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INSUFFICIENT RELIABLE EVIDENCE to RATE

• Diabetes. It is unclear if oral banaba is beneficial in patients with type 2 diabetes. Details: One preliminary clinical study in patients with type 2 diabetes shows that a specific banaba extract (Glucosol), standardized to corosolic acid 1%, taken as 32 or 48 mg daily for 2 weeks is associated with 10% lower blood glucose levels when compared with placebo (11954). Another preliminary clinical study in patients with type 2 diabetes inadequately controlled by oral antidiabetic agents shows that taking a specific combination product containing extracts of banaba leaf and Padang cassia (Inlacin, Dexa Medica) 100 mg daily for 12 weeks reduces glycated hemoglobin (HbA1c) by 0.65% when compared with baseline (92849). The validity of this finding is limited by the lack of a comparator group. Additionally, it is unclear if this effect is due to banaba, Padang cassia, or the combination.
• Impaired glucose tolerance (prediabetes). Oral banaba has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in patients with impaired glucose tolerance shows that taking a specific combination product containing extracts of banaba leaf and Padang cassia (Inlacin, Dexa Medica) daily for 12 weeks preserves beta-cell function and insulin release and improves insulin sensitivity, but not 2-hour postprandial glucose levels, when compared with placebo. All patients received 50 mg once daily for 4 weeks, and those considered to be non-responders were titrated up to 100 mg once daily for the remaining 8 weeks (92848). It is unclear if these effects are due to banaba, Padang cassia, or the combination.
• Metabolic syndrome. It is unclear if oral banaba is beneficial in patients with metabolic syndrome. Details: A small clinical study in patients with metabolic syndrome shows that a specific banaba extract (MonoHerb), standardized to corosolic acid 1.13%, taken as 500 mg twice daily for 12 weeks improves systolic blood pressure, fasting blood glucose, triglycerides, and very low-density lipoprotein (VLDL) cholesterol when compared with baseline (108617). The lack of statistical comparison to the placebo group limits the validity of these findings. More evidence is needed to rate banaba for these uses.

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POSSIBLY SAFE ...when banaba extract is used orally and appropriately, short-term (11954,92848,92849). A specific banaba extract (Glucosol) has been safely used at doses of 32-48 mg daily for 2 weeks (11954). Another specific product containing extracts of banaba leaf and Padang cassia (Inlacin, Dexa Medica) has been safely used at doses up to 100 mg daily for 12 weeks (92848,92849). There is insufficient reliable information available about the safety of banaba extract when used long-term.

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = B Theoretically, concomitant use of banaba and hypoglycemic drugs might have additive effects.  Details Human and animal research suggests that banaba can lower blood glucose levels (11954,11955,33554,92848,92849).

ANTIHYPERTENSIVE DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = B Theoretically, concomitant use of banaba and antihypertensive drugs might cause additive effects.  Details Human and animal research suggests that banaba can lower blood pressure (33557,92848,92849).

ORGANIC ANION-TRANSPORTING POLYPEPTIDE SUBSTRATES (OATP) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, concomitant use of banaba with substrates of OATP might reduce the bioavailability of the OATP substrate.  Details In vitro research shows that banaba inhibits OATP, particularly OATP2B1 (35450). OATPs are expressed in the small intestine and liver and are responsible for the absorption of drugs and other compounds.

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General ...Orally, banaba extract appears to be well tolerated.
Most Common Adverse Effects:
Orally: Diaphoresis, dizziness, headache, palpitations, stomach upset, tremor, and weakness have been reported with a specific product containing extracts of banaba leaf and Padang cassia (Inlacin, Dexa Medica); however, it is unclear if these adverse effects were caused by banaba extract, Padang cassia, or the combination.

Cardiovascular ...Orally, palpitations have been reported with a specific product containing extracts of banaba leaf and Padang cassia (Inlacin, Dexa Medica); however, it is unclear if this adverse effect was caused by banaba extract, Padang cassia, or the combination (92848).

Gastrointestinal ...Orally, stomach upset has been reported with a specific product containing extracts of banaba leaf and Padang cassia (Inlacin, Dexa Medica); however, it is unclear if this adverse effect was caused by banaba extract, Padang cassia, or the combination (92849).

Neurologic/CNS ...Orally, dizziness, headache, tremor, and weakness have been reported with a specific product containing extracts of banaba leaf and Padang cassia (Inlacin, Dexa Medica); however, it is unclear if these adverse effects were caused by banaba extract, Padang cassia, or the combination (92848,92849).

Other ...Orally, diaphoresis has been reported with a specific product containing extracts of banaba leaf and Padang cassia (Inlacin, Dexa Medica); however, it is unclear if this adverse effect was caused by banaba extract, Padang cassia, or the combination (92849).

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