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Taxonomic class
Fabaceae
Common Trade Names
Multi-ingredient preparations: Alvita Tea Licorice Root, Alvita Tea Licorice Sticks, Full Potency Licorice root VegiCaps, Gaia Herbs Licorice Root A / F, Gaia Herbs SFSE licorice root, Licorice ATC Concentrate, Licorice and Garlic, Licorice Root Extract, Licorice Root Tea, VegetarianNatrol licorice root Capsules, Natural Arthro-Rx, Nature's Answer licorice root alcohol and Low Free, Nature's Herbs Licorice Phytosome capsulesNature's Herbs Certified Potency Power Licorice Capsules, Solaray Licorice, Tea with Mint, Tubi's Organic Licorice Licorice Bars and chewed Tummy soother.
Common forms
Capsules: 100 to 520 mg licorice root
Liquid extracts: licorice extract, licorice extract deglycyrrhizinized
Tablets: 7 mg of licorice root and 333 mg of concentrated garlic
Also available in candy, chewing gum, herbal teas, throat windows and tobacco.
Source
Mostmedicinal use of dried roots and rhizomes of Glycyrrhiza gZabra, a perennial herb or low growing shrub. Spanish drop, the most common variety, derived from G. glabra var. typica. Licorice plants are native to the Mediterranean but widely cultivated in the United States, Russia, Spain, Turkey, Greece, India, Italy, Iran and Iraq.
Chemical components
The rhizomes and roots contain 5% to 9% glycyrrhizin (glycyrrhizic acid), a glycoside that is 50 times sweeter thansugar. Hydrolysis of glycyrrhizin yields glycyrrhetic acid, not sweet. Other compounds are ammonia, Oléane triterpenoids, glucose, mannose, and sucrose. Aqueous extracts of licorice contain 10% to 20% glycyrrhizin.
Actions
Glycyrrhizin is hydrolyzed by the intestinal flora of the pharmacologically active form, glycyrrhetic acid. The main effect oflicorice would enhance rather than to mimic, endogenous steroids.
Animal studies suggest that glycyrrhizinglycyrrhetic acid have mild anti-inflammatory effect. Glycyrrhizin may stimulate gastric mucosal synthesis through effects on prostaglandins, which may explain its ulcer-healing properties.
Anecdotal, licorice, efficient emollient (soothing) and mucus-dissolving properties and mild laxative and antispasmodic effects. A Chinese licorice preparation called Zhigancao been shown that the anti-arrhythmic effects, including prolonged PR and QT intervals have. Glycyrrhizin is also lowercholesterol and triglycerides and practice antianemic, antihepatotoxic and immunosuppressive effects.
Previously
Because of its anecdotal use for gastric irritation, licorice derivatives have been studied for antipeptic action. Licorice was also evaluated as a treatment for Addison's disease and showed improvement mineralocorticoid activity, but could not imitate, because adrenal activity was absent.
Glycyrrhizic acid was used as a shampoo to reduce sebum secretionof the scalp and cold sores, eczema, and mouth ulcers.
In the United States, glycyrrhizin mainly used as flavoring and sweetener for bitter drugs, and in beverages, candy, chewing gum, tobacco products, and toothpaste. It also has a number of cough and cold preparations for its expectorant and soothing effect.
Dosage
For ulcers, daily 200 to 600 mg PO of glycyrrhizin longer than 6 weeks, according to the German Commission E.
TheThe next tea is considered to provide glycyrrhizin in the middle of this range: 1 teaspoon (2 to 4 g) of crude to drop Yo cup (120 ml) boiling water, simmered for 5 minutes. Cool, strain, and take PO after a meal.
Unwanted
CNS: hypertensive encephalopathy.
CV: heart failure and cardiac arrest (with overdose), ventricular tachycardia.
A T: transient visual loss and disturbances after ingestion of 1.4 to 2 pounds oflicorice candy.
Endocrine: growthretardation, decreased serum testosterone levels.
GU: renal tubular damage.
Metabolic: hypokalemia pseudo primary aldosteronism.
Musculoskeletal: muscle weakness (with hypokalemia), myopathy, rhabdomyolysis.
Respiratory: pulmonary edema.
Interaction
Antihypertensives, diuretics: May increase hypokalemic effects of some diuretics. Avoid administration with licorice.
Corticosteroids (including local), the effects. Use togethercarefully.
Digoxin can cause hypokalemia; risk of digitalis toxicity. Avoid administration with licorice.
Loratadine, procainamide, quinidine, other drugs that can prolong the QT interval: May have additive effects. Use with caution.
Spironolactone, can block the ulcer-healing and aldosterone-like effect of liquorice. Avoid administration with licorice.
Contraindications and precautions
Licorice is contraindicated in patients with arrhythmias, CV, renal orliver disease, or hypertension. Avoid using it in pregnant or lactating patients; effects are unknown. Use caution in elderly patients under medical supervision.
Special considerations
Monitor for hypokalemia in patients taking diuretics.
A single large dose of licorice is less likely to cause toxicity than prolonged intake of smaller amounts.
Alert Licorice poisoning is insidious. Monitor pseudo primary aldosteronism causesmineralocorticoid-like effects (headache, lethargy, sodium and water retention, hypokalemia, hypertension and heart failure). Monitor electrolytes (potassium, calcium and sodium) imbalances, alkalosis, electrocardiographic abnormalities, and hypertension.
Caution the patient about the dangers of excessive and chronic licorice ingestion, including fluid retention and electrolyte balance.
Inform the patient about potential drug interactions.
Sightseeing
Liquoricehas been used medicinally since Roman times and is popular in Chinese herbal medicine.
Most "licorice candy" sold in the U.S. are seasoned with anise oil and not actually contain licorice.
Commentary
Although licorice derivatives have been studied for use against peptic ulcer, these products have not fared better than H 2 antagonists and may be less well tolerated. Glycyrrhetic acid playa role in increasing the current efforts of low powersteroids while minimizing systemic effects, but research is still preliminary. Glycyrrhetic acid is the main cause of drop-induced pseudohyperaldosteronism syndrome seen with licorice ingestion, because the inhibitory effect on the enzyme 11-beta-dehydrogenase hydroxysteroïd. Surprisingly, drop in any form, even as candy, should be considered cautiously because chronic ingestion of low doses and high doses can be toxic, illustrated by a number of serious adverse eventsevents documented in the literature.