Page 139 - 2018 SP Product Guide

Recommended Action Avoid long-term use at doses > 100 mg/day glycyrrhizin unless under close supervision. U Place patients on a high potassium diet. Avoid long-term use at doses > 100 mg/day glycyrrhizin unless under close supervision. U Place patients on a high potassium diet. Monitor (medium level of risk). Place patients on a high potassium diet. Monitor (very low level of risk at normal doses). Monitor (low level of risk at normal doses) when drug admini

effect greater in women, and effect shown for dose as low as 50 g/day of licorice (75 mg/day of glycyrrhetinic
volunteers. 185 Clinical study to establish a no-effect level for glycyrrhizin (healthy female volunteers): significant
4 mg/kg (220–332 mg/day) taken for 8 weeks, but no effect at lower doses of 1–2 mg/kg (55–166 mg/day)
Clinical studies (up to 200 g/day of licorice): dose-dependent relationship found between licorice and increase
in blood pressure, more pronounced effect in hypertensive patients than in normotensive volunteers, adverse
Hypokalemic paralysis reported (184 mg/day of glycyrrhizin for 2 months), although hypertension was mild,
results (eg blood pressure, serum potassium and aldosterone) compared to controls found for daily dose of
blood pressure (see note T) – renal function may be a factor. 184 The increase in blood pressure after taking
glycyrrhetinic acid (874 mg/day of glycyrrhizin) was more pronounced in salt-sensitive than salt-resistant
acid = 130 mg/day of glycyrrhizin S ) taken for 2 weeks. 181-183 Other studies show variation of effects on
Hypertension demonstrated in case reports, usually from long-term intake and/or very high dose. 179
When consumed in high doses, licorice can cause pseudoaldosteronism and high blood pressure.
possibly due to coexisting sodium wasting related to uropathy from prostate cancer. 180

Chinese herbs containing 5 g licorice, taken for 14 days). 188 Case reports (licorice tea, 3 L/day; patient still hypertensive despite treatment with drugs; 187 decoction of Case report (patient consumed licorice herbal medicine (200–240 mg/day glycyrrhizin)). Drug dosage was reduced, leading to pseudoaldosteronism. 189 See note V. Case report (patient taking 150 mg/day of glycyrrhizin). Serum potassium levels were stable prior to I

Basis of Concern Herb or Constituent Alone of glycyrrhizin. 186 Herb and Drug administration of drug. 190 does not happen in the liver. Herb or Constituent Alone plasma cortisol. 201 Herb or Constituent and Drug Herbal Constituent and Drug (= 700 mg/day glycyrrhizin). 206

Potential Interaction General: May decrease effectiveness of drug. ACE-inhibitor: May mask the development of pseudoaldosteronism. May cause hypokalemia, which can potentiate the toxicity of the drug. Cortisol: May potentiate the action (rather than increase level of drug). Prednisolone: May potentiate the action or increase level of drug.

Licorice Glycyrrhiza glabra Antihypertensive medications

Drug other than diuretics Cilostazol Corticosteroids

138 MediHerb Product Catalog 2018 • Herb-Drug Interaction Chart
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