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Allium cepa
Aloe vera
Allium sativum
Astragalus membranaceus
Angelica sinensis
Aesculus hippocastanum
Althaea officinalis
Andrographis paniculata
Arctostaphylos uva-ursi
Ammi majus
Ammi visnaga
Anethum graveolens
Arnica montana
Azadirachta indica


 

 

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Arctostaphylos uva-ursi (L.) Spreng. (Ericaceae)

Synonyms
Arbutus uva-ursi L., Arctostaphylos media Greene, Arctostaphylos officinalis Wimm., Arctostaphylos procumbens Patzke, Mairania uva-ursi Desv., Uva-ursi buxifolia S.F. Gray, Uva-ursi procumbens Moench.

Local names
Achelblätter, Achelkraut, arberry, arctostaphylos, Bärenkraut, Bärentraube, Bärentraubenblätter, bearberry, bear’s grape, Beredruif, berry leaves, brockberry, busserole, coralillo, crowberry, dogberry, enab edhdhib, feuille de busserole, feuille de raisin d’ours, folia artostaphyli, folia garjubae, folia uvae-ursi, folia vaccinii ursi, foxberry, gayuba, herba garjubae, hog cranberry, hojas de ayuba, kinnikinnick, leesikas, lisc maçznicy, mealyberry, medveszölölevel, Moosbeerenblätter, mountain box, ptarmigan berry, raisin d’ours, red bearberry, sagochomi, Sandblätter, Steinbeerenblätter, upland cranberry, uva ursi, uvaursina, uwaurushi, Wolfsbeerenblätter

Description
Procumbent evergreen shrub with trailing stems bearing short ascending branches; branches bear leaves that are ovate, ovate-spatulate to spatulate. Flowers bell-shaped, pinkish-white, hypogynous and borne in small clusters at ends of branches; each flower consists of a calyx of 5 reddish sepals, a reddish-white urceolate corolla, gamopetalous but divided at the margin into 5 short reflexed segments, 10 short stamens with 2-lobed anthers, and syncarpous pistil of 5 carpels. Style portion of the pistil simple, longer than the stamens and ends in a knob-like stigma

Plant material used
dried leaves

Chemical assays
Contains not less than 7% hydroquinone derivatives calculated as anhydrous arbutin, according to The Japanese pharmacopoeia. Contains not less than 8%

Major chemical constituents
The major constituent is arbutin (5–15%). Related hydroquinone derivatives present include hydroquinone and methylarbutin (up to 4%). Gallic acid is the major phenolic carboxylic acid present, together with galloyl arbutin and up to 20% of gallotannins, flavonoids and triterpenes, mainly ursolic acid and uvaol

Medicinal uses
Uses supported by clinical data
None.

Uses described in pharmacopoeias and well established documents
Internally, as a mild urinary antiseptic for moderate inflammatory conditions of the urinary tract and bladder, such as cystitis, urethritis and dysuria.

Uses described in traditional medicine
As a diuretic, to stimulate uterine contractions, and to treat diabetes, poor eyesight, renal or urinary calculi, rheumatism and venereal disease. Topical applications have been used for skin depigmentation

Proven pharmacological activity
Animal studies
Antimicrobial, Anti-inflammatory, Antitussive, Skin lightening

Human studies
Antibacterial

Toxicity and overdose
The oral LD50 of hydroquinone ranged from 300 to 1300mg/kg body weight in rodents and dogs, but was only 42–86mg/kg body weight in cats. Acute exposure of rats to high doses of hydroquinone (over 1300mg/kg body weight) caused severe effects on the central nervous system, including hyperexcitability, tremor, convulsions, coma and death

Contraindications
During pregnancy or lactation, or in children under the age of 12 years. Folium Uvae Ursi is also contraindicated in patients with kidney disorders.

Warnings
Folium Uvae Ursi should not be used for prolonged periods. Patients with persistent symptoms of a urinary tract infection should consult a physician. Use of Folium Uvae Ursi may cause a greenish-brown coloration of the urine that darkens on exposure to air due to the oxidation of hydroquinone.

Precautions
Drug interactions
Folium Uvae Ursi should not be administered with foods or medicines that acidify the urine.

Carcinogenesis, mutagenesis, impairment of fertility
Folium Uvae Ursi was not mutagenic in the Salmonella/microsome assay with S. typhimurium strains TA98 or TA100. Hydroquinone was also not mutagenic in the Salmonella/microsome assay with S. typhimurium strains TA98, TA100, TA1535 or TA1537, with or without metabolic activation. Although extracts of the leaves do not appear to be carcinogenic, there is some evidence that hydroquinone is carcinogenic. Treatment of F344/N rats with hydroquinone resulted in a marked increase in tubular cell adenomas of the kidney in males, and an increase in mononuclear cell leukaemia in females. There was also some evidence of carcinogenic activity of hydroquinone in female B6C3F1 mice, as shown by an increase in hepatocellular neoplasms, mainly adenomas. There was no evidence, however, of carcinogenic activity of an aqueous extract of the leaves in male B6C3F1 mice (treated by gavage with 50–100mg extract/kg body weight). The sources of human exposure to hydroquinone (including environmental sources) have bee reviewed, as have data on its kinetics and metabolism, and its effects in animals and humans. Arbutin was administered subcutaneously at 25, 100 or 400mg/kg body weight daily to male rats before mating, and to female rats during pregnancy and lactation. No effect on reproduction of male and female rats, or the development of the offspring was observed at doses of up to 100mg/kg body weight. Fetal toxicity was observed at doses of 400mg/kg body weight.

Pregnancy: teratogenic effects
See Contraindications.

Pregnancy: non-teratogenic effects
See Contraindications.

Nursing mothers
See Contraindications.

Paediatric use
See Contraindications.

Other precautions
No information available on general precautions or precautions concerning drug interactions; or drug and laboratory test interactions.

Adverse reactions
Internal use of Folium Uvae Ursi may cause nausea and vomiting due to stomach irritation from the high tannin content. The hydroquinone concentration in topical preparations is limited to 2% in Nigeria, the United Kingdom and the United States of America, following reports that preparations containing more than 2% hydroquinone caused exogenous ochronosis in black women in South Africa. Topical application of preparations containing less than 3% hydroquinone in different bases caused negligible effects in male volunteers from different racial groups. However, there are case reports suggesting that skin-lightening creams containing 2% hydroquinone have produced leukoderma as well as ochronosis. Hydroquinone (at a concentration of 1% in aqueous solution or 5% in a cream) has caused erythema and allergic contact dermatitis.

Dosage forms
Crude drug for infusions or cold macerates, extracts and solid forms for oral administration. Store in a well-closed container, protected from light.

Posology
(Unless otherwise indicated)
Daily dose: 3g crude drug in 150 ml water as an infusion or cold macerate, up to three or four times daily; 400–850mg hydroquinone derivatives. Other preparations accordingly calculated as arbutin. Patients should avoid highly acidic foods, such as acidic fruits or fruit juice, during treatment, and be advised to drink plenty of fluids.

 

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