PDR for Herbal Medicines

18 /ALOE PDR FOR HERBAL MEDICINES

ALOE CAPENSIS

Unproven Uses: Aloe capensis has been used as a stool

softener in the presence of anal fissures, hemorrhoids, and

after recto-anal operations. The fresh juice is used for eye

inflammations and for syphillis in South Africa.

Homeopathic Uses: The herb is used for gastrointestinal

disorders, hemorrhoids, and constipation.

CONTRAINDICATIONS

Aloe is contraindicated in cases of intestinal obstruction,

acutely inflamed intestinal diseases (e.g., Crohn's disease,

ulcerative colitis), appendicitis and abdominal pain of

unknown origin.

PRECAUTIONS AND ADVERSE REACTIONS

General: If cramping of the gastrointestinal tract after single

dosing occurs, the dosage should be reduced. Spasmodic

gastrointestinal complaints are a side effect to the drug's

purgative effect. Heart arrhythmias, nephropathies, edema

and accelerated bone deterioration may occur in rare cases.

Prolonged use of Aloe may lead to pigmentation in the

intestinal mucosa (pseudomelanosis coli), a harmless side

effect, which usually reverses upon discontinuation of the

drug. Long-term use can also lead to albuminuria and

hematuria.

Hypersensitivity: Hypersensitivity, manifested by general-

ized nummular eczematous and papular dermatitis, have

been reported after long-term use of oral and topical Aloe

preparations (Morrow, 1980).

Loss of Electrolytes: Long-term use can cause loss of

electrolytes, in particular potassium. The loss of potassium

can result in hyperaldosteronism, inhibition of intestinal

motility and enhancement of the effect of cardioactive

medications.

Malignancy: Prolonged use of anthracene drugs increases the

relative risk of colon carcinoma (Siegers, 1993). Recent

studies fail to demonstrate a connection between the

administration of anthracene drugs and frequency of carcino-

mas in the colon (Schorkhuber; 1998). Low molecular

weight compounds found in Aloe vera gel are cytotoxic

(Avila, 1997). The component 1,8-dihydroxyanthraquinone

inhibits the catalytic activity of topoisomerase II resulting in

genotoxicity and mutagenicity (Mueller, 1999).

Tissue Damage: Chronic treatment with high doses of Aloe

reduces vasoactive intestinal peptide and somatostatin levels,

which may damage enteric nervous tissue (Tzavella, 1995).

Drug Interactions:

Cardiac glycosides and antiarrhythmic drug—Chronic use of
Aloe can lead to potassium loss, which can increase the
actions of cardiac glycosides and antiarrhythmic drugs.

Thiazide diuretics, loop diuretics, licorice and cortico-

steroids—There is an increase in the possibility of potassium

deficiency when Aloe is used along with these agents.

Pregnancy: Aloe should not be used during pregnancy.

Pediatric Use: Aloe should not be prescribed to children

under 12 years of age.

DOSAGE

Mode of Administration: Due to the side effects of the drug,

it is rarely used and is not recommended. Aloe powder,

aqueous- and aqueous-alcoholic extracts in powdered or

liquid form are available for oral use.

How Supplied:

Capsule—250 mg, 470 mg

Cream

Gel—99%, 72%

Softgel—1000 mg

Preparation: A stabilized aloe extract is prepared with hot

water. The extract will have a content of 19% to 21% aloin.

Daily Dosage: The recommended daily dosage is 20 to 30

mg hydroxyanthracene derivatives/day, calculated as anhy-

drous aloin. The recommended single dosage is 0.05 g aloe

powder from Aloe barbadensis or 0.05 to 0.2 g aloe powder

of Aloe capensis in the evening. Aloe capensis can be given

as a single dose of 0.1 g in the evening.

Homeopathic Dosage: For Aloe capensis, administer 5

drops, 1 tablet, 10 globules, or parenterally 1-2 ml three

times daily (HAB1).

Note: The smallest dosage needed to maintain a soft stool

should be used. Stimulating laxatives must not be used over

an extended period of time (1 to 2 weeks) without medical

advice.

Storage: Aloe should be protected from light and moisture.

LITERATURE

Anonym, Aloe und Aloine - Aktuelles iiber weltweit

verwendete Arzneistoffe. In: DAZ 135(39):3644-3645. 1995.

Avila H, Rivero J, Herrera F, Fraile G, Cytotoxicity of a low

molecular weight fraction from Aloe vera (Aloe barbadensis

Miller) gel. Toxicon 1997 Sep;35(9): 1423-30.

BGA, Arzneimittelrisiken: Anthranoide. In: DAZ 132(21): 1164.

1992.

Byeon SW, Pelley RP, Ullrich SE et al., Aloe barbadensis

extracts reduce the production of interleukin-10 after exposure

to ultraviolet radiation. J Invest Dermatol 1998 May; 110(5):

811-7.

Che QM, Akao T, Hattori M, Kobashi K, Namba T,

Metabolism of barbaloin by intestinal bacteria. 2. Isolation of