Orally,
gentian is used for digestive disorders, such as loss of appetite, fullness, flatulence,
diarrhea, gastritis, heartburn, and vomiting. It is used orally for fever; hysteria;
hypertension; and stimulating menstrual flow; and as an antispasmodic, anthelmintic,
and antiseptic.
Topically,
gentian is used for treating wounds and cancer.In combination with European
elder flower, verbena, cowslip flower, and sorrel, gentian is used orally for maintaining
healthy sinuses and treating sinusitis. It is used in combination with other
products for malaria.
In foods
and beverages, gentian is used as an ingredient.
In
manufacturing, gentian is used in cosmetics.
Safety:
LIKELY
SAFE ...when the root preparations are used in amounts commonly found in foods.
Gentian root has Generally Recognized As Safe status (GRAS) for use in foods in
the US (3).
POSSIBLY
SAFE ...when gentian root is used orally in a specific combination that
contains gentian root, elderflower, verbena, cowslip flower, and sorrel
(SinuComp,
Sinupret) (1, 2).
There is
insufficient reliable information available about the safety of the topical use
of gentian.
PREGNANCY
AND LACTATION: There is insufficient reliable information available about the
safety of gentian in medicinal amounts during pregnancy and lactation; avoid
using.
Effectiveness:
POSSIBLY
EFFECTIVE
Sinusitis.
Taking gentian orally in a specific combination product that also contains
elderflower, verbena, cowslip flower, and sorrel (SinuComp, Sinupret) seems to
help treat acute or chronic sinusitis Clinical studies have used Sinupret (1, 2).
There is
insufficient reliable information available about the effectiveness of gentian
for its other uses.
Mechanism of Action:
The
applicable parts of gentian are the root and bark. The root is most commonly used.
Gentian root contains triterpenoids, xanthones, and other constituents (5, 6).
Preliminary research suggests gentian root has sedative effects. The xanthone
gentiacaulein seems to have antidepressant activity, possibly through inhibition
of monoamine oxidase (MAO)-A (6). Preliminary research suggests that gentian
bark extracts might have MAO-B inhibitor effects (7).
Gentian
root has been used historically as an antihypertensive. Gentian root extracts
seem to have vasorelaxant properties (8, 10). Preliminary research
suggests
that the xanthone constituents gentiacaulein and gentiakochianin may be
responsible for vasodilation by an unknown mechanism (9).
Adverse Reactions:
Orally,
gentian root in combination with other herbs can cause gastrointestinal adverse
effects and allergic skin reactions (1, 2).
Interactions with Herbs & Supplements:
HERBS AND
SUPPLEMENTS WITH HYPOTENSIVE EFFECTS: Gentian is thought to have hypotensive
effects. Theoretically, combining gentian with other herbs and supplements with
hypotensive effects might increase the risk of hypotension. Some of these herbs
and supplements include andrographis, casein peptides, cat's claw, coenzyme
Q-10, fish oil, L-arginine, lycium, stinging nettle, theanine, and others.
Interactions with Drugs:
ANTIHYPERTENSIVE
DRUGS <<interacts with>> GENTIAN
Interaction
Rating = Moderate Be cautious with this combination.
Severity
= Moderate • Occurrence = Possible • Level of Evidence = D
Theoretically,
concurrent use might increase risk of hypotension with drugs that lower blood
pressure (8, 10). These include captopril (Capoten), enalapril (Vasotec), losartan
(Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc),
hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.
Interactions with Foods:
None
known.
Interactions with Lab Tests:
None
known.
Interactions with Diseases or Conditions:
HYPOTENSION:
Theoretically, gentian use might worsen hypotension or interfere with drug
therapy to increase blood pressure (8, 10).
SURGERY:
Gentian might affect blood pressure. Theoretically, gentian might interfere
with blood pressure control during and after surgical procedures. Tell
patients
to discontinue gentian at least 2 weeks before elective surgical procedures.
Dosage/Administration: chronic
ORAL: For
acute or sinusitis, a specific combination product (SinuComp Phytopharmica)
containing gentian root 12 mg and 36 mgeach of European
elder
flower, verbena, sorrel, and cowslip flower has been used three times daily (1,
2).
TOPICAL:
No typical dosage.
Editor's Comments:
The
highly toxic white hellebore (Veratrum album) can be misidentified as gentian
and has caused accidental poisoning when used in home-made preparations (4).
Gentian
root is unrelated to the gentian violet dye (methylrosaniline chloride).
Specific References: Ginseng
1.
Neubauer N, Marz RW. Placebo-controlled, randomized,double-blind, clincal trial
with Sinupret sugar coated tablets on the basis of a therapy with antibiotics
and decongestant nasal drops in acute sinusitis. 1994;1:177-81.
2. Marz
RW, Ismail C, Popp MA. Action profile and efficacy of a herbal combination
preparation for the treatment of sinusitis. Wien Med Wochenschr 1999;149:202-8.
3.
Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally
Recognized As Safe. Available at: http://ecfr.gpoaccess.gov/cgi/t/text/textidx?c=ecfr&sid=
786bafc6f6343634fbf79fcdca7061e1&rgn=div5&view= text&node=21:3.0.1.1.13&idno=21
4. Zagler
B, Zelger A, Salvatore C, et al. Dietary poisoning with Veratrum album--a
report of two cases. Wien Klin Wochenschr 2005;117:106-8.
5.
Toriumi Y, Kakuda R, Kikuchi M, et al. New triterpenoids from Gentiana lutea.
Chem Pharm Bull (Tokyo) 2003;51:89-91.
6. Tomic
M, Tovilovic G, Butorovic B, et al. Neuropharmacological evaluation of
diethylether extract and xanthones of Gentiana kochiana. Pharmacol Biochem
Behav 2005;81:535-42.
7.
Haraguchi H, Tanaka Y, Kabbash A, et al. Monoamine oxidase inhibitors from
Gentiana lutea. Phytochemistry 2004;65:2255-60.
8. Uncini
Manganelli RE, Chericoni S, Baragatti B. Ethnopharmacobotany in Tuscany: plants
used as antihypertensives. Fitoterapia 2000;71:S95-100.
9.
Chericoni S, Testai L, Calderone V, et al. The xanthones gentiacaulein and gentiakochianin
are responsible for the vasodilator action of the roots of 144 Gentiana
kochiana. Planta Med 2003;69:770-2.
10.
Baragatti B, Calderone V, Testai L, et al. Vasodilator activity of crude methanolic
extract of Gentiana kokiana Perr. et Song. (Gentianaceae). J Ethnopharmacol
2002;79:369-72.
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