old woman with type 2 diabetes who was being treated with insulin developed hypoglycemia 2 weeks after beginning to eat salads containing dandelion (46960).
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Theoretically, dandelion might increase levels of drugs metabolized by CYP1A2.
Details
Laboratory research suggests that dandelion might inhibit CYP1A2 (12734). So far, this interaction has not been reported in humans. However, until more is known, watch for an increase in the levels of drugs metabolized by CYP1A2 in patients taking dandelion.
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Theoretically, dandelion might increase the clearance of drugs that are UDP-glucuronosyltransferase substrates.
Details
There is some preliminary evidence that dandelion might induce UDP-glucuronosyltransferase, a phase II enzyme (12734).
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Theoretically, through diuretic effects, dandelion might reduce excretion and increase levels of lithium.
Details
Animal research suggests that dandelion has diuretic properties (13475). As diuretics can increase serum lithium levels, the dose of lithium might need to be decreased when taken with dandelion.
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Theoretically, dandelion might increase the risk of hyperkalemia when taken with potassium-sparing diuretics.
Details
Dandelion contains significant amounts of potassium (13465).
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Theoretically, dandelion might lower fluoroquinolone levels.
Details
Animal research shows that dandelion reduces absorption of ciprofloxacin and can lower levels by 73% (13477). However, this effect has not been reported in humans.
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Theoretically, taking European barberry with anticholinergic drugs might cause additive effects.
Details
In vitro evidence suggests that European barberry might have anticholinergic properties (13527).
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Theoretically, European barberry may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Details
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Theoretically, taking European barberry with antidiabetes drugs might increase the risk of hypoglycemia.
Details
Preliminary clinical evidence suggests that European barberry juice reduces fasting glucose levels in patients with type 2 diabetes who are also taking antidiabetes drugs (98575). Additionally, some animal studies show that berberine, a constituent of European barberry, has antiglycemic potential (33622,33667). Monitor blood glucose levels closely.
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Theoretically, taking European barberry with antihypertensive drugs might increase the risk of hypotension.
Details
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Theoretically, taking European barberry with cholinergic drugs might decrease the effects of cholinergic drugs.
Details
In vitro evidence suggests that European barberry might have anticholinergic properties (13527).
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Theoretically, concomitant use with drugs that have sedative properties may cause additive effects.
Details
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Theoretically, concomitant use with cyclosporine may cause additive effects.
Details
Berberine, a constituent of European barberry, can reduce the metabolism and increase serum levels of cyclosporine. This effect is attributed to the ability of berberine to inhibit cytochrome P450 3A4 (CYP3A4), which metabolizes cyclosporine (13524). Theoretically, European barberry might have a similar effect.
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Theoretically, European barberry might increase the levels and clinical effects of CYP3A4 substrates.
Details
There is very preliminary evidence suggesting that berberine, a constituent of European barberry, might inhibit the CYP3A4 enzyme (13524). Theoretically, European barberry might have a similar effect.
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Research in vitro shows that chelidonine, a constituent of greater celandine, inhibits cytochrome P450 2D6 (CYP2D6) enzyme activity (99455). Theoretically, greater celandine might increase levels of drugs metabolized by CYP2D6.
Details
Some drugs metabolized by CYP2D6 include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and many others.
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There is some concern that greater celandine can adversely affect the liver. Greater celandine has been linked to many cases of hepatotoxicity (363,13410,16839,41412,53502,53504,53506,53507,53510). Theoretically, concomitant use with other potentially hepatotoxic drugs might increase the risk of developing liver damage. Some of these drugs include acarbose (Precose, Prandase), amiodarone (Cordarone), atorvastatin (Lipitor), azathioprine (Imuran), carbamazepine (Tegretol), cerivastatin (Baycol), diclofenac (Voltaren), felbamate (Felbatol), fenofibrate (TriCor), fluvastatin (Lescol), gemfibrozil (Lopid), isoniazid, itraconazole, (Sporanox), ketoconazole (Nizoral), leflunomide (Arava), lovastatin (Mevacor), methotrexate (Rheumatrex), nevirapine (Viramune), niacin, nitrofurantoin (Macrodantin), pioglitazone (Actos), pravastatin (Pravachol), pyrazinamide, rifampin (Rifadin), ritonavir (Norvir), rosiglitazone (Avandia), simvastatin (Zocor), tacrine (Cognex), tamoxifen, terbinafine (Lamisil), valproic acid, and zileuton (Zyflo).
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Preliminary clinical research suggests that taking a specific semi-synthetic derivative of the greater celandine constituent chelidonine (Ukrain; not available in North America) might stimulate immune responses in cancer patients (53473,53497). Theoretically, taking greater celandine might decrease the effects of immunosuppressive therapy. Immunosuppressant drugs include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), and other corticosteroids (glucocorticoids).
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Theoretically taking monoamine oxidase inhibitors (MAOIs) with greater celandine might increase the risk of serotonergic side effects including serotonin syndrome. In vitro research shows that chelerythrine, an isoquinoline alkaloid in greater celandine, strongly, selectively, and reversibly inhibits an isoform of recombinant human monoamine oxidase-A (MAO-A). It was also a weak but selective inhibitor of monoamine oxidase-B (MAO-B) (99454). Some MAOIs include phenelzine (Nardil), tranylcypromine (Parnate), and others.
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Animal research suggests that juniper berry has hypoglycemic activity (4). Theoretically, taking juniper berry with antidiabetes medications might cause additive blood glucose reduction. Monitor blood glucose levels closely. Dose adjustments to antidiabetes medications might be necessary.
Details
Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
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Juniper berry can cause the body to lose water. Theoretically, juniper berry might increase the effectiveness of diuretic therapy, causing the body to lose too much water and increasing the likelihood of experiencing side effects (4, 512).
Details
Some diuretic drugs include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.
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Juniper berry might have mild diuretic effects (4,512). Theoretically, due to these potential diuretic effects, juniper berry might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
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Theoretically, wild yam might increase or decrease the effects of estrogen.
Details
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Below is general information about the adverse effects of the known ingredients contained in the product Drainage. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General
...Orally, artichoke extract seems to be well tolerated.
Most Common Adverse Effects:
Orally: Abdominal pain, diarrhea, flatulence, hunger, and nausea.
Topically: Contact dermatitis in sensitive individuals.
Serious Adverse Effects (Rare):
Orally: Anaphylaxis to artichoke inulin has been reported in individuals sensitive to inulin.
Topically: Chest tightness, cough, and dyspnea after occupational exposure in sensitive individuals.
Dermatologic
...Artichoke can cause an allergic reaction in some patients.
Patients sensitive to the Asteraceae/Compositae family may be at the greatest risk. Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many other herbs. Topically, allergic contact dermatitis can occur with the use of artichoke. This has been attributed to the constituent cynaropicrin (11,52206,52226,52230). Redness in the face (11774) and sweating (91475) have been reported rarely following oral use of artichoke extract.
Occupational or airborne exposure to artichoke may also cause allergic reactions. In one case, a 52-year-old male presented with severe spongiotic dermatitis in exposed areas that was recurrent over the past 8 years. A patch test confirmed allergies to artichokes and sesquiterpene lactones, a group of allergens from the Compositae family, and the patient confirmed occupational and airborne exposure to artichokes during the time of his symptoms. The patient improved considerably after treatment with dupilumab (111565).
Gastrointestinal
...Orally, artichoke extract might increase abdominal discomfort, flatulence, diarrhea, hunger, and nausea in some patients (2562,52238,91475).
Abdominal pain and a bitter taste in the mouth were reported by a single person following oral use of a dietary supplement containing artichoke extract, as well as red yeast rice, pine bark extract, and garlic extract (89452). It is not clear if this adverse effect was due to artichoke, other ingredients, or the combination.
In one case report, the autopsy of an 84-year-old female revealed a colonic bezoar comprised of artichoke fiber and fragments. This bezoar caused complete intestinal obstruction, leading to fatal acute peritonitis. Although rare, patients who lack adequate teeth and/or who have a history of gastric surgery are at increased risk for fibrous bezoar formation (97716).
Pulmonary/Respiratory
...Following occupational exposure, allergic symptoms including dyspnea, cough, chest tightness, and asthma symptoms or exacerbation have been reported.
The effects were attributed to sensitization to artichoke. Subsequent nasal challenge with artichoke extract caused reduced nasal patency in these patients (52210,52230).
Orally, severe anaphylactic shock in response to artichoke inulin as an ingredient in commercially available products has been reported (52217). Individuals with a noted sensitivity to artichokes should consume inulin with caution. While rare, individuals with a known inulin allergy should avoid artichoke and artichoke extract.
General ...Orally, there is limited information available about the adverse effects of blessed thistle when used in medicinal amounts.
Dermatologic ...Topically, blessed thistle can cause an allergic reaction, such as dermatitis, in individuals sensitive to the Asteraceae/Compositae family. Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many other herbs (12).
Gastrointestinal ...Orally, when blessed thistle is used in doses higher than 5 grams per cup of tea, it can cause stomach irritation and vomiting (12).
Immunologic ...Blessed thistle can cause allergic reaction in individuals with sensitivity to the Asteraceae/Compositae family, which includes ragweed, chrysanthemums, marigolds, daisies, and many other herbs (12).
General
...Orally, bryonia root can cause dizziness, vomiting, convulsions, colic, bloody diarrhea, abortion, nervous excitement, and kidney damage.
Large doses of bryonia can cause anuria, collapse, paralysis, and death (2). Bryonia berries can be fatal when taken orally; 40 berries can be fatal in adults, and 15 berries can be fatal in children (18).
Topically, skin contact with fresh bryonia may cause irritation (19).
Dermatologic ...Topically, skin contact with fresh bryonia may cause irritation (19).
Gastrointestinal ...Orally, bryonia root can cause vomiting, colic, and bloody diarrhea (2).
Genitourinary ...Orally, bryonia root can cause abortion (2). Large doses of bryonia can cause anuria and death (2).
Musculoskeletal ...Orally, large doses of bryonia can cause paralysis and death (2).
Neurologic/CNS ...Orally, bryonia root can cause dizziness, convulsions, and nervous excitement (2). Large doses of bryonia can cause paralysis and death (2).
Renal ...Orally, bryonia root can cause kidney damage (2). Large doses of bryonia can cause anuria and death (2).
Other ...Orally, bryonia berries can be fatal. Consuming 40 berries can be fatal in adults and as few as 15 berries can be fatal in children (18).
General
...Information on the adverse effects of cinchona is limited.
Orally, prolonged use of high doses of cinchona can cause severe adverse effects. Topically, a thorough evaluation of safety outcomes has not been conducted.
Most Common Adverse Effects:
Orally: Diarrhea, nausea, ringing ears, vomiting.
Topically: Contact dermatitis, urticaria.
Serious Adverse Effects (Rare):
Orally: Arrhythmias, cinchonism syndrome, hemolytic uremic syndrome, QT prolongation, thrombotic thrombocytopenic purpura.
Cardiovascular ...Cinchona contains the alkaloids quinidine and quinine that can prolong the QT interval on the electrocardiogram, and cause potentially fatal cardiac arrhythmias such as torsades de pointes (3046,93232)
Dermatologic ...Topical use of cinchona bark extracts and occupational exposure to cinchona bark dust can cause contact dermatitis and other urticarial reactions (11,93234). A 31-year old man developed itching, erythema, and edema of the face and upper chest after occupational exposure to dust from cinchona bark. Skin testing produced reactions to ethanol and ether extracts of the bark, but not to the individual alkaloids quinine and quinidine (93234).
Gastrointestinal ...Cinchona stimulates secretion of stomach acid and has been associated with nausea, vomiting, and diarrhea (6,19).
Hematologic ...Quinine, which is present in cinchona, has been associated with serious, sometimes fatal, hematological disorders including thrombocytopenia, thrombotic thrombocytopenic purpura (TTP), and hemolytic uremic syndrome (hemolytic anemia, acute renal failure, and thrombocytopenia) (93232,93233). Initial symptoms may include bleeding from the gums, nose or gastrointestinal tract, easy bruising, and petechiae (93233). Bone marrow depression and thrombocytopenia have also been associated with quinidine (505).
Immunologic ...Oral use of quinine, an alkaloid present in cinchona, has been associated with severe allergic skin reactions, as well as anaphylaxis (19,93232).
Ocular/Otic ...Cinchona contains quinine that can cause dose-related adverse effects on hearing and vision, including tinnitus, deafness, vision changes, and blindness (6,8,12,93232).
Other ...Orally, prolonged use of high doses of cinchona or its alkaloids, or a single dose of 3 grams or more of the alkaloid quinine are associated with a toxicity syndrome known as cinchonism. Symptoms include headache, dizziness, nausea and vomiting, diarrhea, hemolysis, hypotension, cardiac arrhythmias, tinnitus, deafness, vision changes, blindness, abdominal pain, delirium, convulsions, paralysis, and collapse (6,12,19,505,93232). Doses of 10-15 grams of quinine may be fatal (18).
General
...Orally, dandelion seems to be well tolerated.
Most Common Adverse Effects:
Orally: Diarrhea, heartburn, and stomach discomfort.
Topically: Dermatitis in sensitive individuals.
Serious Adverse Effects (Rare):
Orally: Anaphylaxis in sensitive individuals.
Cardiovascular ...In one report, a 39-year-old obese woman developed palpitations and syncope after taking a weight loss supplement containing a combination of dandelion, bladderwrack, and boldo for 3 weeks. The patient was found to have prolonged QT-interval on ECG and frequent episodes of sustained polymorphic ventricular tachycardia (14321). It is not clear whether dandelion, another ingredient, or the combination of ingredients is responsible for this adverse effect. The product was not analyzed to determine the presence of any potential toxic contaminants.
Dermatologic ...Topically, dandelion can cause contact dermatitis and erythema multiforme in sensitive individuals. Dandelion can cause an allergic reaction in individuals sensitive to the Asteraceae/Compositae family (13478,13481,42893,46945,46977). Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many other herbs.
Endocrine ...In one report, a 56-year-old man with renal impairment developed hyperoxalaemia and peripheral gangrene after ingesting large amounts of dandelion tea (10 to 15 cups daily for 6 months). The adverse effect was attributed to the high oxalate content of dandelion tea (258 mcmol/L) and reduced renal oxalate clearance caused by renal impairment (90639). In another report, a 58-year-old woman with type 2 diabetes who was being treated with insulin developed hypoglycemic symptoms 2 weeks after beginning to eat salads containing dandelion (46960). The hypoglycemic effect was attributed to the potential alpha-glucosidase inhibitory activity of dandelion.
Gastrointestinal ...Gastrointestinal symptoms, including stomach discomfort, diarrhea, and heartburn, have been reported following oral use of dandelion (19146,36931). A case of intestinal blockage has been reported for a patient who ingested a large amount of dandelion greens three weeks after undergoing a stomach operation (46981). Also, a case of hemorrhagic cystitis has been reported for a 33-year-old woman who took a specific herbal product (Slim-Kombu, Balestra and Mech, Vicenza, Italy) containing 20 herbal extracts, including dandelion extract. Symptoms resolved after the patient discontinued using the product, and symptoms resumed when the patient began taking the supplement again four months later. While various ingredients in the supplement may have contributed to the symptoms, it is possible that dandelion extract may have contributed to the effect due to its diurectic, laxative, cholagogue, and antirheumatic properties (46959).
Other ...Orally, products containing dandelion pollen can cause allergic reactions, including anaphylaxis (13479,13480). Also, rhinoconjunctivitis and asthma have been reported after handling products such as bird feed containing dandelion and other herbs, with reported positive skin tests for dandelion hypersensitivity (46948). Dandelion pollen may cause pollinosis, such as allergic rhinitis and conjunctivitis (18065,46951,46964,46966,46972).
General ...European barberry is generally well tolerated when consumed in amounts commonly found in food. A thorough evaluation of safety outcomes has not been conducted for the use of larger, medicinal amounts. Topically, European barberry seems to be well tolerated.
Hepatic ...Orally, a case of hepatitis-associated aplastic anemia is reported in an adult male after consuming European barberry 15 drops and nannari root 15 drops twice a day for 2 weeks. The patient presented with lethargy, loss of appetite, and jaundice that progressed to high-grade fevers, chills, rigors, severe pancytopenia, and abnormal liver function tests. Liver biopsy was suggestive of drug-induced liver injury. The patient was hospitalized for multiple infections and symptomatic thrombocytopenia. Despite receiving supportive care, blood transfusions, and corticosteroids, the patient died 7 weeks after diagnosis (110021). The exact reason for this adverse effect is not clear.
General
...Orally, greater celandine has been implicated in dozens of cases of liver damage (363,13410,16839,41412,53502,53504,53506,53507,53510).
Greater celandine can also cause rash (13410). Greater celandine extract has caused a single case of hemolytic anemia (53508).
Topically, greater celandine can cause contact dermatitis (13411).
Intravenously, a derivative of the greater celandine constituent chelidonine (Ukrain) can cause gastrointestinal symptoms, increased body temperature, general burning sensations, and bleeding (13409,53460).
Dermatologic ...Orally, greater celandine can cause rash (13410). Topically, greater celandine can cause contact dermatitis (13411).
Gastrointestinal ...Intravenously, a derivative of the greater celandine constituent chelidonine (Ukrain) can cause gastrointestinal symptoms, including obstipation, nausea, and diarrhea (13409,53460).
Hematologic
...Orally, greater celandine extract has caused a single case of hemolytic anemia.
This resulted in thrombocytopenia, destruction of liver cells, and kidney failure, requiring treatment (53508).
Intravenously, a derivative of the greater celandine constituent chelidonine (Ukrain) can cause bleeding (13409,53460).
Hepatic ...Orally, greater celandine has been implicated in dozens of cases of liver damage (363,13410,16839,41412,53502,53504,53506,53507,53510). The cause is unknown, but appears to be idiopathic. It seems to be independent of dose, and the amount of time before development of liver disease is generally long and variable (363,53506). The main symptom is usually jaundice (53506). Liver enzymes are elevated at least two-fold in all cases where measurements were completed (53506). Although other causes of liver toxicity cannot be ruled out in some cases, many reported cases of hepatotoxicity are probably or likely associated with the use of greater celandine. Recurrence of hepatitis with unintentional re-exposure has also been reported (53506,94282). Discontinuation of greater celandine usually results in a fairly rapid recovery although liver enzymes need months to return to normal (53506,94282). Death has occurred in one patient with hepatitis due to bleeding associated with colonic diverticulitis. Causality was described as possible, not probable, in this case (53506).
Neurologic/CNS ...Intravenously, a derivative of the greater celandine constituent chelidonine (Ukrain) can cause increased body temperature and general burning sensations (13409).
General ...Orally and topically, juniper seems to be generally well tolerated when used short-term. However, a thorough evaluation of safety outcomes has not been conducted. Most reported adverse effects are related to ingestion of excessive amounts of juniper berry oil. Symptoms of overdose include kidney pain and irritation, diuresis, albuminuria, hematuria, purplish urine, tachycardia, hypertension, convulsions, metrorrhagia, and abortion (4). Topically, juniper can cause skin irritation (4,103756). Repeated exposure to the juniper pollen can cause occupational allergies (6).
Dermatologic ...Topically, juniper can cause skin irritation. Signs of topical poisoning include burning, erythema, inflammation with blisters, and edema (4). Repeated exposure to the juniper pollen can cause occupational allergies that affect the skin (6). In a case report, a 62-year-old woman developed burn-like blistering lesions after carrying juniper in close contact to her skin. Concurrent sun exposure was thought to worsen the skin irritation caused by juniper (103756).
Genitourinary ...Orally, large amounts of the juniper berry can cause purplish urine (4).
Pulmonary/Respiratory ...Repeated exposure to the juniper pollen can cause occupational allergies that affect the respiratory tract (6).
General ...Orally, 30-50 mg nux vomica (5 mg strychnine) can cause restlessness, feelings of anxiety, heightening of sense perception, enhanced reflexes, equilibrium disorders, painful neck and back stiffness, followed later by twitching, tonic spasms of jaw and neck muscles, painful convulsions of the entire body triggered by visual or tactile stimulation with possible opisthotonos, muscle hypertonicity and agitation. Dyspnea may follow spasm of the respiratory muscles (18). Seizures occur within 15 minutes of ingestion (or 5 minutes of inhalation) and may result in hyperthermia, metabolic and respiratory acidosis, rhabdomyolysis, and myoglobinuric renal failure (17,65345). Nux vomica can be fatal (13,505); most deaths occur 3-6 hours post-ingestion from respiratory and subsequent cardiac arrest, anoxic brain damage, or multiple organ failure secondary to hyperthermia (18,505). Strychnine accumulates with extended administration (2).
Neurologic/CNS ...Orally, 30-50 mg nux vomica (5 mg strychnine) can cause restlessness, feelings of anxiety, heightening of sense perception, enhanced reflexes, equilibrium disorders, painful neck and back stiffness, followed later by twitching, tonic spasms of jaw and neck muscles, painful convulsions of the entire body triggered by visual or tactile stimulation with possible opisthotonos, muscle hypertonicity and agitation. Dyspnea may follow spasm of the respiratory muscles (18). Seizures occur within 15 minutes of ingestion (or 5 minutes of inhalation) and may result in hyperthermia, metabolic and respiratory acidosis, rhabdomyolysis, and myoglobinuric renal failure (17). In one case report, a 58-year old woman developed dizziness with abdominal and leg pain following a seizure, after ingestion of one nux vomica fruit. Her muscles were tense and hyper-reflexive and she had lactic acidosis and nystagmus (65345). Most deaths occur 3-6 hours post-ingestion from respiratory and subsequent cardiac arrest, anoxic brain damage, or multiple organ failure secondary to hyperthermia (18,505). Strychnine accumulates with extended administration, particularly in individuals with liver damage (2).
General
...Orally, wild yam is generally well tolerated.
Most Common Adverse Effects:
Orally: Fever, headache, upset stomach, and vomiting.
Serious Adverse Effects (Rare):
Orally: Anaphylaxis.
Gastrointestinal ...Orally, wild yam can cause upset stomach and vomiting, especially at higher doses (12,86450).
Hematologic ...In one case report, a 55-year-old female with protein S deficiency and systemic lupus erythematosus (SLE) had temporary vision loss in the left eye from hemiretinal vein thrombosis 3 days after taking a combination phytoestrogen product containing wild yam 276 mg, dong quai 100 mg, red clover 250 mg, and black cohosh 250 mg (13155). It is unclear if wild yam contributed to this event.
Immunologic ...There are three case reports of anaphylaxis after ingestion of cooked wild yam (96722).
Neurologic/CNS ...Orally, wild yam can cause headache and fever, especially at higher doses (86450).