aloe

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

PO: Laxative.
Topical Use on burns/sunburns, wounds, irritated skin, psoriasis; topical anti-infective.

Contraindicated in:

Intestinal obstruction;
Inflammatory intestinal diseases;
Appendicitis and abdominal pain of unknown origin;
OB: Pregnancy;
Pedi: Oral aloe not appropriate for children <12 yr. Topically applied aloe gel-containing formulations have been safely used in clinical trials.

Use Cautiously in:

Renal disease;
Fluid or electrolyte abnormalities;
Diabetes;
Alcohol-containing products should be used cautiously in patients with known intolerance or liver disease;
Lactation: Safety not established in breastfeeding;
Pedi: Use oral aloe with caution in children >12 yr.

Derm: contact dermatitis, skin irritation

Endo: hypoglycemia

F and E: dehydration, HYPOKALEMIA

GI: cramping, diarrhea, laxative dependence (chronic use)

GU: hematuria

Natural-Drug Products:

Combining oral aloe with potassium-wasting drugs (e.g., diuretics, other laxatives, corticosteroids, cisplatin, amphotericin B) may worsen hypokalemia. Hypokalemia may ↑ risk of toxicity from digoxin and some antiarrhythmics.
May have additive effects with antidiabetic agents.
May ↑ risk of bleeding with anticoagulants and antiplatelets.
Alcohol-containing preparations may interact with disulfiram and metronidazole.

Natural-Natural Products:

↑risk of hypokalemia with licorice and horsetail.
Additive effects with stimulant laxative herbs and herbs with hypoglycemic potential.
Herbs with anticoagulant or antiplatelet properties may ↑ bleeding risk when combined with chamomile, including: anise, asafoetida, bogbean, boldo, capsicum, celery, clove, danshen, dong quai, fenugreek, feverfew, garlic, ginger, ginkgo, Panax ginseng, horse chestnut, horseradish, licorice, meadowsweet, prickly ash, onion, papain, passionflower, poplar, quassia, red clover, turmeric, wild carrot, wild lettuce, and willow.

Alone or in combination with other herbal medicinals: ^OTC
Capsules: ^OTC
Juice: ^OTC
Tincture (1:10 in 50% alcohol): ^OTC
Topical or gel or applied directly from cut plant:

PO (Adults ): Constipation: 100–200 mg of aloe or 50 mg of aloe extract taken in the evening. Do not use for >1–2 wk without medical advice; Juice: 30 mL 3 times a day after meals.
(Adults ): Aloe gel can be applied liberally to affected areas 2–3 times daily.

Aloe vera, Cape aloe, Aloe latex, Burn plant, Curacao aloe

PO: Exerts a laxative effect by causing ↑ mucous secretion and peristalsis. The cathartic effects occur within 10 hr. Water and electrolyte reabsorption are inhibited.
Topical May help accelerate wound healing through inhibition of thromboxane A2 and ↑ microcirculation, preventing ischemia in wounds.

Therapeutic effects:

Relief of constipation.
Improved wound healing.

Therapeutic Classification: laxatives, wound/ulcer/decubiti healing agent

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

ROUTE	ONSET	PEAK	DURATION
PO, Topical	unknown	unknown	unknown

Explain purpose and side effects of herbal to patient.
Advise patient to consult with health care provider before using any herbal supplement, especially when taken concurrently with Rx or OTC medications or vitamins.
Constipation: Instruct patient with pre-existing intestinal disorders (ulcerative colitis, Crohn disease, irritable bowel syndrome) not to take aloe juice without the advice of a health care provider.
Counsel patients that the oral juice should not be taken if they are experiencing abdominal pain, nausea, vomiting, or fever.
Inform patient that occasional constipation may not be an issue, but persistent constipation may represent a more serious health problem and to consult their health care provider.
Advise patient to expect laxative response to the oral juice in 8–12 hr.
Caution patient that the laxative effects may be dramatic and that accompanying dehydration and electrolyte imbalances may occur. If severe diarrhea occurs or persists, seek out treatment from health care provider.
Advise patient other than those with spinal cord injury that laxatives should only be used for short-term therapy. Although this is considered by some to be a natural way of correcting constipation, it still carries the risk of electrolyte imbalance and dependency with chronic use.
Encourage patient to use other forms of bowel regulation, such as ↑ dietary fiber and fluid intake and ↑ mobility, as appropriate. Normal bowel habits are individualized and may vary from 3 times/day to 3 times/wk.
Advise patient to consume 1500–2000 mL/day of fluids during therapy to prevent dehydration.
Advise patient with a known cardiac history not to take this herbal supplement without the advice of health care provider because of the risk of hypokalemia worsening arrhythmias.
Caution patient with cardiac history to avoid straining during bowel movements (Valsalva maneuver).
Topical Advise patient that topical applications should only be used for minor burns, abrasions, or wounds. Wounds of larger size or more serious burns should be treated by a health care provider.
Instruct patient using topical application on a nonintact skin surface about signs and symptoms of infection (milky or discolored drainage, redness, warmth, swelling, pain) and to promptly seek out treatment of a health care provider if these occur.
Advise patient to stop treatment and seek medical attention from a health care provider if wound shows no signs of improvement or worsens.
Advise patient with risk factors for delayed wound healing (diabetes, vascular disease) not to self-medicate with aloe vera without the approval from a health care provider.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding. Avoid use in pregnancy; may cause uterine contractions and trigger miscarriage.

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Indications ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Availability ⬆ ⬇

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US Brand Names ⬆ ⬇

Action ⬆ ⬇

Classifications ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Pronunciation ⬆