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adverse effects, and interactions of anthranoid laxatives (AEH). CAN cautions that the
anthraquinones are purgative and irritate the GI tract. Because of the anthraquinones, nonstand-
ardized preparations should be avoided during pregnancy and lactation (CAN). Anthraquinones
may be secreted into breast milk. Also contraindicated in arthrosis, hemorrhoids, and nephrop-
athy (CAN), intestinal obstruction, abdominal pain of unknown causes, any enterosis (appen-
dicitis, colitis, Crohn’s disease, IBS), hemorrhoids, nephropathy, menstruation (AHP), and
urethrosis (CAN). Do not use more than 8–10 days (AHP). Not for use in cases of diarrhea or
abdominal pain. Discontinue use if diarrhea or watery stools occur. Consult a health care
provider in cases of pregnancy or lactation. Not for long-term use or overdosage (PHP; CAN).
Rhubarb leaves, high in oxalic acid, should not be eaten (CAN). One case of anaphylaxis
following ingestion reported (CAN). Contains 4–11% stilbene derivatives, which pose such
risks that the herb “can no longer be recommended” (SHT). While widely used, anthranoid-
containing laxatives can be habit-forming; some contain compounds suspected of being cyto-
toxic, genotoxic, mutagenic, and even tumorigenic. Epidemiological studies in Germany reveal
that abusers of anthranoid laxatives have a three times higher rate of colon carcinoma (AEH).
At low doses, the tannins in rhubarb act as antidiarrheal; at high doses, the laxative anthraquino-
nes kick in (CAN). As the major source of the major COX-2 inhibitor ([+]-catechin), this might
be viewed by enthusiasts as another herbal miracle aspirin (COX).
RIBWORT (Plantago lanceolata L.) ++Madaus (1939) treats ribwort and plantain in the same entry.
Activities (Ribwort) — Analgesic (f; PH2); Antiatherosclerotic (1; BGB); Antibacterial (1; BGB;
HH2; KOM; PIP); Anticancer (1; HH2); Antiedemic (1; BGB); Antiinflammatory (1; HH2); Anti-
tussive (f; BGB); Astringent (2; DEP; KOM; PIP); Decongestant (1; BGB); Demulcent (1; BGB);
Diuretic (1; BGB; PH2); Emollient (1; BGB; PIP); Expectorant (f; BGB); Hemostat (1; PHR; PH2);
Hepatoprotective (1; BGB; CAN; FNF; HH2); Hypocholesterolemic (1; BGB; CAN; PH2);
Hypoglycemic (1; PH2); Hypotriglyceridemic (1; BGB; CAN); Laxative (1; BGB; DEP; PH2);
Lipolytic (1; BGB); Litholytic (f; PH2); Vulnerary (1; HH2).