Question 1

How does Frangula alnus work as a laxative?

Accepted Answer

Frangula alnus contains anthraquinone glycosides, primarily frangulin and glucofrangulin, which act as stimulant laxatives. These compounds are metabolized by intestinal bacteria into active metabolites such as emodin, which stimulate colonic motility and increase fluid secretion into the intestinal lumen. This promotes bowel movements typically within 8-12 hours after ingestion. The mechanism involves stimulation of the myenteric plexus and inhibition of water and electrolyte reabsorption in the colon. Evidence level: C.

Question 2

Is Frangula alnus safe to take during pregnancy?

Accepted Answer

No, Frangula alnus is contraindicated during pregnancy and breastfeeding. The anthraquinone compounds can stimulate uterine contractions and may cause miscarriage or premature labor. Active metabolites can also pass into breast milk, potentially causing diarrhea in nursing infants. Women who are pregnant, planning pregnancy, or breastfeeding should avoid this herb entirely. Children under 12 years of age should also not use Frangula alnus. Evidence level: Traditional/C.

Question 3

What is the correct dosage of Frangula alnus bark?

Accepted Answer

The standard adult dosage of Frangula alnus is 1-2 grams of dried bark prepared as a tea or infusion. The bark must be aged for at least one year before use, as fresh bark contains higher levels of emetic compounds that can cause nausea and vomiting. The laxative effect typically occurs 8-12 hours after ingestion, so it is commonly taken before bedtime. Use should be limited to short-term periods of 1-2 weeks maximum. Evidence level: C/Traditional.

Question 4

Does Frangula alnus interact with any medications?

Accepted Answer

Yes, Frangula alnus may interact with several medications due to its potential to cause potassium loss with prolonged use. This can increase the risk of toxicity from cardiac glycosides such as digoxin and may affect the action of antiarrhythmic drugs, diuretics, and corticosteroids. Concomitant use with other stimulant laxatives should be avoided. Patients taking heart medications, diuretics, or corticosteroids should consult a healthcare provider before using this herb. Evidence level: C/Traditional.

Question 5

What are the side effects of Frangula alnus?

Accepted Answer

Common side effects of Frangula alnus include abdominal cramps and diarrhea, particularly at higher doses. These effects result from the stimulant action of anthraquinones on intestinal smooth muscle. Prolonged use may lead to electrolyte imbalances, especially potassium deficiency, and can result in laxative dependence or cathartic colon. The herb is contraindicated in cases of intestinal obstruction, inflammatory bowel disease, and in children under 12 years of age. Evidence level: C/Traditional.

Frangula alnus

Sources & Citations

Summary

Background

Traditional uses

Active compounds

Mechanism of action

Clinical evidence

Safety & adverse effects

Pregnancy & lactation

Evidence summary

PubMed sources

Government sources