HERBAL MONOGRAPHS EVENING PRIMROSE / 299respond were given 3 g of Evening Primrose Oil (EPO) daily
for a one-month period followed by 2 g daily for an
additional two months. Other women were given the
Evening Primrose oil regimen as first-line treatment. 58% of
the pyridoxine/EPO treatment group reported pain relief and
w 59% of the EPO first-line group reported relief. The author
concluded that good responses can be obtained from
products devoid of significant side effects, such as EPO and
Vitamin B-6 as a first line treatment (McFayden, 1992).
Tamoxifen and danazol should be reserved for those patients
who do not respond to EPO or pyridoxine.Premenstrual SyndromeA meta-analysis of 7 placebo-controlled trials involving the
use of EPO for the treatment of premenstrual syndrome
(PMS) was carried out in 1996. The authors note that two
well-constructed studies in the group failed to show any
statistically relevant beneficial effects with EPO in treating
PMS symptoms. The scoring in the remaining studies was
not consistent and therefore the authors were not able to pool
the results for statistical analysis (Budeiri, 1996).
INDICATIONS AND USAGE
^ Unproven Uses: Evening Primrose oil is used for neuroder-
matitis, premenstrual syndrome and as a dietary aid. The
drug is also used to treat hyperactivity in children, high
cholesterol levels, menopausal hot flashes and mastalgia.Capsules containing 500 mg of Evening Primrose oil have
been approved for use in Germany, in the treatment of and to
relieve the symptoms of atopic eczema.
PRECAUTIONS AND ADVERSE REACTIONS
There are case reports of seizures in schizophrenic patients
that were being treated with Evening Primrose oil along with
phenothiazine medications. Practitioners should be aware
that Evening Primrose oil has a potential to lower the seizure
threshold in patients with seizure disorders or those being
treated with drugs that lower the seizure threshold.
DOSAGE
Mode of Administration: Evening Primrose oil is available in
capsules for oral administration.
How Supplied:
_ Capsules—500 mg, 1300 mg.
Most commercial products (capsules) are standardized for
gamma linolenic acid content of 9%.
Daily Dosage: Treatment with Evening Primrose oil may
require up to 3 months duration before positive results are
attained for all indications listed below (Newall, 1996).
Atopic eczema
Adult—6 to 8 grams daily in divided dosesPediatric—2 to 4 grams daily in divided doses
Mastalgia (breast pain)3 to 4 grams daily in divided doses
Storage: Evening Primrose oil is rinsed in nitrogen and
stored in cooled tanks lined with polyethylene. Commercial
products should be stored at room temperature in an area that
is dry and not in direct sunlight.
LITERATURE
Berth-Jones J, Placebo controlled trial of essential fatty acid
supplementation in atopic dermatitis. In: Lancet 341:1557-1560.
1993.
Budeiri D, Li Wan Po A, Doman JC, Is Evening Primrose oil
of value in the treatment of premenstrual syndrome? Control
Clin Trials 17:60-68. 1996.
Haslett C et al., (1983) Int J Obesity 7(6):549.
Horrobin DF. (1983) J Reprod Med 28(7):465.
Ihrig M, Blume H, Nachtkerzenol-Praparate: Ein
Qualitatsvergleich. In: PZ 139(9):668. 1994.
Ippen H, Gamma-Linolensaure besser aus Nachtkerzen- oder aus
Borretschol? In: ZPT 16(3): 167-170. 1995.
McFayden IJ. Forrest AP, Chetty U, Cyclical breast pain -
some observations and the difficulties in treatment. BJCP
46:161-164.1992.
Midwinter RE et al., (1982) Lancet I, 339.
Pye J K et al., (1985) Lancet II, 373.
Seaman GVF et al., (1979) Lancet 1:1139.
Ten Hoor F. (1980) Nutr Metab 24(Suppl. 1):162.
Willuhn G, Phytopharmaka in der Dermatologie. In: ZPT
16(6):325-342. 1995.
Wright S, Burton JL, (1982) Lancet II, 1120.
Further information in:
Hansel R, Keller K, Rimpler H, Schneider G (Hrsg.). Hagers
Handbuch der Pharmazeutischen Praxis, 5. Aufl., Bde 4-6
(Drogen), Springer Verlag Berlin, Heidelberg. New York. 1992-
1994.
Madaus G, Lehrbuch der Biologischen Arzneimittel. Bde 1-3,
Nachdruck, Georg Olms Verlag Hildesheim 1979.
Newall CA, Anderson LA & Phillipson JD, Herbal Medicines.
The Pharmaceutical Press, London, 110-113.1996.
Schulz R, Hansel R, Rationale Phytotherapie, Springer Verlag
Heidelberg 1996.
Steinegger E, Hansel R, Pharmakognosie, 5. Aufl., Springer
Verlag Heidelberg 1992.
Teuscher E, Biogene Arzneimittel, 5. Aufl., Wiss. Verlagsges.
Stuttgart 1997.
Wagner H, Wiesenauer M, Phytotherapie. Phytopharmaka und
pflanzliche Homoopathika, Fischer-Verlag, Stuttgart, Jena, New
York 1995.