Cleavers
Botanical Description & Habitat
Galium aparine
Family
Rubinaceae
Common Names
| Burweed | Cheese rennet |
| Curdwort | Eriffe |
| Hayriffe | Lady's bedstraw |
| Yellow bedstraw | Yellow cleavers |
Habitat
Europe and the United States; primarily a mountain plant, grows in moist or grassy places.
Description
Cleavers is an annual plant. Its stem is weak, sparsely branched, square, and prickly. The plant is hairy at the joints and can reach 2-6 feet in height. The lanceolate leaves grow in rings of 6 or 8, and possess bristly hairs at the margin. Small white or greenish-white flowers grow in clusters on long peduncles from May to September. The fruits consist of 2 joined, 1-seeded capsules covered with hooked bristles.
Medicinal Parts
Dried aerial parts, gathered during the flowering/fruiting period.
Historical Properties & Uses
Cleavers is used in several common herbal applications as a diuretic, diaphoretic, antispasmodic, febrifuge, anti-cancer, hypotensive, and vulnerary. Its hypotensive property is especially important whenever cleavers is used as a diuretic for cardiovascular disease.
Cleavers act directly on the kidneys much like uva ursi, but with milder action. However, its effect on acute inflammation or irritation of the urinary tract is stronger than most treatments. Cleavers also possesses some antibiotic activity.
Early eclectic physicians often combined cleavers with buchu and uva ursi for maximum benefit, including the elimination of gallstones and kidney stones.
Method of Action
Interesting data has been collected concerning the hypotensive properties of cleavers. Aqueous extracts produced a fall up to 30mm in the blood pressure of dogs given cleavers i.v. Asperuloside, an active constituent, in a dose of 4mg/kg, lowered blood pressure of the rabbit an average of 12mm. In all cases, the animals showed a rapid but incomplete recovery from the depressed state.
Asperuloside is believed to be the beta-glucoside of an enolic lactone. Interestingly, cleavers in which no asperuloside could be detected also produced a depressor effect on the blood pressure of dogs. Asperuloside may not, therefore, be the only active constituent in cleavers.
Drug Interactions & Precautions
Known Interactions
Since cleavers' diuretic action increases the renal excretion of sodium and chloride, may potentiate the hyperglycemic and hyperuricemic effects of glucose elevating agents.
This diuretic may also potentiate the action of antihypertensive, ganglionic or peripheral adrenergic blocking drugs, tubocurarine, and, to a lesser degree, norepinephrine.
It should be noted the effects of dopamine and diuretic agents are additive.
Possible Interactions
Vitamin K, menadione, and menadiol sodium diphosphate may antagonize the anticoagulant effects of coumarins, such as cleavers.
The nicotinic acid content of cleavers may antagonize the effects of heparin, while the antituberculous activity of cleavers may potentiate the adverse effects of other antituberculous drugs, especially ethionamide.
Conversely, the hypotensive effect of cleavers may be potentiated by anorectic drugs such as fenfluramine (whose effects are mediated by brain stem serotonin), and may be additive with the analgesics nalbuphine HCl and propoxyphene HCl.
When taken in conjunction with corticotropin (ACTH) or corticosteroids, this diuretic herb is more prone to produce hypokalemia. The use of this diuretic may require dosage adjustments of antidiabetic drugs. In addition, the diuretic action of cleavers may reduce renal clearance of lithium. It should also be noted an initial dose of the antihypertensive captopril may cause a severe drop in blood pressure within three hours if the person is also using a strong diuretic.
Comments
Although the coumarin content of cleavers is not high at normal usage levels, it is important to note coumarins can affect the action of almost any drug.
Due to hypotensive principles and in order to eliminate the chance of central nervous system depression, cleavers should not be taken by persons on procarbazine antineoplastic agents.
Prolonged use of this diuretic herb may affect certain laboratory test results, such as electrolytes (especially potassium and sodium), blood urea nitrogen (BUN), uric acid, glucose, and protein bound iodine (PBI).
The strong diuretic action of cleavers may produce digitalis toxicity if digitalis glycosides are being used. When taken in conjunction with aminoglycoside antibiotics, cleavers may also produce ototoxicity. In combination with ethyl alcohol, barbiturates, or narcotics, it may produce orthostatic hypotension. In addition, cleavers may enhance the nephrotoxicity of cephaloridine.
Strong diuretics such as this in conjunction with indomethacin may produce natriuretic effects.
Safety Factors & Toxicity
Cleavers is nontoxic in therapeutic amounts.
Preparation & Administration
Three times a day
Dried herb
2-4 grams
Tea
1 tsp dried herb
Fluid extract
1:1 in 25% alcohol, 2-4 ml
Expressed juice
3-15 ml
Note: This Herbal Preparation information is a summary of data from books and articles by various authors. It is not intended to replace the advice or attention of health care professionals.
References
Am Hospital Formulary Service. Am Soc of Hosp Pharm. Wash, D.C.
Bressler, R., M. Bogdonoff & G. Subak-Sharpe. 1981. Physicians Drug Manual. Doubleday & Co, Inc. Garden City, NY. 1213 pp.
Chambers, G., R.J. Kerry & G. Owen. 1977. Lithium used with a diuretic. British Medical Journal, 2. pp. 805-806.
Chiles, V.K. 1968. Drug interactions and the pharmacist. Canadian Pharaceutical Journal, 101(7). pp. 241-247.
Committee on Pharmocopaeia of Am Institute of Homeopathy, The Homeopathic Pharmacopaeia of the US. 8 ed., Vol 1. Clapp & Son, Agents, Boston, l981.
Delas, et.al., Sur l'action hypotensive des extraits de buxus balearica willd., de hedere helix l. et de galium aparine l. Toulouse Med, 1948.
De Martinis, M., et.al. 1980. Milk thistle (silybum marianum) derivatives in the therapy of chronic hepatopathies. Clin. Ter., 94(3). pp. 283-315.
Dodds, M. & R. Foord. 1970. Enhancement by potent diuretics of renal tubular necrosis induced by cephaloridine. British J of Pharma, 40.p.227.
Drug package insert (FDA approved official brochure) and other labeling based on sponsored clinical investigations and New Drug Application data.
Goldner, M., H. Zarowitz & S. Akgun. 1960. Hyperglycemia and glycosuria due to thiazide derivatives administered in diabetes mellitus. New England Journal of Medicine, 262(Feb 2). pp. 403-405.
Goodman, L.S. & A. Gilman. 1975. Pharm Basis of Thera. MacMillan, NY.
Hansten, P.D. 1979. Drug Interactions, 4th ed. Lea & Febiger, Phila.
Hansten, P.D. 1968. Antidiabetic drug interactions. Hosp. Form. Mgmt, 4(2). pp. 30-32.
Hurtig, H.I. & W.L. Dyson. 1974. Lithium toxicity enhanced by diuresis. New England Journal of Medicine, 290(Mar 28). pp. 748-749.
Hyde, F.F. British Herbal Pharmacopoeia. British Herbal Medicine Assoc: West Yorks, England, 1983
Indocin. 1978. Product Information. Merck Sharp & Dohme.
Kastrup, E.K., ed. 1981. Drug Facts and Comparisons, 1982 edition. Facts and Comparisions Division, J.P. Lippincott Co, Phila(St. Louis).
Knott, R.P. & R.S. McCutcheon. Phytochemical investigation of a rubiaceae. Galium triflorum. Journal of Pharmaceutical Sci., 50(11). pp. 963-965.
List, P. & L. Hoerhammer. 1969-1976. Hagers Hanbuch der Pharmazeutischen Praxis, vols. 2-5. Springer-Verlag, Berlin.
Lutz, E.G. 1975. Lithium toxicity precipitated by diuretics. Journal of the Medical Society of New Jersey, 72(5). pp. 439-440.
Martin, E. Drug Interactions Index, 1978/79. J.B. Lippincott Co, Phila.
Miller, R.D., et.al. 1976. Enhancement of d-tubocurarine neuromuscular blockage by diuretics in man. Anesthesiology, 45. p. 442.
Miller, L. & R. Lindeman. Red Blood Cell and Serum Selenium Concentration as Influenced by Age and Selected Diseases. J of Am Col Nutri, 2 (1983).
Mowrey, Daniel B., Ph.D. Exper. Psych., Brigham Young University. Director of Nebo Institute of Herbal Sciences. Director of Behavior Change Agent Training Institute. Director of Research, Nova Corp.
Nagata, R. 1969. Drug interactions -- digitalis glycosides and kaliuresis. Hospital Form Management, 4(8). pp. 30-32.
Scientific Committee, British Herbal Pharmocopaeia, British Herbal Med Assoc, Lane House, Cowling, Na Keighley, West Yorks, Bd Bd220lx, l983
Thorn, G.W. 1966. Clinical considerations in the use of corticosteroids. New England Journal of Medicine, 274(Apr 7). pp. 775-781.
Tuttle, C.1969. Drug interactions. Canadian Journal of Hospital Pharmacy, 22(5-6). pp. 2-15.
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