Contents Foreword iv Alphabetical Index i-i Lists all scientific, common, and brand names found in the herbal monographs. Therapeutic Category Index 1-45 Groups herbs by therapeutic or medicinal category. Listings are alphabetical by category and accepted common name. Herbs deemed effective by Commission E are flagged for quick recognition. Indications Index 1-81 Lists herbs by their primary indications. Entries are alphabetical by indication and accepted common name. Herbs deemed effective by Commission E are specially flagged. Homeopathic Indications Index 1-131 Catalogs herbal applications in homeopathy. Entries are alphabetical by indication and scientific name. Asian Indications Index 1-141 Groups herbs by their therapeutic uses in Chinese and Indian medicine. Listings are alphabetical by indication and accepted common name. Side Effects Index 1-161 Groups herbs by the adverse reactions with which they have been associated. Listings are alphabetical by reaction and accepted common name. Drug/Herb Interactions Guide 1-179 Lists problem combinations alphabetically by the name of the drug and the name of the interacting herb, and provides a brief description of each combinations potential effect.Safety Guide 1-191Lists herbs that must be avoided while pregnant or nursing, and herbs that should be used only underprofessional supervision. Includes all scientific, common, and brand names.Manufacturers Index 1-203Provides contact information for each supplier whose products appear in the monographs.Herb Identification Guide G-lPermits rapid, positive identification of unknown botanicals.Includes nearly 400 full-color photos.Product Identification Guide G-27Present photos of a representative group of popular commercial formulations.Herbal Monographs 1Profiles of 700 medicinal herbs, including trade names, description, actions, indications, contraindications,precautions, adverse effects, overdosage, dosage, and literature citations.Organized alphabetically by accepted common name, and cross-referenced by scientific name.Glossary 849A key to the specialized botanical nomenclature and other unfamiliar terminology employed in the herbal monographs.Poison Control Centers 855
IV PDR FOR HERBAL M E D I C I N E SForeword With 150,000 copies of its first edition in print, PDR ing—the findings of the German Regulatoryfor Herbal Medicines has almost instantly become one Authoritys herbal watchdog agency, commonly called of the nations leading pharmacological references. "Commission E." This agency has conducted an The reasons for its phenomenal reception are evident. intensive assessment of the peer-reviewed literature on Hundreds of herbal remedies now fill the shelves in some 300 common botanicals, weighing the quality of virtually every supermarket and pharmacy, and the the clinical evidence and identifying the uses for popularity of self-medication with "natural" supple- which the herb can reasonably be considered effective. ments continues to rise, making the benefits—and Its conclusions represent the best expert consensus on risks—of these preparations an ever more compelling medicinal herbs currently available. concern. For the herbs not considered by Commission E, PDRNow, to better address the host of questions that still for Herbal Medicines provides the results of ansurround most herbal remedies. Physicians Desk exhaustive literature review conducted by the respect-Reference® is proud to present this completely revised ed PhytoPharm U.S. Institute of Phytopharmaceuticalsand updated second edition of PDR for Herbal under the direction of noted botanist, Dr. JoergMedicines. Significantly enhanced and expanded, this Gruenwald. These additional monographs, now somenew edition extends both the range and depth of the 400 in number, provide a detailed introduction to anoriginal volume. Among the many improvements array of exotic botanicals that youll be hard pressedyoull find: to find in any other source. • Broader Coverage: With some 100 new entries, To make the information in the monographs as useful the book now covers a total of 700 botanicals, includ- and accessible as possible, PDR® has echoed the struc- ing a wide selection of popular Chinese herbs. ture of standard U.S. product labeling. Each mono- • More Research Data: Hundreds of entries have graph contains up to ten standard sections, covering been augmented with additional information on safety considerations ranging from description to dosage. and efficacy. Heres a closer look at what you will find: • Additional Adverse Effects: The entries includenew information on drug/herb interactions. The Side • Title: Each monograph begins with the herbsEffects and Interactions indices have been enriched generally accepted common name, followed by itsand expanded scientific name. In addition, all monographs are cross-• Available Formulations: Whenever applicable, referenced by their botanical designation.the herbal monographs now list the names and suppli-ers of popular commercial preparations. • Trade Names: Listed here are common commer-• New Indices: The index section has been enhanced cial preparations of the herb.with four additional indices:— Homeopathic Indications Index • Description: This section provides a detailed— Asian Indications Index— Safety Guide botanical overview of the herb, including information— Manufacturers Index on its medicinal parts; flower and fruit; leaves, stem,• Better Organization: In this edition, remedies and root; unique characteristics, habitat, production,appear under their more familiar common name, related plants, and additional common names and syn-instead of their botanical designation. All monographs onyms.are cross-referenced by scientific name. • Actions and Pharmacology: Here youll find dataOne important aspect of the first edition does, howev- on the active compounds or heterogeneous mixtureser, remain constant. Because it is still extremely hard found in the plant, followed by a summary of theto come by reliable information on the swarm of herbs clinical effects. If various parts of the plantunregulated "dietary supplements" in todays market- possess different pharmacological activity, the partsplace, this new edition continues to provide you with are discussed individually, here and throughout thethe closest available analog to FDA-approved label- remainder of the monograph.
FOREWORD V • Indications and Usage: Information on the uses To assist you in quickly locating the information you of the herb is listed under five categories, as applica- require, the monographs have been indexed by name, ble: therapeutic category, general indications, homeopathic — Approved by Commission E indications, Asian indications, and side effects. To aid — Unproven Uses you in evaluating potential risk, a drug/herb interac- — Chinese Medicine tion guide and a safety guide are also included. An — Indian Medicine index of manufacturers completes the set. Heres an — Homeopathic overview of what each index provides: . Approved uses are presented in list fashion. Other uses are described with provisos as necessary regard- • Alphabetical Index: This index includes all scien- ing route and form of administration. tific, common, and brand names found in the herbal monographs, together with appropriate page numbers. • Contraindications: Although most natural reme- dies can be used under all medical circumstances, a • Therapeutic Category Index: This index lists the few pharmacologically potent herbs must be avoided monographs and their page numbers, alphabetically by in the presence of certain medical conditions. If any accepted common name, under appropriate therapeutic such contraindications exist, they are summarized category headings. Herbs deemed effective by here. Commission E are flagged with a (•) symbol at their left. To facilitate comparison with prescription and • Precautions and Adverse Reactions: Found in nonprescription drugs, PDRs standard therapeutic cat- this section are any cautions or special considerations egories are used throughout. regarding safe use of the herb, including any restric- tions on use in pregnancy or childhood. Although • Indications Index: This index lists herbs and their most herbal remedies are notably free of known side page numbers, alphabetically by accepted common effects, any reported in the available literature are name, under their various indications. Herbs deemed noted here. effective for the indication by Commission E are flagged with a (•) symbol at their left. To help you• Overdosage: As we all know, "natural" is not syn- quickly identify conventional alternatives, the indica-onymous with "benign," and an overdose of many tion headings match those found in PDRs Indications"healing" herbs can have serious—even fatal—conse- Index, which appears in the PDR Companion Guide™quences. Whenever adverse effects of overdose have and the PDR Electronic Library ™ CD-ROM.been found in the literature, they are reported here,along with the appropriate medical interventions to be • Homeopathic Indications Index: Included in thisundertaken when an overdose occurs. index are only the uses found in homeopathy. Herbs, which homeopaths typically prescribe by scientific • Dosage: Listed here are common modes of admin- name, are listed here in the same manner, followed by istration, forms and strengths of available commercial their accepted common name in parentheses. As in preparations, methods for preparing the natural herb, the main indications index, headings are chosen to and representative dosage recommendations drawn match those in the PDR Companion Guide. from the literature. Note, however, that dosage recom-mendations can be used only as a general guide. The • Asian Indications Index: Entries in this index arepotency of individual preparations and extracts is sub- limited to uses found in Chinese and Indian medicine.ject to substantial variation, so the manufacturers (Chinese entries are signified with a "C;" Indiandirections should be consulted whenever available. entries with an "I.") Herbs are listed by accepted com- mon name. Once again, indication headings employ• Literature: This section provides you with a the nomenclature used in the PDR Companion Guide.unique bibliography of the technical literature.Because German researchers have been particularly • Side Effects Index: In this index, youll find a listactive in the herbal arena, you will find an unusual of all herbs associated with a given adverse reaction.number of German-language citations. However, Herbs are listed alphabetically by accepted commonwork in the English literature is included as well. name, with the scientific name and page number
VI PDR FOR HERBAL MEDICINES appended. Nomenclature employed in the side effect evidence and cannot be considered firm or final. The headings matches that used in PDRs Side Effects publisher does not warrant that any herb will unfail- Index, another feature of the PDR Companion Guide ingly and uniformly exhibit the properties ascribed to and the PDR Electronic Library CD-ROM. it by Germanys Commission E or any other scientific authority. • Drug/Herb Interactions Guide: In this convenient reference, each potential interaction is listed under In the United States, herbal products are marketed both the name of the drug and the name of the interact- under the provisions of the Dietary Supplement and ing herb. A brief description of the interactions effect Health Education Act of 1994, which prohibits their follows each item. sale for the diagnosis, treatment, cure, or prevention of any disease. Enumeration of specific commercial • Safety Guide: This section lists botanicals in three preparations within an herbal monograph should not precautionary categories: be construed as a claim or warranty of their efficacy — Not for use during pregnancy for any purpose, by either the manufacturer or the pub- — Not for use while nursing lisher. Furthermore, it should be understood that, just — For use only under supervision as omission of a product does not signify rejection, Here, the scientific, common, and brand names of all inclusion of a product does not imply endorsement, herbs in each category are listed alphabetically, togeth- and that the publisher is not advocating the use of any er with the appropriate page number for further infor- product or substance described herein. mation. Please remember, too, that dosing of herbal prepara- • Manufacturers Index: This index provides you tions is highly dependent on a variety of factors, such with contact information for each supplier whose prod- as cultivation and harvesting conditions, the specific ucts appear in the herbal monographs. The names of parts of the plant to be processed, the extraction meth- the products, together with the page number of the ods employed, and the dosage form chosen by the monograph in which they appear, are included in each manufacturer. Since there are no official standards manufacturers entry. governing the production of herbal medicines in the United States, and the potency and the purity of herbalFollowing the indices, just as in PDR itself, youll find products are subject to substantial variation, dosagean extensive full-color identification section. The first ranges set forth in the herbal monographs must bepart of the section—the Herb Identification Guide— employed only as general guidelines.encompasses nearly 400 of the most widely usedherbs. The second part—the Product Identification In addition, the publisher does not guarantee thatGuide—includes photos of some of the more popular every possible hazard, adverse effect, contraindication,commercial formulations. Together, these guides pro- precaution, or consequence of overdose is included invide you with a truly unique reference unmatched in the summaries presented here. The publisher has per-any other printed resource. Weve also included a formed no independent verification of the data report-brief glossary of the unfamiliar terms found in the ed herein, and expressly disclaims responsibility formonographs. any error, whether inherent in the underlying literature or resulting from erroneous translation, transcription,PDR for Herbal Medicines is the product of one of the or typography.most thorough and inclusive examinations of theherbal literature ever undertaken. Nevertheless, its When patients approach you—as they surely will—forimportant to remember that it merely summarizes and advice on the latest herbal "discovery" to hit the night-synthesizes key data from the underlying research ly news, we hope that PDR for Herbal Medicines willreports, and of necessity includes neither every pub- provide you with all the facts you need to offer sound,lished report nor every recorded fact. rational guidance firmly grounded in fact. Certainly such counseling is the aim of every dedicated healthAs in all scientific investigation, conclusions regarding care professional. And at PDR, we fully share thatthe effectiveness of the herbs discussed in this com- goal.pendium are based on the preponderance of current
1-1 Alphabetical Index Listed here are all scientific, common, and brand names to be found in the herbal monographs. Generally accepted common names that serve as monograph titles appear in bold type. Scientific names are shown in italic type. Brand names are followed by the suppliers name in parentheses. If an entry lists two page numbers, the first refers to a photograph of the plant or product in the Identification Guide, the second to the herbal monograph. A Acorus calamus G-7, 138 AGA Acrid Crowfoot 133 (Amanita muscaria) G-3, 8 Aarons Rod Acrid Lettuce 433 AGAR (Sempervivum tectorum) . .0-14, 411 Actaea spicata so Aarons Rod (Gelidium amansii) 9 Activated Ginkgo Tablets (Solidago canadensis) 145 Agar-Agar 9 (Aim for Herbs) 342 Aarons Rod Aged Garlic Extract, Kyolic Activin Capsules (Solidago virgaurea) 0-11, 289 Hi-Po Formula Capsules (Advanced Nutritional) 362 Aarons Rod (Wakunaga) 327 Adams Apple G-16, 476 (Verbascum densiflorum) .0-18, 832 Agrimonia eupatoria G-3, 10 Adams Flannel G-18, 532 Abelmoschus moschatus 833 AGRIMONY Abelmosk 833 ADAMS NEEDLE (Agrimonia eupatoria) G-3, 10 Abies alba 802 (Yucca filamentosa) 4 Agropyron repens G-23, 771 Abrus precatorius 43s Adders Eyes 0-22, 668 Agrostemma githago 222 ABSCESS ROOT Adders Mouth 180 Ague Grass 11 (Polemonium reptans) 0-3, 3 Adders Root 46 Ague Tree G-21, 662 Adderwort o-s, 82 Ague-Root 11 Absinthe 0-2*, 829 Adiantum capillus-veneris 491 Agueweed o-6, 113 Abyssinian Tea 447 ADONIS Ailanthus altissima 770ACACIA Ailanto 770 (Acacia arabica) 3 (Adonis vernalis) 0-3, 3 Airelle G-3, 7s Acacia 378 Adonis vernalis c-3, 3 Ajuga chamaepitys G-13, 373Acacia arabica 3 ADRUE Ajuga reptans G-6, 12s Acacia Bark 3 (Cyperus articulatus) c-3, 6 Akebia 189Acacia catechu 183 Akebia quinata 189 Adulsa G-17, 492Acacia Senegal 378 Alant (Inula britannica) 119 Aegle marmelos 88Acalypha indica 419 Alant (Inula helenium) G-10,266 Aegopodium podagraria ... .0-13, 36iAcer rubrum 0-21, 838 Alcanna : G-14, 391 Aesculus hippocastanum ... G-14, 403Achillea millefolium G-26, 833 Alcea rosea G-14, 398 Aethusa cynapium 0-12, 316Achillea ptarmica 700 Alchemilla vulgaris G-13, 436 Aframomum melegueta G-13, 362Achweed 0-13, 36i Alchornea floribunda . 424 African Pepper 0-8, iesAconite 0-18,321 Alcohol Free Black WalnutAconite Bean 376 AFRICAN POTATO Green Hulls Fluid ExtractAconitum napellus G-18, 321 (Hypoxis rooperi) 7 (Natures Answer) 134