Alder Buckthorn bark (Rhamnus Frangula)
Scientific Name: Frangula alnus, synonym Rhamnus frangula.
Other names:Alder Dogwood, Arraclán, Arrow Wood, Aulne Noir, Black Dogwood, Bois Noir, Bois à Poudre, Bourdaine,Bourgène, Buckthorn, Coudrier Noir, Dog Wood, Frángula, Frangula, Frangulae Cortex, Frangule, Glossy Buckthorn, Nerprun Bourdaine, Nerprun Noir, Rhubarbe des Paysans.
Uses: Orally, alder buckthorn is used as a laxative, as a tonic, and as a component in the Hoxsey cancer formula.
Safety: 4 Stars
Orally, alder buckthorn can cause cramp-like discomfort (HYPERLINK \l “6:”6) Chronic use can cause pseudomelanosis coli (pigment spots in intestinal mucosa) which is harmless, usually reverses with discontinuation (6), and is not associated with an increased risk of developing colorectal adenoma or carcinoma (18). Chronic use or abuse of the bark can lead to potassium depletion, albuminuria, and hematuria. Potassium depletion can lead to disturbed heart function and muscle weakness (6). The fresh or improperly aged bark can cause severe vomiting due to the presence of the free anthrone, an emetic constituent.
Interactions with Supplements:
CARDIAC GLYCOSIDE-CONTAINING HERBS: Theoretically, potassium depletion associated with alder buckthorn might increase the risk of cardiac glycoside toxicity when used with other cardiac glycoside-containing herbs (22). Cardiac glycoside-containing herbs include black hellebore, Canadian hemp roots, digitalis leaf, hedge mustard, figwort, lily of the valley roots, motherwort, oleander leaf, pheasant’s eye plant, pleurisy root, squill bulb leaf scales, and strophanthus seeds.
HORSETAIL: Theoretically, overuse or misuse of horsetail with alder buckthorn may increases the risk of toxicity due to potassium depletion (22).
LICORICE: Theoretically, anthraquinone-containing herbs such as alder buckthorn can increase the risk of potassium depletion associated with licorice (22).
STIMULANT LAXATIVE HERBS: Theoretically, concomitant use of alder buckthorn with other stimulant laxative herbs can increase the risk of potassium depletion (22). Stimulant laxative herbs include aloe, black root, blue flag, butternut bark, colocynth, European buckthorn, fo ti, gamboge, gossypol, greater bindweed, jalap, manna, Mexican scammony root, rhubarb, senna, and yellow dock
Interactions with Drugs:
Corticosteroids : Moderate interaction: Concominate use of corticosteroids with alder buckthorn can increase the risk of potassium depletion. (6)
Digoxin: Moderate interaction: In theory, Potassium depletion accociated with alder buckthorn might increase the risk of digoxin toxicity. (22)
Diuretic Drugs: Moderate interaction: Theoretically, overuse of alder buckthorn might compound diuretic-induced potassium loss (22). There is some concern that people taking alder buckthorn along with potassium depleting diuretics might have an increased risk for hypokalemia. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), and hydrochlorothiazide (HCTZ, HydroDIURIL, Microzide), and others.
Oral drugs: Moderate interaction: Theoretically, alder buckthorn can reduce absorption of some drugs due to reduced gastrointestinal transit time (22).
Stimulate laxatives: Moderate interaction: Concomitant use might compound fluid and electrolyte loss (22).
Warfarin: Moderate interaction: Alder buckthorn has stimulant laxative effects. In some people alder buckthorn can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of alder buckthorn.
6: Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
8: Tyler VE. Herbs of Choice. Binghamton, NY: Pharmaceutical Products Press, 1994.
11: Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
13: Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physician’s Guide to Herbal Medicine. Terry C. Telger, transl. 3rd ed. Berlin, GER: Springer, 1998.
14: McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association’s Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
18: Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. View abstract.
22: Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.