licorice (Suppl/herb)

Action and Spectrum

Actions and spectrum: 

licorice is a plant with several biological activities, including anti-inflammatory, anti-tumor, and anti-viral properties. licorice root contains several active compounds, including glycyrrhizin, flavonoids, and polysaccharides.

These compounds give licorice its potential health benefits, including its use as an expectorant, anti-inflammatory, and digestive aid. licorice may also have potential therapeutic effects in treating viral infections, such as hepatitis C and HIV, and as an adjunct treatment for certain types of cancer. 

Drug Interaction

Adverse Reaction

Frequency not defined 

CHF 

Edema 

Headache 

Hypertensive encephalopathy 

Hypokalemic myopathy 

Lower extremity weakness 

Myoglobinuria 

Quadriplegia 

Sodium 

Amenorrhea 

Decreased libido 

Erectile dysfunction 

Hypertension 

Hypokalemia 

Lethargy 

Mineralocorticoid effects
Pulmonary edema 

Rhabdomyolysis 

Fluid retention 

Black Box Warning

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypertension: licorice can increase blood pressure, and hence should be avoided by individuals with high blood pressure. 
• Hypokalemia: Long-term use of licorice can lead to low potassium levels in the blood. Hence, it should be avoided by individuals with low potassium levels or those taking medications that can cause hypokalemia. 
• Pregnancy: licorice should be avoided during pregnancy as it may increase the risk of preterm delivery. 
• Breastfeeding: licorice should also be avoided during breastfeeding as it may decrease milk production. 
• Hormone-sensitive cancers: licorice may have estrogenic effects, and hence, it should be avoided by individuals with hormone-sensitive cancers like breast cancer, ovarian cancer, and uterine cancer. 
• Liver disease: licorice can worsen liver disease and hence should be avoided by individuals with liver disease. 
• Heart disease: licorice can increase the risk of heart disease and should be avoided by individuals with a history of heart disease.

Caution: 

licorice should be used with caution in individuals with a history of hypertension, hypokalemia, renal disease, heart disease, and hormonal imbalances. It may also interact with various medications, so it is essential to consult a healthcare provider before using licorice supplements or products. Pregnant and breastfeeding women should also avoid the use of licorice, as it may affect fetal growth and development.  

Comorbidities: 

• High blood pressure: licorice can increase blood pressure, so it should be avoided or used cautiously in people with hypertension. 
• Low potassium levels: licorice can lower potassium levels in the body, so it should be used cautiously in people with low potassium levels. 
• Diabetes: licorice may interfere with blood sugar control, so it should be used cautiously in people with diabetes. 
• Hormone-sensitive conditions: licorice may act like estrogen in the body and can worsen hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, and uterine fibroids. 
• Kidney disease: licorice can affect kidney function, so it should be used cautiously in people with kidney disease. 
• Liver disease: licorice may worsen liver disease, so it should be used cautiously in people with liver problems. 

Pregnancy / Lactation

Pregnancy consideration: N/A 

Lactation: N/A  

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 
• Category B: There is no evidence of risk to the fetus found in animal reproduction studies and there are not enough studies on pregnant women. 
• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women. 
• Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh risks over benefits These category drugs should be prohibited for pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

licorice (Glycyrrhiza glabra) contains several bioactive compounds, including triterpenoids, flavonoids, and glycyrrhizin. Glycyrrhizin is a natural sweetener and the primary active ingredient in licorice. It has been shown to have anti-inflammatory, antimicrobial, antiviral, and anticancer effects.

Glycyrrhizin can also inhibit the activity of an enzyme called 11-beta-hydroxysteroid dehydrogenase, which results in an increase in the concentration of cortisol, a natural steroid hormone in the body. Additionally, licorice has been shown to have antioxidant properties and can help protect the liver.  

Pharmacodynamics: 

• Anti-inflammatory: licorice has been shown to have anti-inflammatory effects by inhibiting the activity of inflammatory enzymes and reducing the production of pro-inflammatory cytokines. 
• Antioxidant: licorice contains several antioxidants, including flavonoids and phenolic compounds, which help protect cells from oxidative damage. 
• Immunomodulatory: licorice has been shown to modulate the immune system by stimulating the production of certain immune cells, such as T cells and natural killer cells. 
• Antimicrobial: licorice has demonstrated antimicrobial activity against a range of bacteria, viruses, and fungi. 
• Hepatoprotective: licorice has been shown to have hepatoprotective effects by reducing liver damage and protecting against oxidative stress. 
• Anti-cancer: licorice contains compounds that have been shown to inhibit the growth and proliferation of cancer cells in vitro, although more research is needed to determine its potential as an anti-cancer agent in humans. 
• Anti-ulcer: licorice has been shown to have anti-ulcer effects by reducing inflammation and protecting the stomach lining. 
• Cardiovascular: licorice has been shown to have a range of cardiovascular effects, including lowering blood pressure, and reducing LDL cholesterol levels.

Pharmacokinetics: 

Absorption 

Glycyrrhizin, the main active component of licorice, is absorbed in the small intestine. The absorption rate of glycyrrhizin can be increased by taking it with food. 

Distribution 

Glycyrrhizin is widely distributed throughout the body, but primarily accumulates in the liver and kidneys. 

Metabolism 

Glycyrrhizin is metabolized by enzymes in the liver and gut. The primary metabolite of glycyrrhizin is glycyrrhetinic acid. 

Elimination and excretion 

Glycyrrhetinic acid and other metabolites of glycyrrhizin are excreted in the urine. The elimination half-life of glycyrrhizin is approximately 6 hours. 

Adminstartion

Administration: 

licorice can be taken orally in the form of tea, capsules, tablets, or liquid extract. Topical forms of licorice, such as creams or gels, are also available for use on the skin.

It is important to follow dosing instructions on the product label or as directed by a healthcare provider. It is recommended to consult with a healthcare provider before taking licorice supplements. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: licorice 

Pronounced: (Liquor-ish)  

Why do we use licorice? 

licorice (Glycyrrhiza glabra) has been used for medicinal purposes for centuries. It is used to treat a wide range of health conditions, including digestive issues such as stomach ulcers, heartburn, and colic.

It also has anti-inflammatory properties and can be used to relieve sore throat, cough, and respiratory infections. Additionally, it has been used to manage menopausal symptoms, including hot flashes and mood swings, as well as to support adrenal gland function. In some cultures, licorice is also used as a natural sweetener in food and beverages.