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Cowslip

Botanical Description & Habitat

Primula veris

Family
Primulaceae

Common Names
Paigle
Peagle

Habitat
Europe, Siberia, western Asia, and North Africa; found in meadows and pastures and along roadsides, preferring dry locations.

Description
Cowslip is a perennial root. It produces bright green, egg-shaped basal leaves, which are lighter on the underside, are pubescent, wrinkled, and marked with veins. The stem rises from the center of the leaves; it is leafless and reaches 4-5 inches in height. Yellow flowers grow in drooping, single-sided clusters, which bloom during April and May. The fruit is a glabrous, oblong capsule containing numerous brown seeds.

Medicinal Parts
Flowers - dried, roots and leaves

Historical Properties & Uses

Cowslip is used as a mild expectorant, as a diuretic to ease kidney complaints, and as an antispasmodic in the treatment of respiratory problems such as bronchitis, pneumonia, colds, and coughs.

Cowslip contains a number of potentially beneficial substances, including saponins and glycosides, but none of its properties have been experimentally tested.

Cowslip should not be ingested raw.

Method of Action

The method of action of cowslip, including basic pharmacological work, has not been investigated. Several components of the plant have been identified: saponins, A-primulic acid, glycosides (primulaveroside, primveroside, salicylic ester), and flavones. These are potentially bio-active substances.

Drug Interactions & Precautions

Known Interactions
Since cowslip's diuretic action increases the renal excretion of sodium and chloride, this herb may potentiate the hyperglycemic and hyperuricemic effects of glucose-elevating agents.

Diuretics in general may potentiate the action of antihypertensive, ganglionic or peripheral adrenergic blocking drugs, tubocurarine and, to a lesser degree, norepinephrine.

Possible Interactions
When taken in conjunction with corticotropin (ACTH) or corticosteroids, this diuretic herb is more prone to produce hypokalemia. The use of diuretic herbs may require dosage adjustments of antidiabetic drugs.

Furthermore, the diuretic action of cowslip may reduce renal clearance of lithium.

Caution should be used when taking cowslip in conjunction with CNS depressants or stimulants.

Due to presence of salicylates, cowslip may potentiate the effects of other anticoagulant agents, such as heparin. Cowslip, because of its salicylate-like constituents may also potentiate para-aminosalicylic acid (PAS) toxicity in patients using aminosalicylate drugs.

By competing for renal tubular secretion, salicylates prolong the half-life of penicillin G, increasing both its effectiveness and its toxicity.

Cowslip's analgesic effects may be additive with other analgesics and anesthetics. Conversely, they may be inhibited by barbiturates, despite any CNS-depressant effects which may occur. The analgesic property of cowslip may be reversed or even eliminated by P-chlorophenylalaine, cyproheptadine HCl, and phenobarbital.

The CNS depressant tendency of this analgesic herb may be potentiated by chlorprothixene HCl , haloperidol, and tranquilizers.

Comments
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).

To minimize cns depression and possible synergism, cowslip should not be used by persons on procarbazine antineoplastic drugs.

Salicylates block renal tubular secretion of methotrexate (cancer drug), thereby increasing the amount of active drug.

Plasma salicylate concentration may be increased by ammonium chloride, vitamin C, and para-aminobenzoic acid (PABA); it may be decreased by antacids.

The salicylate action of cowslip will increase the renal clearance of naproxen, and inhibit the uricosuric effect of sulfinpyrazone.

Safety Factors & Toxicity

Most herbalists agree the raw plant contains irritating alkaloids. Cowslip should be dried before use.

Preparation & Administration

Three times a day

Dried flowers
1-2 grams

Tea
made of 1-2 grams dried flowers

Fluid extract
1:1 in 25% alcohol, 1-2 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.D. Bogdonoff & G.J. Subak-Sharpe. 1981. The 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.

Clark, T.H., A.H. Conney & B.P. Harpole, et.al. 1967. Drug interactions that can affect your patients. Pat Care, 1(11) pp.33-71.

Coldwell, B.B. & B.H. Thomas. 1971. Effect of aspirin on the fate of bishydroxycoumarin in the rat. J of Pharm & Pharm, 23(3) pp. 226-227.

De Martinis, M., et.al. 1980. Milk thistle (silybum marianum) derivatives in the therapy of chronic hepatopathies. Clin. Ter., 94(3). pp. 283-315.

Drug package insert (FDA approved official brochure) and other labeling based on sponsored clinical investigations and New Drug Application data.

Fausa, O. 1970. Salicylate-induced hypoprothrombinemia. Acta Medica Scandinavica, 188(11). pp. 403-408.

Feldman, S. & B.C. Carlstedt. 1974. Effect of antacid on absorbtion of enteric-coated aspirin. JAMA, 227. p. 660.

Goldner, M.G., 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. 1968. Antidiabetic drug interactions. Hospital Form. Management, 4(2). pp. 30-32.

Hansten, P.D. 1979. Drug Interactions, 4th ed. Lea & Febiger, Phila.

Hartshorn, E.A. 1968. Drug interaction. Drug Intel 2(7). pp. 198-201.

Hurtig, H.I. & W.L. Dyson. 1974. Lithium toxicity enhanced by diuresis. New England J of Med, 290(Mar 28). pp. 748-749.

Hyde, F.F. British Herbal Pharmacopoeia. British Herbal Medicine Assoc: West Yorks, England, 1983

Kastrup, E.K., ed. 1981. Drug Facts and Comparisons, 1982 edition. Facts and Comparisions Division, J.P. Lippincott Co, Phila (St. Louis).

List, P. & L. Hoerhammer. 1969-1976. Hagers Hanbuch der Pharmazeutischen Praxis, vols. 2-5. Springer-Verlag, Berlin.

Levy, G. & J.R. Leonards. 1971. Urine pH and salicylate therapy. JAMA, 217. p. 81.

Lutz, E.G. 1975. Lithium toxicity precipitated by diuretics. J. of the Medical Society of New Jersey, 72(5). pp. 439-440.

Martin, E.W. 1978. Drug Interactions Index, 1978/79. J.B. Lippincott Company, Philadelphia.

Melmon, K., H.F. Morelli, J.A. Oates, et. al. 1967. Drug interactions that can affect your patients. Pat Care, Nov. pp. 33-71.

Miller, R.D., et.al. 1976. Enhancement of d-tubocurarine neuromuscular blockage by diuretics in man. Anesth, 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 Nutr, 2 (1983).

Morrelli, H.F. & K.L. Melmon. 1968. The clinician's approach to drug interactions. California Medicine, 109(11). pp. 380-389.

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.

Ngai, S.H., L.C. Mark & E.M. Papper. 1970. Pharmacologic and physiologic aspects of anesthesiology. N Eng J of Med, 282 pp. 479-491.

Salissa, R., J. Bollman & T. Dry. 1948. The effect of para-aminobenzoic acid on the metabolism and excretion of salicylate. J of Lab and Clin Med, 33. pp. 1393-1401.

Scientific Committee, British Herbal Pharmocopaeia, British Herbal Med Assoc, Lane House, Cowling, Na Keighley, West Yorks, Bd Bd220lx, l983.

Segre, E.J., M. Chaplin, et.al. 1974. Naproxen-aspirin interactions in man. Clin Pharmacology and Therapeutics, 15(4), pp. 374-379.

Stuart, D.M. 1968. Drug metabolism Part 2. Drug interactions. PharmIndex, 10(10). pp. 4-16.

Thorn, G.W. 1966. Clin considerations in the use of corticosteroids. New England J of Medicine, 274(Apr 7) pp. 775-781.

Tuttle, C.B. 1969. Drug interactions. Canadian Journal of Hospital Pharmacy, 22(5-6). pp. 2-15.

Udall, J.A. Drug interference with warfarin therapy. Clin Med, 77 p.20.

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