PDR for Herbal Medicines

780/UVA-URSI

beta-D-0-6'-galloyl galactoside, quercitrin, isoquercitrin,

myricitrin, myricetin-3-O-beta-D-galactoside, 2 isomeric

quercetin arabinosides, aglycones of these compounds

Enzymes: including a beta-glucosidase (arbutase), that is

rendered inactive with dehydration and processing of the

drug, due to the high tannin content

Triterpenes: including among others ursolic acid (0.4-0.8%),

alcohol uvaol, beta-amyrin

EFFECTS

The tannins in Uva-Ursi act as an astringent, and the phenol

glucocsides and their aglyca have an antibacterial effect. The

antimicrobial effect is associated with the aglycon hydroqui-

none released from arbutin (transport form) or arbutin waste

products in the alkaline urine. The drug has urine-sterilizing

properties that are attributed to bacteriostatic hydroquinones,

conjugates of glucuronic acid and sulfuric acid. The maxi-

mum antibacterial effect is expected 3 to 4 hours after

administration. There are no clinical studies available that

have been definitively evaluated.

CLINICAL TRIALS

Neph rolith iasis

The effects of Uva-Ursi with prevention and treatment of

kidney stone formation was studied in rats. It concluded that

beneficial effects from Uva-Ursi on urolithiasis can be

attributed to some disinfectant action (Grases, 1994).

Diuresis

The aqueous extract of Arctostaphylos uva-ursi was studied

in rats involoving diuresis. The pharmacological evaluation

revealed an increase in urine flow without an increase in

urinary sodium excretion (Beaux, 1999).

Antibacterial Properties

The effect of aqueous extracts of Uva-Ursi leaves to decrease
surface hydrophobicity of 155 Escherichia coli strains was
determined in cattle. The adhesion of microbes on host cells
is important for development of Gram-negative microbe-
induced infections and is influenced by the surface hydro-
phobicity of the microbial cell. Bactericidal action of Uva-
Ursi was low, but the decrease in cell surface hydrophobicity
may influence the bacteria's virulent properties (Turi, 1997).
The aqueous extract of Uva-Ursi leaves was also studied in
Helicobacter pylori (H. pylori) strains to determine possible
changes in cell surface hydrophobicity. The tannic acid in
the Uva-Ursi was determined to have the highest activity of
decreasing cell surface hydrophobicity as well as antibacteri-
al activity against H. Pylori (Annuck, 1999)

PDR FOR HERBAL MEDICINES

INDICATIONS AND USAGE

Approved by Commission E:

• Infections of the urinary tract

Uva-Ursi is used for inflammatory disorders of the efferent

urinary tract.

Unproven Uses: In folk medicine, the herb is used for all

forms of urogenital and biliary tract disease.

Homeopathic Uses: The herb is used for inflammations of

the efferent urinary tract.

CONTRAINDICATIONS

The drug is contraindicated in pregnant women, nursing

mothers and children under 12 years of age.

PRECAUTIONS AND ADVERSE REACTIONS

General: No health hazards are known in conjunction with

the proper administration of designated therapeutic dosages.

Individuals with gastric sensitivity may experience nausea

and vomiting following intake of preparations made from the

drug due to its high tannin content.

Pregnancy: The drug is contraindicated during pregnancy.

Nursing Mothers: The drug is contraindicated in nursing

mothers.

Pediatric Use: Liver damage is conceivable in connection

with administration of the drug over extended periods,

particularly with children, due to the possible hepatotoxicity

of the hydroquinones released. The drug is contraindicated in

children under 12 years of age.

Drug Interactions: Uva-Ursi preparations should not be

administered with any substance that causes acidic urine

since this reduces the antibacterial effect. Because the urine-

disinfecting effect of the hydroquinones released in the

urinary tract only occurs in an alkali environment, the

simultaneous administration of medication or food that

increase uric acid levels in the bladder is to be avoided.

The sodium sparing effect of Uva-Ursi may offset the

diuretic effect of thiazide and loop diuretics.

Uva-Ursi may add to the gastrointestinal irritation that

occurs with NSAID use.

OVERDOSAGE

Overdosage can lead to inflammation and irritation of the

bladder and urinary tract mucous membranes. Liver damage

is conceivable in connection with administration of the drug

over extended periods, particularly with children, due to the

possible hepatotoxicity of the hydroquinones released.

DOSAGE

Mode of Administration: Uva-Ursi is available as comminut-

ed drug, drug powder or dried extract for infusions or cold