PDR for Herbal Medicines

318/FRANGULA PDR FOR HERBAL MEDICINES

EFFECTS

The bark contains anthracene derivatives and their aglycones

which have an anti-absorptive and hydrogogic effect. The

anthracene derivatives induce active secretion of electrolytes

and water in the intestinal lumina and inhibit the absorption

of electrolytes and water from the colon by stimulating

propulsive contractions. This results in accelerated intestinal

passage time. In this manner, the increased water and

subsequent volume of the intestinal content raise pressure

and stimulate intestinal peristalsis.

INDICATIONS AND USAGE

Approved by Commission E:

• Constipation

Unproven Uses: Frangula bark is used to ease bowel

evacuation in the case of anal fissures, hemorrhoids and after

rectal-anal surgery. It may also be used in preparation for

exploratory surgery of the gastrointestinal tract.

Homeopathic Uses: Rhamnus frangula is used for weak

digestion with a tendency to diarrhea.

CONTRAINDICATIONS

The drug is not to be used with intestinal obstruction, acute

inflammatory intestinal diseases, appendicitis or with chil-

dren under 12 years of age. The drug is not to be

administered during pregnancy or while nursing.

PRECAUTIONS AND ADVERSE REACTIONS

General: Long-term use leads to loss of electrolytes,

especially potassium ions. This may lead to hyperaldosteron-

ism, inhibition of intestinal motility and enhancement of the

effect of cardioactive steroids, which may lead to arrhyth-

mias. Nephropathies, edema and accelerated bone deteriora-

tion are possible after long term use.

The question of an increased incidence of carcinoma of the

colon following long-term administration of anthracene

drugs has not yet been fully clarified. Recent studies show no

definite connection between the administration of anthracene

drugs and the frequency of carcinoma of the colon.

Pregnancy: Not to be used during pregnancy.

OVERDOSAGE

Vomiting and spasmodic gastrointestinal complaints could

occur as side effects to the drug's purgative effect or with

overdosages.

DOSAGE
Mode of Administration: Frangula Bark is available in solid
pharmaceutical form and in commercial compounded prepa-
rations for oral intake. It is also available parenterally for
homeopathic use.

Preparations:

Tea — scald 2 gm finely cut drug and strain after 15

minutes. The drug may also be left to steep in cold water for

12 hours.

Dry extract — percolation of 100 gm bark with methanol,

after 1 day 400 gm to 500 gm percolate are extracted. The

liquids (percolate and pressed juice) are left to stand for 8

days at 2 to 8° C before being filtered and dried. The

glucofrangulin content must be stabilized at 15 to 17%.

Daily Dosage: 20 mg to 180 mg hydroxy-

anthracene derivatives

Tea — 1 cup mornings and evenings

The correct dosage for each individual is the smallest dosage

necessary to maintain a soft stool. Frangula bark should not

be used continuously for more than 1 or 2 weeks.

Homeopathic Dosage: from D3: 5 drops, 1 tablet or 10

globules every 30 to 60 minutes (acute) or 1 to 3 times daily

(chronic); parenterally: 1 to 2 ml sc acute: 3 times daily;

chronic: once a day (HAB1)

Storage: Frangula may be stored for at least 1 year if

protected from light and moisture.

LITERATURE

Anonym, Abwehr von Arzneimittelrisiken, Stufe II. In: DAZ

136(38):3253-2354. 1996.

Anonym. Pharmaceutical Care: "Den MiJ3brauch von Laxanzien

vermeiden helfen". In: DAZ 135(20): 1867-1868. 1995.

Demirezer LO. Glucofrangulinanthrone A/B, deren

Oxidationsformen und davon abgeleitete Zuckerester aus

Rhamnus-Arten. In: Dissertation Universitat Frankfurt/Main.

1991.

Helmholz H, Ruge A, Piasecki A, Schroder S, Westendorf J,

Genotoxizitiit der Faulbaumrinde. In: PZ 138(43):3478. 1993.

Pailer M, Haslinger E, (1972) Monatsh. Chem 103:1399.

Sydiskis RJ, Owen DG, Lohr JL, Rosier KHA, Blosmster RN,

Inactivation of enveloped viruses by anthraquinones extracted

from plants. In: Antimicrob Agents Chemother 35:2463-2466.

1991.

Van Os FHL, (1976) Pharmacology I4(Suppf 1)7:18.

Wagner H et al., (1978) Planta Med 33:53.

Further information in:

Frohne D, Pfander HJ, Giftpflanzen - Ein Handbuch fur

Apotheker, Toxikologen und Biologen, 4. Aufl., Wiss.

Verlagsges. mbH Stuttgart 1997.

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.