| Taxonomic Class | | | | vomiting. |
| Ranunculaceae | | | | Respiratory: respiratory depression (with high |
| | | | doses). |
| Alvita, Dandelion Goldenseal, Golden Seal Extract, | | | | Skin: contact dermatitis. |
| Golden Seal Extract 4:1, Golden Seal Glycerin | | | | Interactions |
| Extract, Golden Seal Power, Golden Seal Root, Nu | | | | Anticoagulants: Beneficial effects of therapeutic |
| Veg Golden Seal Herb, Nu Veg Golden Seal Root | | | | anticoagulants may be offset. Avoid administration |
| Common Forms | | | | with goldenseal. |
| Capsules, tablets : 250 mg, 350 mg, 400 mg, 404 | | | | Antihypertensives: Goldenseal or its extracts may |
| mg, 470 mg, 500 mg, 535 mg, 540 mg | | | | interfere with or increase hypotensive effects. Do |
| Also available as dried ground root powder, | | | | not use together. |
| ethanol and water extracts, teas, and tinctures. | | | | Beta blockers, calcium channel blockers, digoxin: |
| Source | | | | May increase or interfere with cardiac effects of |
| The rhizome (root stock) of Hydrastis canadensis | | | | these drugs. Do not use together. |
| is commonly used to manufacture the dosage | | | | CNS depressants (alcoho benzodiazepines): May |
| forms. The main chemical components are the | | | | increase sedative effects. Avoid administration |
| alkaloids hydrastine and berberine. Also present | | | | with goldenseal. |
| are hydrastinine, canadine, berberastine, candaline, | | | | Contraindications And Precautions |
| canadaline, chlorogenic acid, carbohydrates, fatty | | | | Goldenseal is contraindicated in patients with CV |
| acids, volatile oil, resin, and meconin. | | | | disease, particularly arrhythmias, heart failure, or |
| Actions | | | | hypertension, and in pregnant patients. |
| Goldenseal is claimed to have antihemorrhagic, | | | | Special Considerations |
| anti-inflammatory, astringent, laxative, and | | | | Alert Death can result from the ingestion of large |
| oxytocic properties. The pharmacologic properties | | | | alkaloid doses. Symptoms of overdose include |
| are attributed to berberine and hydrastine, and | | | | depression, exaggerated reflexes, GI upset, |
| scientific studies have usually focused on these | | | | nervousness, and seizures that progress to |
| alkaloids rather than on the herb itself. | | | | respiratory paralysis and CV collapse. |
| An alkaloid component of goldenseal was reported | | | | Monitor for unusual symptoms. |
| to inhibit muscle contractions in rodent smooth | | | | Monitor for signs of vitamin B deficiency (angular |
| muscle, whereas others have shown an oxytocic | | | | stomatitis, cheilosis, glossitis, infertility, |
| effect. Goldenseal extracts reduce hyperphagia | | | | megaloblastic anemia, peripheral neuropathy, |
| and polydipsia associated with streptozocin-induced | | | | seborrheic dermatitis, and seizures). |
| diabetes in mice. | | | | Caution the patient to avoid hazardous activities |
| Berberine was found to decrease the | | | | until CNS effects of goldenseal are known. |
| anticoagulant effect of heparin in laboratory tests | | | | Instruct the patient not to consume goldenseal |
| of heparinated animal and human blood and to act | | | | because of its potential to cause toxicity. |
| as a cardiac stimulant (at lower doses), increase | | | | Points of Interest |
| coronary perfusion, and inhibit cardiac activity (at | | | | Chronic use of goldenseal has been reported to |
| higher doses) in animals. Antipyretic activity | | | | decrease the absorption of vitamin B and thereby |
| (greater than aspirin) and anthelmintic, | | | | promote its deficiency. |
| antihistaminic, antimicrobial, anti muscarinic, | | | | Tolerance to the herb's pharmacologic effects is |
| antitumorigenic, and hypotensive effects have | | | | thought to develop after only a few weeks of |
| also been documented for berberine in animal and | | | | chronic use. |
| laboratory models. | | | | Berberine is also a component of barberry |
| Hydrastinine causes vasoconstriction and can | | | | (Berberis vulgaris). |
| produce significant changes in blood pressure. | | | | Goldenseal extracts have been a component in |
| Reported Uses | | | | sterile eyewashes for many years without |
| Claims for goldenseal include use for anorexia, | | | | supporting evidence for their inclusion. Also, the |
| cancer, conjunctivitis, dysmenorrhea, eczema, | | | | extracts or their components have been listed in |
| gastritis, GI disorders, mouth ulcers, otorrhea, | | | | the national pharmacopoeias of several countries. |
| peptic ulcer disease, postpartum hemorrhage, | | | | Goldenseal has been inappropriately used to mask |
| pruritus, tinnitus, and tuberculosis and as an | | | | the appearance of illicit drugs on urine drug |
| anti-inflammatory, a diuretic, a laxative, and a | | | | screens in humans and race horses. This |
| wound antiseptic. There are few, if any, clinical trial | | | | information is false and originates from a fictional |
| data available to support these claims. | | | | literary work that depicts the plant to be useful |
| Goldenseal was found to be less effective than | | | | for hiding opioid ingestion. |
| ergot alkaloids when used for postpartum | | | | Goldenseal has been used as a dye. The rhizome |
| hemorrhage in humans. Berberine has been shown | | | | is bright yellow and popular for staining many |
| to shorten the duration of acute Vibrio cholera | | | | fabrics and materials. |
| diarrhea and diarrhea caused by some species of | | | | According to a survey inside a New York City |
| Giardia, Salmonella, and Shigella and some | | | | emergency department, goldenseal tea is among |
| Enterobactereciae. Clinical studies in patients with | | | | the three most commonly cited herbal |
| hepatic cirrhosis have shown that berberine may | | | | preparations consumed by patients . |
| correct some laboratory abnormalities and | | | | Commentary |
| improve biliary secretion and function. | | | | The pharmacologic effects of goldenseal have not |
| Dosage | | | | been adequately studied. Because the risk of |
| Dried rhizome: 0.5 to 1 g P.O. t.i.d. | | | | toxicity appears excessive for this plant, even |
| Ethanol and water extract: 250 mg P.O. t.i.d. | | | | some advocacy texts do not support its use for |
| Adverse Reactions | | | | any disorder. Goldenseal and its alkaloids possess |
| CNS: CNS depression, paralysis (with high doses), | | | | some promising pharmacologic properties; |
| paresthesias, seizures. | | | | additional comprehensive, controlled studies in |
| CV: asystole, bradycardia, heart block. | | | | animals are needed before progressing to human |
| EENT: mouth ulcers. | | | | studies. |
| GI: abdominal cramps and pain, diarrhea, nausea, | | | | |