goldenseal

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

Prevention of colds and flu
Infections of the mucous membranes (bacterial and fungal), conjunctivitis, and GI infections associated with diarrhea, cirrhosis, gallbladder inflammation, and cancer
Dysmenorrhea
Eczema, acne, itching, wounds, herpes labialis

Action ⬆ ⬇

Hydrastine and berberine are the active compounds that exhibit in vitro uterine stimulant activity.
Berberine may have antibacterial and amebicidal properties.
High doses of hydrastine cause potential hypertensive effects and increased cardiac output.

Therapeutic effects:

Antibacterial activity againstEscherichia coli.

Pharmacokinetics ⬆ ⬇

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO, Topical	unknown	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Pregnancy and lactation ;
Newborns (causes kernicterus);
Hypertension.

Use Cautiously in:

Patients with diabetes (monitor for hypoglycemic effects);
Epilepsy;
Cardiovascular disease;
Hyperbilirubinemia;
Large amounts considered toxic;
Large doses may interfere with B-vitamin metabolism;
Do not take for longer than 2 wk;
Inflammatory GI conditions.

Adv. Reactions/Side Effects ⬆ ⬇

GI: kernicterus (in newborns)

Interactions ⬆ ⬇

Natural-Drug Products:

May ↑cyclosporine and digoxin levels.
May ↑ levels of CYP 3A4 substrates includinglovastatin, sildenafil, and clarithromycin.

Route/Dosage ⬆ ⬇

PO (Adults ): Dried root and rhizome: 0.5–1 g tid; liquid extract (1:1 in 60% ethanol): 0.3–1 mL tid; tincture (1:10 in 60% ethanol): 2–4 mL tid; capsule: 250–500 mg/day at first sign of cold or flu.
(Adults ): Used as mouthwash 3–4 times daily or dried root mixed with water and used as a paste applied with a compress.

Availability ⬆ ⬇

Capsules: ^OTC
Dried root: ^OTC
Liquid extract (1:1 in 60% ethanol): ^OTC
Tincture (1:10 in 60% ethanol): ^OTC

Assessment ⬆ ⬇

Assess patient for abdominal distention, presence of bowel sounds, usual pattern of bowel function, and color, consistency, and amount of stool produced.
Monitor temperature, and note signs associated with fever (diaphoresis, tachycardia, malaise).
Assess wounds for size, appearance, and drainage prior to and during therapy.

Implementation ⬆ ⬇

May be taken without regard for food.
To make paste, mix 2 tsp with enough water, and apply with a compress.

Patient/Family Teaching ⬆ ⬇

Warn patients with preexisting medical conditions not to take this herb without the advice of health care professional.
Instruct patient to avoid driving or other activities requiring mental alertness until response to therapy is known.
Warn patient that this herb is associated with excessive toxicity; therefore, some texts do not support its use for any reason.
Instruct patient to consult health care professional before taking any Rx, OTC, or other herbal products concurrently with goldenseal.

Evaluation/Desired Outcomes ⬆ ⬇

Relief of pain associated with dysmenorrhea.
Decrease in abdominal and/or epigastric pain.
Wound healing.

US Brand Names ⬆

Eye balm, eye root, ground raspberry, Indian dye, Indian paint, Indian plant, jaundice root, orange root, turmeric root, warnera, wild curcuma, yellow puccoon, yellow root

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇