PDR for Herbal Medicines

472 /LICORICE PDR FOR HERBAL MEDICINES

folk medicine, the herb is used for appendicitis, constipation,

and to increase milk production and micturation. The drug is

also used as a treatment for epilepsy and inflammation of the

gastrointestinal and urogenital tract. Externally, the herb is

used for dermatoses.

Indian Medicine: Internally, the herb is used for gastric

ulcers, headaches, bronchitis, eye diseases and sore throat.

The drug is used externally for wounds and cuts.

Chinese Medicine: The herb is used for sore throats,

carbuncles, spleen disorders, dry cough, and dehydration.

LICORICE EXTRACT

Unproven Uses: The drug is used for gastritis, gastric ulcers,

ulcer prophylaxis, and viral liver inflammation.

CONTRAINDICATIONS

LICORICE ROOT AND FRUIT

Contraindications include chronic hepatitis, cholestatic dis-

eases of the liver, cirrhosis of the liver, severe renal

insufficiency, diabetes, arrythmias, hypertension, hypertonia,

hypokalemia, and pregnancy. Tobacco use has been associ-

ated with licorice toxicity (Synhaivsky, 1980).

PRECAUTIONS AND ADVERSE REACTIONS

LICORICE ROOT AND EXTRACT

General: Intake of the herb over a prolonged period of time

may result in hypokalemia, hypernatremia, edema, hyperten-

sion and cardiac complaints.

Endocrine: Pseudoaldosteronism reported with the use of

licorice is attributed to glycyrrhetenic acid, the hydrolytic

metabolite of glycerrhizic acid. Hypertension and hypoka-

lemic metabolic alkylosis (e.g. lethargy, paresthesias, muscle

cramps, hejdaches) are possible consequences of the hyper-

mineraTcorticoijJ, effect- of Licorice extracts. Retention of

sodium and water and suppression of the renin-aldosterone

system is associated with extracts of the root (Heikens, 1995;

Seelen, 1996). Hypokalemic rhabdomyolysis, resulting in

acute renal failure and profound deposition of calcium into

the damaged skeletal and cardiac muscles was reported with

glycyrrhizin use (Saito, 1994).

Drug Interactions: Furosemide/Thiazide Diuretics - Due to

the additive effect of hypokalemia, the concomitant use of

these medications with licorice is not recommended.

Digitalis Glycosides - Hypokalemia associated with the

prolonged use of licorice may potentiate digitalis toxicity.

Anti-arrythmic Agents (procainamide, quinidine) - Hypoka-
lemia and severe ventricular tachycardia of torsades de
pointes type reported with licorice consumption may be
potentiated with concomitant use of anti-arrythmic agents
(Eriksson, 1999).

Corticosteroids - Concomitant use of licorice with corticoste-

roids potentiates effects due to the prolonged half-life of

Cortisol.

OVERDOSAGE

LICORICE ROOT AND EXTRACT

The intake of higher dosages (above 20 gm per day for the

extract and above 50 gm per day for the root) over an

extended period of time will lead to hypokalemia, hyperna-

tremia, edemas, hypertension and cardiac complaints. In rare

cases, myoglobinemia has resulted due to the mineralcorti-

coid (aldosterone-like) effect of the saponins (Heikens, 1995;

Saito, 1994; Seelen, 1996). Preparations from the drug

should not be administered for longer than 6 weeks. The

complaints disappear after discontinuing the daig. (SEE PRE-

CAUTIONS AND ADVERSE REACTIONS)

DOSAGE

LICORICE ROOT

Mode of Administration: Comminuted drug, drug powder,

dry extracts for infusions, decoctions, liquid or solid forms

for internal use. Various teas contain extracts of the drug, for

example, bronchial teas, gastric teas, and laxative teas.

The drug should not be .administered for more than 6 weeks

(see side effects).

How Supplied:

Capsules — lOOmg, 200mg, 400mg, 444mg, 445mg, 450mg,

500mg

Preparation: To prepare an infusion, use 1 to 1.5 gm of

finely comminuted drug and add cold water. Bring to a boil,

or pour the boiling water over the drug and allow to draw for

10 to 15 minutes and then strain (1 teaspoonful = 3 gm drug).

Daily Dosage: The average daily dose is 5 to 15 gm of the

root, equivalent to 200 to 600 mg of glycyrrhizin. The drug

is not to be taken longer than 6 weeks (SEE OVERDOSAGE).

Succus liquiritiae: 0.5 to 1 gm for catarrhs of the upper

respiratory tract and 1.5 to 3.0 gm for gastric/duodenal

ulcers.

Tea - Drink one cup of tea after meals.

LICORICE EXTRACT

Mode of Administration: The drug is widely available in

medicinal preparations, as tea or in drop form; the juice of

licorice is found in liquorice edible goods and preparations.

Preparation: For preparation of tea, pour a cup of boiling

water over 1 teaspoon of juice, leave to draw for 5 minutes.

Daily Dosage: Drink one cup of tea after each meal. The

dosage for the drop form is 25 drops to be taken 4 times

daily.