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WHO monographs on selected medicinal plants - travolekar.ru

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<str<strong>on</strong>g>WHO</str<strong>on</strong>g> <str<strong>on</strong>g>m<strong>on</strong>ographs</str<strong>on</strong>g> <strong>on</strong> <strong>selected</strong> <strong>medicinal</strong> <strong>plants</strong><br />

volunteer. The results dem<strong>on</strong>strate that urinary oxalate levels in the volunteers<br />

significantly increased (p = 0.01) by an average of 43.4% during<br />

treatment. The excreti<strong>on</strong> of potential lithogenic i<strong>on</strong>s, calcium, phosphate,<br />

and sodium also increased. However, inhibitors of st<strong>on</strong>e formati<strong>on</strong>, magnesium<br />

and potassium, rose as well (43).<br />

The effect of cranberry juice <strong>on</strong> risk factors for urinary st<strong>on</strong>es was assessed<br />

in a trial involving 12 healthy male subjects. The subjects provided<br />

24-hour urine samples (three samples from each patient during the three<br />

loading phases with water <strong>on</strong>ly). In each loading phase a neutral mineral<br />

water was substituted for 330 ml of the juice. Cranberry juice decreased<br />

the urinary pH, whereas the excreti<strong>on</strong> of oxalic acid and the relative supersaturati<strong>on</strong><br />

for uric acid were increased, indicating the potential for the<br />

development of urinary st<strong>on</strong>es (44).<br />

Adverse reacti<strong>on</strong>s<br />

One rare case of immune-related thrombocytopaenia has been reported<br />

in a 68-year-old patient (45).<br />

Nausea and severe vomiting were reported in a 4-m<strong>on</strong>th-old infant<br />

after administrati<strong>on</strong> of 180 ml of cranberry juice (46).<br />

C<strong>on</strong>traindicati<strong>on</strong>s<br />

The use of cranberry for the treatment of diseases of the urinary tract in<br />

paediatric populati<strong>on</strong>s is ineffective and is not recommended (22, 43).<br />

Warnings<br />

Patients with kidney st<strong>on</strong>es or impaired kidney functi<strong>on</strong> should use products<br />

c<strong>on</strong>taining the f<strong>ru</strong>it <strong>on</strong>ly after c<strong>on</strong>sulting their health care provider (47).<br />

Precauti<strong>on</strong>s<br />

A health care professi<strong>on</strong>al should be c<strong>on</strong>sulted prior to treatment to <strong>ru</strong>le<br />

out serious c<strong>on</strong>diti<strong>on</strong>s such as pyel<strong>on</strong>ephritis.<br />

People with diabetes should be aware of the high c<strong>on</strong>tent of sugar in<br />

the juice and use sugar-free preparati<strong>on</strong>s.<br />

D<strong>ru</strong>g interacti<strong>on</strong>s<br />

One case of a fatal internal haemorrhage was reported in a male patient<br />

whose internati<strong>on</strong>al normalized ratio (INR) increased to > 50 after being<br />

treated with cefalexin, digoxin, phenytoin and warfarin, as well as cranberry<br />

juice for 2 weeks. The subject was also unable to eat during the<br />

2-week period (48). One case report of a possible interacti<strong>on</strong> with warfa-<br />

162

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