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ELM BARK, EUROPEAN FIELD ELM

Commission E approved ma huang for, “Diseases of the respiratory tract with mild bronchospasms in adults,” single dosages of herb equivalent to 15–30 mg total alkaloid, not to exceed 300 mg alkaloid a day, and children over age six years, 0.5 mg total alkaloid/kg body weight) (KOM). Contraindications, Interactions, and Side Effects (Ephedra) —

Class 2b, 2c, 2d. Contraindicated in anorexia, anxiety, bulimia, cerebral perfusion, diabetes, glaucoma, high blood pressure, pheochromocytoma, prostatadenoma, restlessness, and thyrotoxicosis (KOM; PH2; SHT; SKY). Thyroid stimulant, not recommended for long-term use. The herb and/or its ephedrine can cause addiction, anxiety, anorexia, cardiac arrest, cardiac arrhythmia, dizziness, dysuria, flushing, headache, high blood pressure, insomnia, irritability, nausea, nervousness, palpitations, restlessness, tachycardia, uterocontraction, vomiting, and xerostomia (KOM; PH2; SHT; SKY).

Commission E reports contraindications, adverse effects, and interactions of the major alkaloid, ephedrine. Not to be used for prolonged period. Not to be taken with MAOIs. May potentiate MAOIs (AHP). Ephedra-based products should be avoided during pregnancy and lactation, and used with caution in children.

Class 2d. Contraindicated in inflammatory diseases of the bile duct, GI tract, and liver. Do not use near nostrils of infants (AHP). CAN cautions that the oil can cause nausea and vomiting, and should not be taken internally during pregnancy or lactation. “Undiluted eucalyptus oil is toxic and should not be taken internally unless suitably diluted. A dose of 3.5 ml has proved fatal.” (CAN)

Symptoms of poisoning include abdominal pain, bronchospasm, convulsions, cyanosis, delirium, dizziness, epigastric burning, myosis, muscular weakness, respiratory problems, spontaneous vomiting, tachypnea with severe respiratory depression, and a feeling of suffocation. May interfere with hypoglycemic therapy (CAN). Eucalyptus oil causes induction of the foreign-substance degrading enzyme system in the liver.

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This may weaken and/or shorten the activity of other medicinal agents; may cause diarrhea, nausea, and vomiting (PIP). CNS effects include diminution or loss of reflexes and depression of consciousness, possibly progressing to coma. Fatalities have been reported in adults ingesting as little as 4–5 ml eucalyptus oil; 30 ml will usually cause death (AEH1).

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