licorice

General

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

Pronunciation:
lik-e-rish

Trade Name(s)

• Glycyrrhiza glabra
• deglycyrrhized licorice (DGL)
• sweet root

Ther. Class.
antiulcer agents

Common Uses

Dyspepsia.

Action

Licorice blocks the metabolism of prostaglandins E and F2 alpha and may accelerate peptic ulcer healing. Licorice root also has antispasmodic, anti-inflammatory, laxative and soothing properties.

Therapeutic Effect(s):

Improved symptoms of dyspepsia.

Pharmacokinetics

Absorption: Unknown.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: Unknown.

TIME/ACTION PROFILE

Contraindication/Precautions

Contraindicated in:

• Hypersensitivity.
• Pregnancy and lactation.

Use Cautiously in:

• Congestive heart failure.
• Hypertension.
• Renal disease.
• Hypokalemia.
• Consumption of 30 grams/day or more for several wk can cause severe adverse events.

Adverse Reactions/Side Effects

CNS: headache, lethargy

CV: arrhythmias, hypertension

Endo: pseudohyperaldosteronism, hyperparathyroidism, decreased serum testosterone

F and E: hypokalemia, sodium and water retention

GI: nausea, vomiting

GU: acute renal failure

MS: muscle weakness

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Natural Drug Interaction

• ↑ risk of cardiotoxicity with  cardiac glycosides.
• ↓ effectiveness of  antihypertensives.
• ↑ potassium loss with  potassium-depleting diuretics.
• ↑ metabolism and ↓ levels of  warfarin.

Natural-Natural:

• Licorice causes potassium depletion which may increase the risk of cardiotoxicity with cardiac glycoside-containing herbs (digitalis) 
• Additive potassium depletion can occur with  stimulant laxative herbs (senna)  .

Route/Dosage

PO (Adults):  Dyspepsia– 1 mL three times daily (Iberogast – combination product with other herbs) for 4 weeks.

Availability

Liquid extract
Tablets
Capsules

Assessment

• Assess GI function (bowel sounds, abdominal distention, and usual pattern of bowel function) before and periodically during therapy.
• Monitor BP and ECG periodically during prolonged therapy.

Lab Test Considerations:

Monitor 17–hydroxyprogesterone concentrations, electrolytes, LDH, lipid profile, liver function tests, plasma renin, renal function test, and testosterone periodically during therapy.

Potential Diagnoses

• Deficient knowledge, related to medication regimen (Patient/Family/Teaching) 

Implementation

• PO Administration should be limited to 4 wks.

Patient/Family Teaching

• Instruct patient to take as directed.
• Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

Reduction in dyspepsia.