Erandmool Powder by Vedic Care

POSSIBLY EFFECTIVE

• Bowel preparation. Some research suggests that oral castor oil is effective for bowel preparation; however, it is unclear if it is as effective as other products used for this purpose. Clinical practice guidelines do not recommend castor oil for bowel preparation. Details: Clinical research shows that taking a single dose of castor oil 30-60 mL orally is effective for bowel preparation prior to barium and gallium-67 imaging studies when compared with no bowel preparation (40090,40166). However, research evaluating castor oil in comparison to other bowel preparations is limited by complex regimens and high dropout rates. Some clinical research shows that oral castor oil, alone or in combination with a cleansing enema, has similar efficacy for bowel preparation as bisacodyl or bisacodyl plus magnesium citrate (40166,40173,40185). However, other research shows that bisacodyl plus magnesium citrate is superior to castor oil or castor oil plus calcium bisdioctyl sulfosuccinate (40163,40187). Also, solutions of oral sodium phosphate seem to be more effective for bowel preparation prior to a colonoscopy compared to castor oil (40192). According to the American Society for Gastrointestinal Endoscopy (ASGE), castor oil is not a recommended agent for bowel preparation prior to colonoscopy (101419).
• Constipation. Oral castor oil seems to improve symptoms of constipation. Details: Taking castor oil orally is effective as a stimulant laxative for reducing constipation (272). A single 15 mL dose is commonly used (15).
• Dry eye. Some clinical research suggests that castor oil eye drops can improve symptoms of dry eye in adults. Castor oil eye drops appear to reduce tear evaporation but do not increase tear production. Details: One clinical study in patients with mild to moderate dry eye shows that using castor oil 1.25% emulsion eye drops three times daily for 30 days decreases tear evaporation rate when compared with a hypromellose ophthalmic lubricant (40178). Another clinical study in patients with dry eye secondary to obstructive meibomian gland dysfunction shows that using castor oil 2% lubricating eye drops six times daily for 2 weeks improves gland obstruction assessments and dry eye symptom scores and decreases tear evaporation when compared with saline eye drops (40169).
• Parturition. Oral castor oil seems to stimulate labor in pregnant patients who are at term or post-term. Details: Clinical research in pregnant patients who are at term or post-term with no prior signs of labor shows that taking a single 60 mL dose of castor oil stimulates labor within 24 hours in 52-58% of patients compared with about 4% of patients receiving no treatment (7191,40177). There is also some evidence that patients at term pregnancy with premature membrane rupture who take a single dose of 5-120 mL of castor oil have a higher incidence of labor onset and a lower incidence of cesarean section when compared with patients who take no medication (1122).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Abortion. Although there has been interest in using intravaginal castor oil for abortion, there is insufficient reliable information about the clinical effects of castor oil for this purpose.
• Contraception. It is unclear if oral hulled castor seeds are effective for contraception. Details: Small clinical studies in healthy females show that taking a single dose of castor seeds with the outer coat removed can protect against pregnancy for up to 8-12 months (7127,7128). The validity of this finding is limited by the lack of a comparator group.
• Denture stomatitis. It is unclear if topical castor oil is beneficial in patients with denture stomatitis. Details: A small clinical study in institutionalized elderly patients shows that using a specific castor oil polymer mouthwash (Perioquil, Poliquil Araraquara Polimeros Quimicos Ltd) four times daily for 30 days can improve the severity of denture stomatitis when compared to baseline, but does not reduce Candida albicans counts when compared to treatment with miconazole oral gel or nystatin (93503).
• Furuncles (boils). Although there has been interest in using topical castor oil for boils, there is insufficient reliable information about the clinical effects of castor oil for this purpose.
• Osteoarthritis. Although there has been interest in using oral and topical castor oil for osteoarthritis, there is insufficient reliable information about the clinical effects of castor oil for this purpose.
• Rheumatoid arthritis (RA). Although there has been interest in using oral castor oil for RA, there is insufficient reliable information about the clinical effects of castor oil for this purpose. More evidence is needed to rate castor bean for these uses.

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LIKELY SAFE ...when castor oil is used orally and appropriately, short-term (16). In clinical research, a single oral dose of up to 60 mL of castor oil has been used prior to imaging procedures of the colon (40090,40163,40166,40185,40187,40188,40192).

POSSIBLY SAFE ...when the hulled castor seed is used orally and appropriately, short-term. There is some evidence that a single dose of castor seed with the outer coat removed (hulled) can be used safely (7127,7128). ...when castor oil is used topically and appropriately. Castor oil eye drops appear to be safe when used for up to 30 days (40169,40178).

POSSIBLY UNSAFE ...when castor oil is used orally in high doses or for extended periods. Taking castor oil for greater than one week or exceeding the typical dose of 15-60 mL per day can increase the risk of fluid and electrolyte disturbances (272).

UNSAFE ...when the whole seed is used orally. Safety depends on whether or not the seed is chewed or if the outer coat is ruptured. Chewing as few as 1-6 whole seeds can be lethal in an adult. If the seed is swallowed intact, poisoning is less likely; however, prompt medical attention should be sought after ingestion of any whole castor seed (5611).

CHILDREN: POSSIBLY SAFE
when castor oil is used orally and appropriately, short-term (16).

CHILDREN: POSSIBLY UNSAFE
when castor oil is used orally in high doses or for extended periods. Taking castor oil for greater than one week or exceeding the typical children's dose of 1-15 mL per day, depending on age, can increase the risk of fluid and electrolyte disturbances (272).

CHILDREN: UNSAFE
when the whole seed is used orally. The chewed or uncoated seeds can cause severe toxic effects (5611,5612) and death (5611). There is insufficient reliable information available about the safety of the hulled seed or topical use of castor in children.

PREGNANCY: POSSIBLY SAFE
when castor oil is used orally in pregnant women at term. Although there have been reports of fetal meconium passage being more common with castor oil use in pregnant women (40184), clinical research shows that the incidence of fetal meconium passage does not significantly differ from no castor oil use (7191,40177). Midwives routinely use castor oil for labor induction in pregnant women at term. This practice does not appear to adversely affect the mother or fetus (1122,7191,40177). However, castor oil should not be used without the supervision of a clinician.

PREGNANCY: LIKELY UNSAFE
when castor oil is used orally in pregnant women who are not at term. Castor oil might induce premature labor and induce miscarriage (12); avoid using.

PREGNANCY: UNSAFE
when the whole seed is used orally. The chewed or uncoated seeds can cause severe toxic effects, including death (5611); avoid using. There is insufficient reliable information available about the safety of using the hulled seed or topical use of castor during pregnancy.

LACTATION:
Insufficient reliable information available; avoid using.

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DIURETIC DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, castor oil might increase the risk of hypokalemia when taken with diuretic drugs.  Details There is some concern that overuse of castor oil might compound diuretic-induced potassium loss (15).

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General ...Orally and topically, castor oil is generally well tolerated. Hulled castor seeds with the outer coat removed also seem to be well tolerated when used orally. High doses or long-term use of castor oil may be unsafe, and whole castor seeds are generally regarded as unsafe in any amount.
Most Common Adverse Effects:
Orally: Abdominal discomfort, cramping, dizziness, and nausea (castor oil).
Serious Adverse Effects (Rare):
Orally: Severe abdominal pain, diarrhea, fluid and electrolyte disturbances, gastrointestinal bleeding, hemolysis, nausea, vomiting, and death (whole castor bean seeds).

Cardiovascular ...Orally, hulled castor seeds can result in elevated blood pressure (7128). In one case report, a woman at full-term pregnancy experienced amniotic fluid embolism and cardiopulmonary arrest within one hour of ingestion of 30 mL of castor oil (1219).
Orally, chewing whole castor bean seeds can cause peripheral vascular collapse (5611,5612,92998,93000,93505,93507).

Dermatologic ...Topically, the castor plant, crushed castor seeds, or castor seed dust can cause dermatitis in some patients (5611). Castor oil does not appear to cause these effects. In one case report, a child developed cheilitis over the course of 3 weeks, which was determined to be an allergic reaction to castor oil contained in lip balm (103864).

Gastrointestinal ...Orally, castor oil, like all stimulant laxatives, can cause abdominal discomfort, cramping, nausea, and faintness (15,272,40183,40186,40187,40192,40177,40185,40188,40163). Nausea can also occur because of the unpleasant taste of castor oil (7191). Using flavored products might reduce this effect. Castor oil can also cause fluid and electrolyte loss, particularly potassium, which can result in hypokalemia. It can also cause malabsorption from intestinal hypermotility (15,272). Chronic ingestion over long periods of time can lead to cathartic colon (15).
Chewing whole castor bean seeds causes severe toxicity. Gastrointestinal symptoms of castor seed toxicity typically occur with 4-6 hours of ingestion and include nausea, vomiting, diarrhea, and abdominal pain which usually resolves after supportive care (7128,13715,92998,93000,93505).

Genitourinary ...Orally, hulled castor seeds have been associated with cases of dysmenorrhea (7128). Although there have been reports of fetal meconium passage being more common with castor oil use in pregnant women (40184), clinical research shows that the incidence of fetal meconium passage does not significantly differ from no castor oil use (7191,40177). In one case report, a woman at full-term pregnancy experienced amniotic fluid embolism and cardiopulmonary arrest within one hour of ingestion of 30 mL of castor oil (1219). However, midwives routinely use castor oil for labor induction in pregnant women at term. This practice does not appear to adversely affect the mother or fetus (1122,7191,40177).

Hematologic ...Orally, chewing whole castor bean seeds can cause dehydration, hemolysis, and severe fluid and electrolyte disturbances (5611,5612,92998,93000,93505,93507).

Hepatic ...Orally, chewing whole castor bean seeds can cause damage to liver 2-5 days after ingestion (5611,5612,92998,93000,93505,93507).

Immunologic ...Exposure to castor beans, plants, or seed dust can cause contact dermatitis and anaphylaxis in sensitive individuals (5611). Castor oil does not appear to cause these effects. In one case report, a child developed cheilitis over the course of 3 weeks, which was determined to be an allergic reaction to castor oil contained in lip balm (103864). Orally, castor oil did not cause rash in clinical research (40185).

Musculoskeletal ...After inhalation, ricin, the toxic constituent of the castor seed hull, typically causes severe illness within 8 hours, but symptoms may be delayed. Symptoms include arthralgias and fever (13715).

Neurologic/CNS ...Orally, castor oil has been associated with syncope or dizziness in 2-20% of patients in clinical research (40188,40163,40187,40192). In a study of women taking castor seeds as a contraceptive, there were some reports of headache (7128).

Ocular/Otic ...Ophthalmically, castor oil emulsion eye drops resulted in blurred vision in 2 of 27 patients in one study (40178). In another study 2% castor oil eye drops caused slight eye irritation after storage at 60°C for four weeks, and no irritation when stored at 4°C (40169).

Psychiatric ...Taken orally for bowel cleansing, castor oil has been associated with insomnia (40185).

Pulmonary/Respiratory ...After inhalation, ricin, the toxic constituent of the castor seed hull, typically causes respiratory illness within 8 hours, but symptoms may be delayed. Symptoms include cough, dyspnea, and fever. Progression to respiratory distress and death can occur (13715).

Renal ...Orally, chewing whole castor bean seeds can cause renal failure secondary to hypovolemia. Cellular damage to kidneys typically occurs 2-5 days after ingestion (5611,5612,92998,93000,93505,93507).

Other ...Intravenously, castor bean extract can cause multi-organ failure and death. In one case report, a 26-year-old male presented to the emergency room with severe abdominal cramps, nausea, and headache after intravenously injecting castor bean extract as a suicide attempt. The patient rapidly deteriorated and died from multi-organ failure 10 hours after injection despite supportive care (100835).
Orally, chewing whole castor bean seeds can cause significant toxicity and death (5611,5612,92998,93000,93505,93507).

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