Corallium rubrum 6C • Spongia Tosta 2X • Belladonna 3X • Drosera rotundifolia 3X • Rumex Crispus 3X • Ipecacuanha 3X • Pulsatilla 3X • Senega Officinalis 3X • Mentha piperita 4X • Kali Sulphuricum 4X • Arsenicum Iodatum 6X • Sanguinaria Canadensis 6X • Hepar Sulphuris Calcareum 8X • Kali Biochromicum 12X.
Brand name products often contain multiple ingredients. To read detailed information about each ingredient, click on the link for the individual ingredient shown above.
This is a homeopathic preparation. Homeopathy is a system of medicine established in the 19th century by a German physician named Samuel Hahnemann. Its basic principles are that "like treats like" and "potentiation through dilution." For example, in homeopathy, diarrhea would be treated with an extreme dilution of a substance that normally causes diarrhea when taken in high doses.
Practitioners of homeopathy believe that more dilute preparations are more potent. Many homeopathic preparations are so diluted that they contain little or no active ingredient. Therefore, most homeopathic products are not expected to have any pharmacological effects, drug interactions, or other harmful effects. Any beneficial effects are controversial and cannot be explained by current scientific methods.
Dilutions of 1 to 10 are designated by an "X." So a 1X dilution = 1:10, 3X=1:1000; 6X=1:1,000,000. Dilutions of 1 to 100 are designated by a "C." So a 1C dilution = 1:100; 3C = 1:1,000,000. Dilutions of 24X or 12C or more contain zero molecules of the original active ingredient.
Homeopathic products are permitted for sale in the US due to legislation passed in 1938 sponsored by a homeopathic physician who was also a Senator. The law still requires that the FDA allow the sale of products listed in the Homeopathic Pharmacopeia of the United States. However, homeopathic preparations are not held to the same safety and effectiveness standards as conventional medicines. For more information, see the Homeopathy monograph.
Below is general information about the effectiveness of the known ingredients contained in the product Dr. Morrow's Stop Cough Formula. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of pulsatilla.
There is insufficient reliable information available about the effectiveness of yellow dock.
Below is general information about the safety of the known ingredients contained in the product Dr. Morrow's Stop Cough Formula. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
LIKELY SAFE ...when organic arsenic is consumed in normal food amounts. Organic forms of arsenic normally found in foods have not been linked to toxicity (7135,16309). ...when arsenic trioxide is used intravenously and appropriately under the guidance of a healthcare provider. Arsenic trioxide (Trisenox) is an FDA-approved prescription drug (15).
LIKELY UNSAFE ...when inorganic arsenic is used orally, especially when used long-term or in high doses. Taking large doses acutely, or in small doses for prolonged periods of time, can cause serious side effects. Chronic intake of 10 mcg/kg daily has been associated with symptomatic arsenicism. Acute doses of 5 mg, or sometimes less, can cause gastrointestinal symptoms. Higher doses can cause severe poisoning and death (7135,16310,16312,16313,16316,102892). Prolonged exposure to inorganic arsenic in drinking water and other sources has been linked to an increased risk of cardiovascular disease, diabetes, cancer, hypertension, and mortality (99824,99827,99829,99830,99832,99834,99835,109108,109110). Inorganic arsenic is classified as a human carcinogen (16312,16316). The maximum permissible level of arsenic in drinking water is 10 mcg/L (16316).
CHILDREN: LIKELY SAFE
when organic arsenic is consumed in food amounts.
Organic forms of arsenic found in a normal diet have not been linked to toxicity (7135,16309).
CHILDREN: LIKELY UNSAFE
when inorganic arsenic is used orally, especially when used long-term or in high doses.
Large doses acutely, or in small doses for prolonged periods of time, can cause serious side effects. Prolonged exposure to inorganic arsenic in drinking water has been linked to reduced scores on intelligence tests, developmental delays, impaired verbal comprehension, decreased memory and attention, and higher blood pressure in children (16319,99826,99828,99836,102898).
PREGNANCY AND LACTATION: LIKELY SAFE
when organic arsenic is consumed in food amounts.
Organic forms of arsenic found in a normal diet have not been linked to toxicity (7135,16309).
PREGNANCY AND LACTATION: LIKELY UNSAFE
when inorganic arsenic is taken orally, especially when used long-term or in high doses.
While exposure to inorganic arsenic in drinking water does not seem to increase the risk of neural tube defects (102897), it has been associated with an increased risk for spontaneous abortion, stillbirth, and neonatal mortality (99833). Exposure to inorganic arsenic in drinking water and other sources while pregnant has also been linked to changes in birth weight, length, and head circumference (102895), with one study showing that higher maternal blood arsenic levels are associated with 44% greater odds of delivering a small for gestational age infant and 103% greater odds of delivering a large for gestational age infant (102895,102896). Avoid arsenic supplements and water contaminated with arsenic during pregnancy or lactation.
POSSIBLY UNSAFE ...when used rectally. It is not known whether significant amounts of the toxic alkaloids are absorbed from the rectum (106909). ...when used topically. It is not known whether significant amounts of the toxic alkaloids are absorbed through the skin (106909).
LIKELY UNSAFE ...when used orally. Belladonna contains toxic alkaloids and has been linked to reports of serious adverse effects (12,553,34144).
CHILDREN: LIKELY UNSAFE
when used orally.
Fatalities in children may occur at doses of belladonna providing atropine 0.2 mg/kg (34168). Two belladonna berries, which contain 2 mg atropine per fruit, may be lethal for a small child (34144). Severe adverse effects and fatalities have been reported in infants treated with topical homeopathic teething products containing belladonna (17493,34142,34146,93537).
PREGNANCY: LIKELY UNSAFE
when used orally.
Belladonna contains toxic alkaloids and has been linked to reports of serious adverse effects (12,553,34144).
LACTATION: LIKELY UNSAFE
when used orally.
Belladonna can reduce milk production and is secreted into breast milk (15).
POSSIBLY SAFE ...when used orally and appropriately short-term (4).
POSSIBLY UNSAFE ...when excessive doses are used orally. The bloodroot constituent sanguinarine, although thought to be poorly absorbed, is a toxic alkaloid (6,12). ...when applied topically. Use of toothpaste or mouthwash containing bloodroot has been associated with an increased risk of developing oral leukoplakia (36666,36668). When applied to the skin, bloodroot paste causes pain, skin erosion, and a thick scab called an eschar which falls off leaving an indented scar. The U.S. Food and Drug Administration recommends that patients avoid bloodroot containing topical products such as "black salve" (53499,95442,95444,95445,95446).
PREGNANCY: LIKELY UNSAFE
when used orally (12); avoid using.
LACTATION: POSSIBLY UNSAFE
when used orally (4); avoid using.
POSSIBLY SAFE ...when the rhizome or syrup of ipecac is used orally and appropriately, as a single dose. A single 15-30 mL dose of syrup containing 10-21 mg ipecac has been used with apparent safety in clinical research (12,56419,103744).
POSSIBLY UNSAFE ...when in contact with skin or when inhaled. The constituent emetine is a skin irritant, and ipecac powder is a respiratory irritant (6,18).
LIKELY UNSAFE ...when used orally long-term or in amounts greater than 30 mL. Misuse can lead to serious toxicity, including cardiomyopathy and death. Chronic ingestion of ipecac 30 mL (21 mg) 2-3 times daily for 5 months has been associated with cardiomyopathy. The acute lethal dose of ipecac is 850-1780 mL (600-1250 mg) (6,12,19,56412,56460,56467). ...when a total dose of more than 1 gram is injected, it can cause nervous system symptoms, blood in the urine, and circulatory collapse (6).
CHILDREN: POSSIBLY SAFE
when used orally and appropriately as an emetic (272,11349).
CHILDREN: LIKELY UNSAFE
when used orally in large doses and in infants under 1 year old (12,19).
Children are more sensitive to large doses and effects on the nervous system than adults (19).
PREGNANCY: LIKELY UNSAFE
when used orally; ipecac is a potential uterine stimulant (12,19).
LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when peppermint oil is used orally, topically, or rectally in medicinal doses. Peppermint oil has been safely used in multiple clinical trials (3801,3804,6190,6740,6741,10075,12009,13413,14467,17681)(17682,68522,96344,96360,96361,96362,96363,96364,96365,99493).
POSSIBLY SAFE ...when peppermint leaf is used orally and appropriately, short-term. There is some clinical research showing that peppermint leaf can be used safely for up to 8 weeks (12724,13413). The long-term safety of peppermint leaf in medicinal doses is unknown. ...when peppermint oil is used by inhalation as aromatherapy (7107). There is insufficient reliable information available about the safety of using intranasal peppermint oil.
CHILDREN: POSSIBLY SAFE
when used orally for medicinal purposes.
Enteric-coated peppermint oil capsules have been used with apparent safety under medical supervision in children 8 years of age and older (4469).
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in foods (96361).
There is insufficient information available about the safety of using peppermint in medicinal amounts during pregnancy or lactation; avoid using.
LIKELY UNSAFE ...when fresh above ground parts are used orally or topically; pulsatilla is a severe local irritant (4). There is insufficient reliable information available about the safety of the use of dried pulsatilla.
PREGNANCY: LIKELY UNSAFE
when used orally.
The fresh or dried above ground parts are contraindicated due to abortifacient and teratogenic effects (2,4). ...when the fresh above ground parts are used topically. There is insufficient reliable information available about the safety of topical dried pulsatilla during pregnancy.
LACTATION: LIKELY UNSAFE
when the fresh above ground parts are used for oral or topical use (19).
There is insufficient reliable information available about the safety of dried pulsatilla during breast-feeding.
POSSIBLY SAFE ...when properly prepared and consumed in amounts commonly found in foods. Young leaves must be boiled to remove the oxalate content; death has occurred after consuming uncooked leaves (6,18).
POSSIBLY UNSAFE ...when the uncooked leaves are consumed. Young leaves must be boiled to remove the oxalate content; death has occurred after consuming uncooked leaves (6,18). There is insufficient reliable information available about the safety of properly prepared yellow dock when used orally in medicinal amounts.
PREGNANCY: POSSIBLY UNSAFE
when used orally; avoid using.
Yellow dock contains anthraquinone glycosides; unstandardized laxatives are not desirable during pregnancy (4).
LACTATION: POSSIBLY UNSAFE
when used orally; avoid using.
Anthraquinones are secreted into breast milk (4,5).
Below is general information about the interactions of the known ingredients contained in the product Dr. Morrow's Stop Cough Formula. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Arsenic trioxide can prolong the QT interval.
 Details
Up to 40% of patients treated with prescription arsenic trioxide have a prolonged QT interval on their electrocardiogram (ECG) (15). Theoretically, non-prescription arsenic could have an additive effect when combined with drugs that prolong the QT interval.
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Belladonna may increase the risk of adverse effects when used concomitantly with anticholinergic drugs.
Details
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Theoretically, belladonna might reduce the effects of cisapride.
Details
Belladonna contains atropine. In vivo evidence suggests that atropine can prevent cisapride from increasing motility in the gastrointestinal tract (25191).
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Activated charcoal adsorbs and inactivates syrup of ipecac; avoid co-administration (506).
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Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.
Details
In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction (11784). An interaction between peppermint oil and cyclosporine has not been reported in humans.
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Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Details
In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2 (12479,12734). However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference (96359).
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Theoretically, peppermint might increase the levels of CYP2C19 substrates.
Details
In vitro research shows that peppermint oil inhibits CYP2C19 (12479). So far, this interaction has not been reported in humans.
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Theoretically, peppermint might increase the levels of CYP2C9 substrates.
Details
In vitro research shows that peppermint oil inhibits CYP2C9 (12479). So far, this interaction has not been reported in humans.
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Theoretically, peppermint might increase the levels of CYP3A4 substrates.
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Theoretically, yellow dock might increase the risk of digoxin toxicity when used long-term or in large amount.
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Theoretically, yellow dock might increase the risk of hypokalemia when taken with diuretics.
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Theoretically, the laxative effects of yellow dock might increase the effects of warfarin, including the risk of bleeding.
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Below is general information about the adverse effects of the known ingredients contained in the product Dr. Morrow's Stop Cough Formula. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General
...Orally, organic forms of arsenic found in the diet are well tolerated, with no clear links to adverse effects.
However, high doses or chronic intake of inorganic arsenic is associated with potentially serious adverse effects.
Serious Adverse Effects (Rare):
Orally: With the acute ingestion of inorganic arsenic, anemia, arrhythmias, bruising, gastrointestinal irritation or damage, hepatotoxicity, and peripheral neuropathy.
With chronic intake of inorganic arsenic, arsenicism can occur, including anorexia, cancer, skin hyperpigmentation and hyperkeratosis, and toxicity of the cardiovascular and neurological systems.
Cardiovascular
...Orally, doses of inorganic arsenic 1 mg/kg daily can cause hematopoietic depression including anemia, arrhythmias, and blood vessel damage leading to bruising (7135,16309,16312).
Acute ingestion of inorganic arsenic 10 mg/kg daily or more causes vasodilation and myocardial depression leading to myocardial injury, shock, and circulatory failure (17,7135,16313,16316,102892). Chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, characterized in part by cardiomyopathy and arrhythmias (17,7135,16309,16310,16316). Prolonged exposure to inorganic arsenic in drinking water at levels greater than or equal to 20 mcg/L has been linked, in a dose-dependent manner, to a 9% to 43% greater risk of cardiovascular disease, 11% to 55% greater risk of coronary heart disease, and 16% to 90% greater risk of cardiovascular-related death (99827). Also, each interquartile increase in urinary inorganic arsenic levels is associated with an increased risk of both cardiovascular and all-cause mortality in a specific area of the US (109110). A metabolite of arsenic, monomethylarsonic acid, has also been positively linked to stroke risk (99831). Increased exposure to inorganic arsenic has also been linked to the development of left ventricular hypertrophy (99835). The cardiovascular adverse effects of inorganic arsenic appear to be more profound in males with hypertension (99829).
The association between arsenic exposure and hypertension has also been investigated. A meta-analysis of observational research has found that the odds of having hypertension and risk of hypertension were increased by 14% and 30%, respectively, in those with the highest arsenic exposure when compared with the lowest. Exposure was determined based on intake of rice and rice products, as well as exposure in water, or levels in urine, hair, or toenails (109108). Additionally, increased exposure to inorganic arsenic in drinking water has been linked to higher blood pressure in children (102898).
Dermatologic ...Orally, chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, characterized in part by skin hyperpigmentation, hyperkeratosis, alopecia, and occlusive peripheral vascular disease leading to gangrene (17,7135,16309,16310,16316,102894). In one case, chronic intake of inorganic arsenic 30 ng daily has reportedly caused eczema of the hands, arms, and legs (102893).
Endocrine ...Orally, prolonged exposure to inorganic arsenic in drinking water has been associated with a 23% to 75% increase in the risk for diabetes (99830,99834). For every 100 mcg/L increase in inorganic arsenic levels in drinking water, the associated risk for diabetes increases by 13% (99834). A small meta-analysis has found that overall exposure to arsenic, including organic and inorganic arsenic, is associated with an increased risk of developing gestational diabetes (106539).
Gastrointestinal ...Orally, acute ingestion of inorganic arsenic 5 mg, or sometimes less, can cause vomiting, diarrhea, stomach cramps, and flatulence (16316,102893). These effects usually resolve in about 12 hours without treatment (16316). Doses of inorganic arsenic 1 mg/kg daily can cause gastrointestinal irritation (7135,16309,16312). Acute ingestion of inorganic arsenic 10 mg/kg daily or more causes severe gastrointestinal symptoms including bloody rice-water diarrhea (17,7135,16313,16316,102892). Chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, characterized in part by anorexia and gastrointestinal disturbances (17,7135,16309,16310,16316).
Genitourinary ...Orally, chronic intake of inorganic arsenic 30 ng daily has reportedly caused irregular menstruation (102893). A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased mortality from genitourinary diseases (106541).
Hematologic ...Orally, chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, characterized in part by anemia, leukopenia, and occlusive peripheral vascular disease (17,7135,16309,16310,16316).
Hepatic
...Orally, doses of inorganic arsenic 1 mg/kg daily can cause hepatotoxicity (7135,16309,16312).
The homeopathic remedy, arsenicum album, has been associated with three cases of acute liver injury. In one case, a 70-year-old male with pre-existing non-alcoholic steatohepatitis (NASH) cirrhosis died following the acute liver injury associated with use of this compound for about 12 weeks. High levels of arsenic were found in his hair and nail samples. Symptoms in the two other individuals resolved upon discontinuation of homeopathic arsenic and use of corticosteroids (109114).
Musculoskeletal ...Orally, chronic intake of inorganic arsenic 30 ng daily has reportedly caused leg cramps in one patient (102893).
Neurologic/CNS
...Orally, doses of inorganic arsenic 1 mg/kg daily can cause peripheral neuropathy and encephalopathy (7135,16309,16312).
In one case, chronic intake of inorganic arsenic 30 ng daily has reportedly caused headache, dizziness, and difficulty concentrating (102893). Acute ingestion of inorganic arsenic 10 mg/kg daily or more can cause cerebral edema, leading to encephalopathy, convulsions, coma, and death (17,7135,16313,16316). Chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, characterized in part by sensory disturbances, peripheral neuropathy, encephalopathy, confusion, and memory loss (17,7135,16309,16310,16316). A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased mortality from nervous system diseases (106541).
In children, prolonged exposure to inorganic arsenic in drinking water has been linked to reduced scores on intelligence tests, developmental delays, impaired verbal comprehension, and decreased memory and attention (16319,99826,99828,99836).
Ocular/Otic ...Orally, chronic intake of inorganic arsenic 30 ng daily has reportedly caused conjunctivitis in one patient (102893). A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased mortality from traffic accidents. This is suggested to be related to a higher prevalence of visual field narrowing due to macular degeneration, as well as motor or sensory dysfunction, in those exposed to arsenic during infancy (106541).
Oncologic ...Inorganic arsenic is classified as a human carcinogen (16312,16316). Orally, chronic intake of 10 mcg/kg daily of inorganic arsenic produces arsenicism, which can result in cancers of the skin, lungs, liver, kidneys, and bladder (17,7135,16309,16310,16316). Chronic ingestion of lower doses of inorganic arsenic, as a contaminant in well water, has also been linked to cancers of the skin, bladder, kidneys, and lungs (7135,99824,99832,106540). More specifically, levels of inorganic arsenic greater than 200 mcg/L in drinking water have been linked to lung cancer (99824). Levels of inorganic arsenic greater than 10 mcg/L in drinking water are also dose-dependently linked to an increased risk for bladder and kidney cancers (99832). A meta-analysis of observational research has found that arsenic exposure, especially from water and soil, is associated with prostate cancer risk (109109). A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased mortality from liver cancer (106541).
Psychiatric ...Orally, chronic intake of inorganic arsenic 30 ng daily has reportedly caused insomnia and anxiety in one patient (102893).
Pulmonary/Respiratory ...A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased mortality from respiratory diseases (106541).
Other
...Orally, high doses of inorganic arsenic can cause death.
In one case, a 24-year-old female receiving a combination of arsenic trioxide, realgar, and mung bean flour from an illegal medical provider died within days of taking the compounded preparation. Laboratory analysis revealed the amount of arsenic consumed to be around 1.1 grams on day 1 and 0.9 grams on day 4. Researchers concluded that arsenic as the source of poisoning was clear based on the amount of arsenic ingested and the patient's clinical presentation prior to death, which included vomiting, diarrhea, reduced urine output, liver and kidney abnormalities, and myocardial injury (102892).
A long-term observational study in adults has found that exposure to inorganic arsenic from consumption of contaminated milk powder during infancy is associated with increased all-cause mortality (106541).
General
...Orally, belladonna can cause anticholinergic side effects even at low doses, and is considered poisonous.
Most Common Adverse Effects:
Orally: Anticholinergic side effects, including blurred vision, constipation, delirium, dilated pupils, dizziness, dry mouth, fever, headache, hypertension, muscle rigidity and tremor, psychosis, respiratory failure, and slurred speech.
Cardiovascular ...Orally, belladonna can cause anticholinergic side effects such as hypertension, hypotension, tachycardia, and ventricular premature beats (553,34168,34180).
Dermatologic
...Orally, belladonna can cause anticholinergic side effects such as dry, red skin and decreased perspiration (553,34146,34152).
One case of rash and another case of hives have been reported in patients taking belladonna with phenobarbital and ergotamine orally; it is unclear if the adverse effects were due to belladonna or the other ingredients (34154).
Topically, belladonna plaster (Cuxon Gerrard) can cause contact dermatitis (34152).
Gastrointestinal ...Orally, belladonna can cause anticholinergic side effects such as dry mouth and constipation (553,34162,34163,34176,34180,34181).
Genitourinary ...Orally, belladonna can cause anticholinergic side effects such as urinary retention (553,34145,34150,34163).
Neurologic/CNS ...Orally, belladonna can cause anticholinergic side effects such as memory and attention impairment, headache, and confusion (553,34163,34180).
Ocular/Otic ...Orally and topically, belladonna can cause anticholinergic side effects such as dilation of pupils and blurred vision (553,34157,34168,34169,34180). A case report describes anisocoria (unequal pupil sizes) in a 70-year-old female who used homeopathic pink eye relief drops (Similasan) containing belladonna, eyebright, and hepar sulphuris (calcium sulfide) in one eye for 3 days. The pupil dilation lasted more than 2 weeks and did not respond to bright light or pilocarpine (106907). Another report describes a case of acute angle closure glaucoma, requiring referral to an ophthalmologist, in a 55-year-old female who used these eye drops for 2 days (106906).
General ...Orally, bloodroot is generally well tolerated when used in appropriate doses, short term (4). Nausea, vomiting, and central nervous system depression have been reported. Higher oral doses can result in glaucoma, hypotension, shock, and coma (6,12). Long term use of bloodroot toothpaste or mouthwash has been associated with leukoplakia, keratoses of the mouth, impaired taste, and staining of the tongue, teeth, and fillings (36666,36668,36707). Topically, skin contact with fresh bloodroot can cause irritation or contact dermatitis (19). Avoid contact with the eyes and mucous membranes because of its irritant properties.
Cardiovascular ...Orally, high doses of bloodroot may cause hypotension (6).
Dermatologic ...Topically, skin contact with fresh bloodroot can cause irritation or contact dermatitis (19). Topical application of bloodroot can corrode skin and produce a thick dry scab called an eschar which falls off and results in a depressed scar. There are numerous cases of patients applying bloodroot salves topically for 3-4 hours daily for 3-12 days to skin cancers, moles and blemishes. These patients report experiencing severe pain, burning, skin erosion, and scarring (53499,95442,95444,95445,95446).
Gastrointestinal ...Orally, bloodroot may cause nausea and vomiting (12). Some research shows that bloodroot-containing toothpastes and mouth rinses can be used for up to six months without evidence of adverse effects (36679). However observational research has found an association between chronic use of bloodroot toothpaste or mouthwash and leukoplakia or keratoses of the mouth and lip. Discontinuing these products did not always result in a resolution of leukoplakia (36666,36668). Prolonged use of bloodroot oral rinse causes impaired sensation of taste, as well as staining of the tongue, teeth, and fillings. The impaired taste and staining do seem to resolve after discontinuation of the bloodroot rinse (36707).
Neurologic/CNS ...Orally, bloodroot may cause CNS depression. High oral doses may cause shock and coma (6).
Ocular/Otic ...There are reports of worsening vision after small oral doses of bloodroot (36680). Glaucoma has been reported after high oral doses of bloodroot (6). However, some experts disagree that oral use of bloodroot causes ocular toxicity (36680). Direct contact of bloodroot with the eyes and mucous membranes should be avoided because of its irritant properties.
General
...Orally, ipecac syrup can cause nausea, vomiting, diarrhea, GI irritation, dizziness, hypotension, dyspnea, and tachycardia.
Rarely, it can also cause intracerebral hemorrhage, pneumomediastinum, retropneumoperitoneum, esophageal bleeding (3,6,11,13,15,18,56390,56440,56447,56448)(56449,56464). Chronic use is associated with myopathies and death (6,18,56391,56412,56413,56414,56416,56421,56422,56424)(56433,56441,56446,56459,56462,56467). Overdose is associated with erosion of GI tract mucous membranes, cardiac arrhythmias, disorders of respiratory function, convulsions, shock, and coma (18).
Topically, emetine is a skin irritant (6).
When inhaled, ipecac powder is a respiratory irritant and can result in allergic symptoms such as rhinitis, as well as aspiration pneumonitis (18,56406,56445).
Intravenously, emetine may cause inflammation of the muscle tissue at the injection site with chronic administration. In total doses over 1 gram, it can lead to gastrointestinal and nervous system symptoms, hematuria and circulatory collapse (6).
Cardiovascular
...Orally, ipecac can cause hypotension, dyspnea, and tachycardia (11,56440).
Chronic use is associated with cardiac myopathy and death related to heart failure (6,18,56391,56409,56424,56467). Overdose is associated with shock and cardiac arrhythmias (18).
Intravenously, ipecac in total doses over 1 gram can lead to circulatory collapse (6).
Dermatologic ...Topically, emetine, a constituent of ipecac syrup, is a skin irritant (6).
Gastrointestinal
...Orally, ipecac causes nausea, vomiting, diarrhea, and GI irritation (3,6,11,13,15,18,56390,56464).
In some cases, these adverse effects are severe. There is a case report of a pneumomediastinum (air in the membrane around the heart) and retropneumoperitoneum (air behind the chest cavity) indicative of esophageal rupture following administration of a therapeutic dose of ipecac (56448). There is also a case report of esophageal bleeding following therapeutic use of ipecac (56447). Overdose is associated with erosion of GI tract mucous membranes (18).
Intravenously, ipecac in total doses over 1 gram can lead to gastrointestinal symptoms (6).
Hematologic ...Orally, a case of intracerebral hemorrhage related to the use of ipecac syrup has been reported in an elderly patient (56449).
Immunologic ...When inhaled, ipecac powder has resulted in occupational allergy symptoms, such as rhinitis (56445).
Musculoskeletal
...Orally, progressive muscular weakness has occurred following ipecac abuse, in some cases resulting in death.
Discontinuation of ipecac seems to reverse the myopathy (56391,56412,56413,56414,56416,56421,56422,56424,56433,56441)(56446,56459,56462).
Intravenously, emetine may cause inflammation of the muscle tissue at the injection site with chronic administration (6).
Neurologic/CNS
...Orally, ipecac may cause dizziness (11).
Overdose is associated with convulsions and coma (18).
Intravenously, ipecac in total doses over 1 gram can lead to nervous system symptoms (6).
Pulmonary/Respiratory
...Orally, ipecac causes dyspnea (11).
Overdose is associated with disorders of respiratory function (18).
When inhaled, ipecac powder is a respiratory irritant and can result in aspiration pneumonitis (18,56406).
Renal ...Intravenously, ipecac in total doses over 1 gram can lead to hematuria (6).
General
...Orally, topically, or rectally, peppermint oil is generally well tolerated.
Inhaled,
peppermint oil seems to be well tolerated. Intranasally, no adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted. Orally, peppermint leaf seems to be well tolerated.
Most Common Adverse Effects:
Orally: Abdominal pain, anal burning, belching, diarrhea, dry mouth, heartburn, nausea, and vomiting.
Topically: Burning, dermatitis, irritation, and redness.
Dermatologic
...Topically, peppermint oil can cause skin irritation, burning, erythema, and contact dermatitis (3802,11781,31528,43338,68473,68457,68509,96361,96362).
Also, a case of severe mucosal injury has been reported for a patient who misused an undiluted over the counter mouthwash that contained peppermint and arnica oil in 70% alcohol (19106).
In large amounts, peppermint oil may cause chemical burns when used topically or orally. A case of multiple burns in the oral cavity and pharynx, along with edema of the lips, tongue, uvula, and soft palate, has been reported for a 49-year-old female who ingested 40 drops of pure peppermint oil. Following treatment with intravenous steroids and antibiotics, the patient's symptoms resolved over the course of 2 weeks (68432). Also, a case of chemical burns on the skin and skin necrosis has been reported for a 35-year-old male who spilled undiluted peppermint oil on a previous skin graft (68572). Oral peppermint oil has also been associated with burning mouth syndrome and chronic mouth ulceration in people with contact sensitivity to peppermint (6743). Also, excessive consumption of mint candies containing peppermint oil has been linked to cases of stomatitis (13114).
Gastrointestinal ...Orally, peppermint oil can cause heartburn, nausea and vomiting, anal or perianal burning, abdominal pain, belching, dry mouth, diarrhea, and increased appetite (3803,6740,6741,6742,10075,11779,11789,17682,68497,68514)(68532,68544,96344,96360,102602,104219,107955). Enteric-coated capsules might help to reduce the incidence of heartburn (3802,4469,6740,11777). However, in one clinical study, a specific enteric-coated formulation of peppermint oil (Pepogest; Nature's Way) taken as 180 mg three times daily was associated with a higher rate of adverse effects when compared with placebo (48% versus 31%, respectively). Specifically, of the patients consuming this product, 11% experienced belching and 26% experienced heartburn, compared to 2% and 12%, respectively, in the placebo group (107955). A meta-analysis of eight small clinical studies in patients with irritable bowel syndrome shows that taking enteric-coated formulations of peppermint oil increases the risk of gastroesophageal reflux symptoms by 67% when compared with a control group (109980). Enteric-coated capsules can also cause anal burning in people with reduced bowel transit time (11782,11789).
Genitourinary ...Orally, a sensitive urethra has been reported rarely (102602).
Hepatic ...One case of hepatocellular liver injury has been reported following the oral use of peppermint. Symptoms included elevated liver enzymes, fatigue, jaundice, dark urine, and signs of hypersensitivity. Details on the dosage and type of peppermint consumed were unavailable (96358).
Immunologic ...One case of IgE-mediated anaphylaxis, characterized by sudden onset of lip and tongue swelling, tightness of throat, and shortness of breath, has been reported in a 69-year-old male who consumed peppermint candy (89479). An allergic reaction after use of peppermint oil in combination with caraway oil has been reported in a patient with a history of bronchial asthma (96344). It is not clear if this reaction occurred in response to the peppermint or caraway components.
Neurologic/CNS ...Orally, headache has been reported rarely (102602).
Ocular/Otic ...Orally, peppermint has been reported to cause blurry vision (3803).
General
...Orally, fresh pulsatilla is a toxic gastrointestinal irritant (4,19).
It can also cause kidney and urinary tract irritation (2).
Topically, contact with the fresh plant can cause skin irritation, mucous membrane irritation, itching, and pustule formation known as ranunculus dermatitis (2). Allergic reactions to pulsatilla volatile oil have been documented with patch tests (4).
Inhalation of pulsatilla volatile oil may cause nasal mucosal and conjunctival irritation (4).
Dermatologic ...Topically, contact with the fresh plant can cause skin irritation, mucous membrane irritation, itching, and pustule formation known as ranunculus dermatitis (2).
Gastrointestinal ...Orally, fresh pulsatilla is a toxic gastrointestinal irritant (4,19).
Genitourinary ...Orally, fresh pulsatilla can cause urinary tract irritation (2).
Immunologic ...Topically, allergic reactions to the protoanemonin-containing volatile oil of pulsatilla have been documented with patch tests (4).
Ocular/Otic ...Inhalation of the protoanemonin-containing volatile oil of pulsatilla may cause conjunctival irritation (4).
Pulmonary/Respiratory ...Inhalation of the protoanemonin-containing volatile oil of pulsatilla may cause nasal mucosal irritation (4).
Renal ...Orally, fresh pulsatilla can cause kidney irritation (2).
General
...Orally, yellow dock seems to be well tolerated when properly prepared and consumed in food amounts.
Consuming raw yellow dock leaves or rhizomes may be unsafe.
Serious Adverse Effects (Rare):
Orally: Raw leaves or rhizomes can cause hypocalcemia, kidney stones, and vomiting.
Cardiovascular ...Orally, yellow dock has been linked to ventricular fibrillation and death after ingestion of 500 grams (17). Oxalic acid, a constituent of yellow dock, reacts with calcium in plasma, forming insoluble calcium oxalate, which can cause hypocalcemia; the crystals may precipitate in the blood vessels and heart (12). Older or uncooked leaves should be avoided (6).
Dermatologic ...Orally, yellow dock can cause dermatitis when consumed in large amounts (4). Topically, contact with the plant may cause dermatitis in people sensitive to yellow dock (6).
Gastrointestinal ...Orally, vomiting may occur after ingestion of fresh rhizome (18). Consuming excessive amounts can cause diarrhea and nausea (6). Excessive use can also cause abdominal cramps and intestinal atrophy (4). There is one report of a death, preceded by vomiting and diarrhea, after ingestion of 500 grams of yellow dock (17). Older or uncooked leaves should be avoided (6).
Genitourinary ...Orally, yellow dock can cause polyuria when consumed in large amounts (6).
Hematologic ...Orally, in one case report, a 38-year-old female developed immune-mediated thrombocytopenia after consuming a "cleansing" tea containing unknown amounts of yellow dock and burdock. The patient presented with bruising, mild weakness, and fatigue, which started 2-3 days after consuming the tea, and was found to have a platelet count of 5,000 per mcL. Symptoms resolved after platelet transfusion and treatment with oral dexamethasone (108971). It is unclear if these effects were caused by yellow dock, burdock, the combination, or other contributing factors.
Hepatic ...Orally, yellow dock has been linked to liver failure and death after ingestion of 500 grams (17). Oxalic acid, a constituent of yellow dock, reacts with calcium in plasma, forming insoluble calcium oxalate, which can cause hypocalcemia; the crystals may precipitate in the liver (12). Older or uncooked leaves should be avoided (6).
Neurologic/CNS ...Orally, yellow dock has been linked to coma and death after ingestion of 500 grams (17). Older or uncooked leaves should be avoided (6).
Pulmonary/Respiratory ...Orally, yellow dock has been linked to respiratory depression and death after ingestion of 500 grams (17). Oxalic acid, a constituent of yellow dock, reacts with calcium in plasma, forming insoluble calcium oxalate, which can cause hypocalcemia; the crystals may precipitate in the lungs (12). Older or uncooked leaves should be avoided (6).
Renal ...Orally, yellow dock can cause polyuria when consumed in large amounts (6). There is one report of a death, preceded by kidney failure, after ingestion of 500 grams (17). Oxalic acid, a constituent of yellow dock, reacts with calcium in plasma, forming insoluble calcium oxalate, which can cause hypocalcemia; the crystals may precipitate in the kidneys. Individuals with a history of kidney stones should use yellow dock cautiously (12). Older or uncooked leaves should be avoided (6).
Other ...Orally, yellow dock can cause hypokalemia when taken in large amounts (4). There is one report of a death, preceded by severe metabolic acidosis, after ingestion of 500 grams of yellow dock (17). Oxalic acid, a constituent of yellow dock, reacts with calcium in plasma, forming insoluble calcium oxalate, which can cause hypocalcemia; the crystals may precipitate in the kidneys, blood vessels, heart, lungs, and liver (12). Older or uncooked leaves should be avoided (6).
