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Greater celandine (Chelidonium majus)

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Also listed as: Celandine, Chelidonium majus, Ukrain™
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • Benzophenanthridine, berberine, chelerythrine, chelidimerine, chelidonine, C. majus, Chelidonium majus, Chelidonium-30 (Ch-30), Chelidonium-200 (Ch-200), coptisine, greater celandine grass, Iberogast®, NSC 61570, Papaveraceae (family), protoberberine, sanguinarine, Schollkraut (German), STW 5 (Iberogast®), STW 5-II, stylopine, UkrainT, UKSR-222.
  • Combination product examples: Cholagogum F Nattermann® (dried extracts from Schollkraut and Curcuma), Hepeel® (highly diluted, potentized extracts from the following plants: Chelidonium from Chelidonium majus L., Carduus marianus from Silybum marianum L., Veratrum from Veratrum album L., Colocynthis from Citrullus colocynthis L., Lycopodium from Lycopodium clavatum L., Nux moschata from Myristica fragans, Houtt, and China from Cinchona pubescens, Vahl.), Sanguirythrine® (a mixture of alkaloids sanguinarine and chelerythrine, isolated from Chelidonium majus L. and other plants of Papaveraceae family).

Background
  • Greater celandine has been used in Europe for the treatment of many diseases. Although celandine is considered somewhat toxic, its extracts have been used in German and traditional Chinese medicine.
  • UkrainTM is a partly man-made anticancer drug that contains greater celandine. Research suggests that this drug may be of interest for women undergoing menopause, due to its potential effects against osteoporosis.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


UkrainTM is a partly man-made anticancer drug that contains greater celandine. It has been studied in people with various types of cancer, with consistently positive results. UkrainT has been found to stimulate the immune system and may benefit those with breast, bladder, rectal, colon, and pancreatic cancer. More research is needed in this area.

B


Greater celandine has been reported to improve and increase bile flow. More research is needed before a firm conclusion can be made.

B


Greater celandine is a traditional herb for ailments of the liver and gallbladder. However, there is a lack of evidence to support its effectiveness for these conditions. A combination therapy containing greater celandine was found to lack benefit for biliary colic. More research is needed before a conclusion can be made.

C


Most studies looking at greater celandine for cancer use the partly man-made drug UkrainTM. More research is needed before a firm conclusion can be made on the use of greater celandine for cancer of the esophagus.

C


UkrainT has been found to have some benefit even in the most advanced, severe forms of cancer. Further research is needed on the use of greater celandine for cancer of the pancreas.

C


Research suggests that greater celandine may have effects on the immune system. However, the benefit is unclear. A tincture made with greater celandine has been reported to improve immune response. More research is needed.

C


Early study suggests that greater celandine may benefit indigestion. Combination products containing greater celandine have been found to improve symptoms. Further research is needed before a firm conclusion can be made.
C


The effects of UkrainT in people with lung cancer are similar to its effects on other types of cancer. It appears to improve immune system function. Further study is needed on the use of greater celandine for cancer treatment.
C


Greater celandine taken by mouth in the form of a tincture has been found to boost the immune system of children with long-term tonsil inflammation. Greater celandine may also help decrease the risk of recurring tonsil inflammation in children. However, there have been reports of liver toxicity. More research on the safety and effectiveness of this herb are needed. It may not be advised to routinely use greater celandine for upper respiratory infections until there is more information available.

C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Antidepressant, antifungal, anti-inflammatory, antimicrobial, antioxidant, antispasmodic (prevents muscle spasms), antiviral, diabetes, encephalitis (brain inflammation, caused by ticks), irritable bowel syndrome (IBS), jaundice (yellowing of the skin and eyes), liver disorders, pain relief, oral hygiene (mouth hygiene), skin conditions, ulcers, warts.

Dosing

Adults (18 years and older)

  • Note: Doses taken by mouth are based on traditional health practice patterns and expert opinion. Safety and effectiveness information is lacking. Some herbal experts believe that only the dried leaves should be taken by mouth.
  • As an extract, 30 milliliters of greater celandine (as a 50 percent solution in boiling water) has been taken by mouth twice daily for two weeks.
  • As a tea, one teaspoon of dried leaves of greater celandine, one teaspoon of root, or two teaspoons of herb per cup of water have been taken by mouth 2-3 daily.
  • As a tincture, 8-10 drops of greater celandine or 1-2 milliliters have been taken by mouth three times daily.
  • For cancer (general), doses of 10 milligrams of UkrainT have been injected into the vein every three days. A total dose of 50-300 milligrams UkrainT has been injected into the vein.
  • For lung cancer, 10 milligrams of UkrainT has been injected into the vein every three days for a total of 10 injections.
  • For cancer of the pancreas, 20 milligrams of UkrainT has been injected into the vein for seven weeks for one cycle, then for three weeks with one week rest in cycles 2-12.
  • For stage III cancer (unknown type), 10 milligrams of UkrainT has been injected into the vein every second day for a total of 30 injections.
  • For bile flow problems, the following preparations of greater celandine have been placed into the stomach for 22 days up to six weeks: a hydroethanolic extract containing 1.5 percent of total chelidonine alkaloids; 700 milligrams of a hydroalcoholic extract; 125 milligrams of hydroalcoholic extract (equal to 0.675 milligrams of chelidonine) or 3x20 drops of liquid hydroalcoholic extract (equivalent to 0.15 milligrams of chelidonine); and 375-500 milligrams of a hydroethanolic extract (equivalent to 9-12 milligrams of total alkaloids).

Children (under 18 years old)

  • For tonsil inflammation, a greater celandine tincture has been taken by mouth.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in people with known allergy or sensitivity to greater celandine, its parts, or members of the Papaveraceae family.
  • Allergic skin reactions have been reported with exposure to greater celandine.

Side Effects and Warnings

  • Greater celandine is possibly safe when taken by mouth as 20 milligrams of UkrainT weekly for up to two months.
  • Greater celandine may cause anemia, constipation, decreased bone mineral density, diarrhea, gas, increased body weight, liver damage or other liver problems, and nausea.
  • Greater celandine may increase the risk of bleeding. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
  • Use cautiously in people who are undergoing ionizing radiation (IR) or radiation therapy, or those taking amphetamines, dopaminergic or serotonergic agents, hexobarbital, monoamine oxidase inhibitors (MAOIs), or morphine.
  • Use cautiously in people who have disorders of the skin, stomach, or intestines, or those who are overweight.
  • Avoid in pregnant or breastfeeding women, and in people who have liver disease.
  • Avoid in people with known allergy or sensitivity to greater celandine, its parts, or members of the Papaveraceae family.

Pregnancy and Breastfeeding

  • There is a lack of scientific evidence on the use of greater celandine during pregnancy or breastfeeding. Avoid in pregnant or breastfeeding women.

Interactions

Interactions with Drugs

  • Greater celandine may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
  • Greater celandine may also interact with agents for muscle spasms, agents for osteoporosis, agents for retrovirus infections, agents for the stomach and intestines, agents that affect the central nervous system, agents that affect the immune system, agents that stimulate bile, antibiotics, anticancer agents, antidepressants (monoamine oxidase inhibitors [MAOIs], selective serotonin reuptake inhibitors [SSRIs]), antidiabetic agents, antifungal agents, anti-inflammatory agents, antiulcer agents, antiviral agents, bisphosphonates, cytotoxic agents, dopamine agonists and antagonists, interferons, pain relievers, and serotonin receptor antagonists.

Interactions with Herbs and Dietary Supplements

  • Greater celandine may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
  • Greater celandine may also interact with antibacterial herbs and supplements, anticancer herbs and supplements, antidepressants (monoamine oxidase inhibitors [MAOIs], selective serotonin reuptake inhibitors [SSRIs]), antidiabetic herbs and supplements, antifungal herbs and supplements, anti-inflammatory herbs and supplements, antiulcer herbs and supplements, antiviral herbs and supplements, cytotoxic herbs and supplements, dopaminergic herbs and supplements, herbs and supplements for muscle spasms, herbs and supplements for osteoporosis, herbs and supplements for the stomach and intestines, herbs and supplements that affect the central nervous system, herbs and supplements that affect the immune system, herbs and supplements that stimulate bile, pain relievers, and turmeric.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
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  2. Boada A, Carrascosa JM, and Ferrandiz C. [Keloid development on skin lesions after the application of a cream purchased over the internet]. Actas Dermosifiliogr. 2011;102(1):71-72.
  3. Bunchorntavakul C and Reddy KR. Review article: herbal and dietary supplement hepatotoxicity. Aliment.Pharmacol.Ther 2013;37(1):3-17.
  4. Conti E, De Checchi G, Mencarelli R, et al. Lycopodium similiaplex-induced acute hepatitis: a case report. Eur.J Gastroenterol.Hepatol. 2008;20(5):469-471.
  5. Gansauge F, Ramadani M, Schwarz M, et al. The clinical efficacy of adjuvant systemic chemotherapy with gemcitabine and NSC-631570 in advanced pancreatic cancer. Hepatogastroenterology 2007;54(75):917-920.
  6. Gilca M, Gaman L, Panait E, et al. Chelidonium majus--an integrative review: traditional knowledge versus modern findings. Forsch.Komplementmed. 2010;17(5):241-248.
  7. Glazev AA and Nefedov LI. [Changes in amino acid patterns of blood plasma in tumor patients treated with anticancer drug NSC-631570: possible approaches to cancer diagnostics]. Biomed.Khim. 2008;54(3):289-300.
  8. Hardeman E, Van Overbeke L, Ilegems S, et al. Acute hepatitis induced by greater celandine (Chelidonium majus). Acta Gastroenterol.Belg. 2008;71(2):281-282.
  9. Moro PA, Cassetti F, Giugliano G, et al. Hepatitis from Greater celandine (Chelidonium majus L.): review of literature and report of a new case. J Ethnopharmacol. 7-15-2009;124(2):328-332.
  10. Stickel F and Schuppan D. Herbal medicine in the treatment of liver diseases. Dig.Liver Dis. 2007;39(4):293-304.
  11. Tarantino G, Pezzullo MG, di Minno MN, et al. Drug-induced liver injury due to "natural products" used for weight loss: a case report. World J Gastroenterol. 5-21-2009;15(19):2414-2417.
  12. Teschke R, Frenzel C, Glass X, et al. Greater Celandine hepatotoxicity: a clinical review. Ann.Hepatol. 2012;11(6):838-848.
  13. Teschke R, Glass X, and Schulze J. Herbal hepatotoxicity by Greater Celandine (Chelidonium majus): causality assessment of 22 spontaneous reports. Regul.Toxicol.Pharmacol. 2011;61(3):282-291.
  14. Teschke R, Glass X, Schulze J, et al. Suspected Greater Celandine hepatotoxicity: liver-specific causality evaluation of published case reports from Europe. Eur.J Gastroenterol.Hepatol. 2012;24(3):270-280.
  15. Teschke R, Wolff A, Frenzel C, et al. Herbal hepatotoxicity: a tabular compilation of reported cases. Liver Int 2012;32(10):1543-1556.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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