23. Common Herbal Medications

Here is a short and comprehensive list of common herbs used in medication.

Herb	Uses	How it works	Cautions
Aloe vera	Aloe vera gel is used topically as a moisturizer, treating sunburn, psoriasis and minor wounds. A liquid extract has strong laxative properties.	The gel (best obtained from a fresh plant but also available in commercial packaging) encourages skin regeneration, increases blood flow and has emollient properties.  The extract is a strong stimulant laxative.	Generally safe when used to treat skin disorders, except for occasional minor irritation. Causes stomach irritation when taken orally as a laxative.
Black Cohosh	Reduces prementrual syndrome, painful menstruation and other symptoms of menopause (such as hot flashes, night sweats and vaginal dryness).	Functions like an estrogen substitute and suppresses release of LH (luteinizing hormone).	Occasional stomach pain. No long-term studies.  Limit use to six months.  May potentiate the effects of CNS depressants and blood pressure medications.
Capsicum (chili/cayenne pepper)	Hot chili and cayenne pepper extract.  Applied to skin to treat shingles, trigeminal neuralgia and arthritis.  Also used as a thermogenic (increase body temperature).	Capsicum is a counterirritant and decreases pain by depleting substance P, a neurotransmitter of pain stimuli.	With overuse, can result in prolonged insensitivity to pain.  Concentrated products can cause local irritation and burning.  Avoid contact with eyes, genitals and mucous membranes.
Chamomile	Chamomile, a flowering plant that looks like a daisy, is prepared as a tea and used as a mild sedative, relaxant and sleeping aid.  Also used for indigestion, itching and inflammation.	Chamomile is the most popular herbal tea on the market.  Active agents produce mild sedative and anti-inflammatory effects.	A member of the ragweed family and may cause allergic reactions.  Separate drinking the tea from other medications by at least two hours.
Clove Oil	Clove oil (or eugenol) is used to treat teething pain and toothache.	Eugenol is a local anesthetic action.	Use sparingly in children. May irritate mucous membranes.
Cranberry	Cranberries and their juice are useful in preventing urinary tract infections (UTIs).	The effectiveness of cranberries does not relate to their acidifying the urine, rather it prevents E. colibacteria from adhering to the interior of the urinary tract.	Look for 100% cranberry juice, most “cocktail” products contain only 27%. DO NOT use if patient has an active UTI, seek professional medical attention.
Dong quai (or) Dang qui	An “all-purpose” women’s tonic used to treat menstrual problems.  Often referred to as “women’s ginseng”.  Extracts of the Angelica sinesis plant.	Active ingredients relieve menopause symptoms and painful or lacking menstration.	Some plant species are phototoxic and may cause photosensitivity or a rash. DO NOT use if taking anticoagulants (warfarin).
Echinacea	The purple cornflower appears to shorten the intensity and duration of colds and flus. Works to boost the immune system.  Applied topically to speed minor wound healing.	Not an antibiotic, however echinacea helps the body fight off infection.	DO NOT use for prolonged periods of time.  If infection does not improve, seek professional medical assistance.  DO NOT use if you have an autoimmune disease (multiple sclerosus, rheumatoid arthritis or HIV)
Eucalyptus	Eucalyptus may be inhaled as vapors or applied directly to the chest wall to treat congestion and to break up phlegm and mucous in the respiratory tract. Also applied externally to treat arthritis symptoms.	The active ingredients in eucalyptus act as an expectorant to break up thick mucous or phlegm.  In arthritis, eucalyptus is a mild blood vessel dilator, increasing blood flow to joints.	DO NOT take eucalyptus internally, it can cause severe stomach upset.  DO NOT apply to the face or nose of young children, use jelly in vaporizer.
Feverfew	Dried feverfew leaves have been shown to reduce the frequency and severity of migraine headaches.  Also reduces the occurrence of nausea and vomiting during migraine attacks.	Acts as on blood vessels in the central nervous system to make them less reactive to certain substances.  Also, may be a serotonin antagonist.	Most commercial preparations are at too high of a concentration.  Doses of 125 milligram of herb (250 micrograms of active ingredient) are necessary. Chewing raw leaves may cause mouth ulcers.
Garlic	Primary use is to lower cholesterol and thereby inhibiting the formation of blood clots or developing high blood pressure.	Fresh garlic must be used and crushed to convert the active ingredient, the enzyme allicin.  Capsules contain this active ingredient.	Excessive use of garlic may result in heartburn, flatulence or other gastrointestinal symptoms. Patients may become odoriferous (smell like garlic).  DO NOT use if taking anticoagulants (warfarin).

Ginger	Time-honored herb to relieve stomach upset, motion sickness and nausea.	Fresh ginger slices allowed to soak in water are the best dosage form.  Promotes saliva and gastric juice secretion.	May prolong bleeding, aggravate gallstones o cause heartburn.  Generally considered safe.
Ginkgo	Used for hundreds of years in Orient.  Used to improve short-term memory and concentration, especially in patients with Alzheimer’s disease.	It appears that ginkgo enhances blood flow in the brain, as well as increasing the brain’s tolerance to low levels of oxygen.	Generally considered safe. May cause indigestion, headaches or allergic skin reactions.
Ginseng	Panax ginseng (Korean, Chinese, American or Asian ginseng) has been used as a “cure-all” tonic for centuries.  Used to treat fatigue and also considered an aphrodisiac.	Antifatigue properties may be related to enhances muscle tissue use of glycogen, as well as the transformation of fatty acids into energy.	Generally deemed safe. DOD NOT use if patient has kidney failure or taking anticoagulants (warfarin) or digoxin.
Kava Kava	A South Pacific plant extract that is made into a tonic.  A Pacific “moonshine” used to relieve anxiety, stress and restlessness and helps with insomnia.	The active ingredients cause muscle relaxation.	Interacts with alcohol.       DO NOT drink with alcohilic beverages.  DO NOT take if pregnant or nursing.  DO NOT use for longer than three months.  May cause red skin and eye discoloration.
Licorice	Pure licorice extract (not the common candy version), applied topically, is useful in treating canker sores and fever blister/cold sore ulcers.  Taking orally licorice treats heartburn, ulcers and coughs (an expectorant).	Glycyrrhizin, the active ingredient of licorice is 50 times sweeter than sugar.  It is converted into steroid-like compounds.	Can effect blood pressure, pregnancy and should NOT be used in patients taking corticosteroid medications.
Ma Huang (ephedra)	Ma Huang is used as a stimulant and increases heart rate.  Also used to treat asthma and cold symptoms.	The ephedra compounds relax the airways and increases heart rate and blood pressure.	DO NOT use if patient has high blood pressure, glaucoma or prostate problems.
Milk Thistle	Used as a liver protectant and encourages the regeneration of liver cells.	Milk thistle seeds contain silymarin, which helps liver cells keep out poisons and regenerate.	No harmful effects reported when taken at normal recommended doses (200 milligrams extract or 140 milligrams of silymarin)
Peppermint	Peppermint is used to treat indigestion and stomach upset. The menthol extract of peppermint is useful in treating colds and congestion.  Applied topically, menthol relieves pain.	The active ingredient (menthol) exerts an antispasmodic effect on the stomach, increases bile flow, and has a cooling effect when inhaled or applied topically.	DO NOT use in babies because it may cause choking effect from menthol.  DO NOT inhale for prolonged periods of time.
Psyllium	A natural bulk-forming laxative.	Psyllium seeds contain soluble fiber that swells when put in contact with water, thus adding bulk and lubrication to stool.	Increased flatulence is common.
Saw Palmetto	The dwarf palm (found and now protected from harvesting in Southeastern states) extract is useful in treating Benign Prostatic Hypertrophy (BPH).	Nonhormonal agents in saw palmetto extract have antiandrogen and anti-inflammatory activity.	Generally safe.  Large doses may cause diarrhea.  Some experts feel that men taking saw palmetto may experience altered PSA readings, used to diagnose prostate cancer.
Senna	Used as a stimulant laxative and for bowel cleansing.  Senna is safe for use in pregnancy and in the elderly.	Produces smooth muscle contractions of the intestines.	May cause abdominal cramping and dependency.
St. John’s Wort	Used to treat mild depression and anxiety.  St John’s Wort is used extensively in Germany as an anti-depressant.	The active ingredient hypericin may exert anti-depressant activity relating to serotonin-like activity.	May produce sensitivity to sun light, especially in fair-skinned people.  DO NOT use with other antidepressants.
Valerian	A mild tranquilizer and sleep aid.	The dried roots of valerian have antianxiety and mild hypnotic effects.	Long-term use may lead to headache, restlessness, insomnia and heart problems.

Sources:

1.       Herbs of Choice; The Therapeutic Use of Phytomedicinals, VE Tyler, Pharmaceutical Products Press, 1994.

2.       The New Age Herbalist, Richard Mabey, Collier Books, 1988.

3.       Herbal Remedy Handbook, 5^th Edition,  750^th Medical Squadron Pharmacy Services, Onizuka Air Station.

4.       The Complete German Commission E Monographs; Therapeutic Guide to Herbal Medicines, Mark Blumenthal, et al., The American Botanical Council, Integrative Medicine, 1998

        Prepared by:         
LCDR (sel) Edward T. Moldenhauer, MSC, USN
Naval School of Health Sciences July 1999

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

(Available to Ayur Info from: Military Obstetrics & Gynecology- Pharmacy , on 15 Sept 2012)