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

ONSETPEAKDURATION
POunknownunknownunknown

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

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

Neuro: headache, lethargy

* 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

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.