African Plantain, Brown Psyllium, Dietary Fiber, Erva-das-pulgas, Fibre Alimentaire, Fleaseed, Fleawort, Flohkraut, Flohsamen, French Psyllium, Glandular Plantain, Graine de Psyllium, Herbe aux Puces, Œil-de-Chien, Pilicaire, Plantain, Plantago afra, Plantago arenaria, Plantago indica, Plantago psyllium, Plantain, Plantain Pucier, Psyllii Semen, Psyllion, Psyllios, Psyllium, Psyllium arenarium, Psyllium Brun, Psyllium d'Espagne, Psyllium indica, Psyllium Noir, Psyllium Seed, Pucière, Pucilaire, Scharzer Flohsame, Spanish Psyllium, Zaragatona.
Overview InformationBlack psyllium is a plant. People use the seed to make medicine. Be careful not to confuse black psyllium with other forms of psyllium including blond psyllium.
Black psyllium is found in some over-the-counter medicines and is effective for treating and preventing constipation. It is also used for diarrhea, obesity, diabetes, and for reducing the risk of heart disease, but there is less evidence that it is effective for these conditions.
How does it work?Black psyllium adds bulk to the stool which might help with constipation, diarrhea, and irritable bowel syndrome. It also controls how quickly sugars are absorbed from the gut, which might help control blood sugar levels in people with diabetes.
Uses & Effectiveness
- Constipation. Black psyllium is safe and effective for short-term, over-the-counter use for treating constipation.
Likely Effective for
- Heart disease. Black psyllium is a soluble fiber. Foods high in soluble fiber can be used as part of a low-fat, low-cholesterol diet to prevent heart disease. Research shows that a person must eat at least 7 grams of psyllium husk each day to reduce the risk for heart disease.
Insufficient Evidence for
- Diabetes. Early research suggests that taking black psyllium might help control blood sugar in people with diabetes by reducing how quickly sugars are absorbed from food.
- High blood pressure. Research suggests that taking psyllium can decrease blood pressure in some people, but the effect is very small.
- Build up of fat in the liver in people who drink little or no alcohol (nonalcoholic fatty liver disease or NAFLD). Early research shows that taking psyllium can lower body weight and body mass index (BMI) in people with NAFLD. But it doesn't work any better than standard care.
- Obesity. Research suggests that psyllium does not reduce weight, body mass index (BMI), or waist measurement in people who are overweight or obese.
- A long-term disorder of the large intestine that causes stomach pain (irritable bowel syndrome or IBS).
- High levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia).
- Other conditions.
Side Effects & SafetyWhen taken by mouth: Black psyllium is LIKELY SAFE for most people when taken with plenty of water. Drink at least 8 ounces of fluids for every 3-5 grams of husk or 7 grams of seed. Mild side effects include bloating and gas. In some people, black psyllium can cause allergic reactions such as runny nose, red eyes, rash, and asthma, or, rarely, a life-threatening reaction called anaphylaxis.
Black psyllium is LIKELY UNSAFE when taken by mouth without enough water. Be sure to take black psyllium with plenty of water. Otherwise, it might cause choking or block the gastrointestinal (GI) tract.
Special Precautions & Warnings:Pregnancy and breast-feeding: Taking black psyllium during pregnancy or breast-feeding seems to be LIKELY SAFE, as long as enough water is taken with the dose.
Diabetes: Black psyllium can lower blood sugar levels in people with type 2 diabetes by slowing down absorption of sugars from foods. Monitor blood glucose levels closely if you have diabetes and use black psyllium. Doses of your medications for diabetes may need to be adjusted.
Intestinal problems: Don't use black psyllium if you have impacted stools, a complication of constipation in which the stool hardens in the rectum and can't be moved by usual movement of the bowel. Don't use black psyllium if you have any condition that increases your risk of getting blockages in your intestines. The concern is that when black psyllium absorbs water and swells up, it might block the GI tract in people with these types of conditions.
Allergies: Some people are severely allergic to black psyllium. This is more likely to happen to people who have been exposed to black psyllium on the job, such as nurses who prepare doses of powdered laxatives, or workers in factories that process psyllium. These people shouldn't use black psyllium.
Phenylketonuria: Some black psyllium products might be sweetened with aspartame (NutraSweet). If you have phenylketonuria, avoid these products.
Surgery: Because black psyllium might affect blood sugar levels, there is a concern that it might interfere with blood sugar control during and after surgery. Stop using black psyllium at least 2 weeks before a scheduled surgery.
Swallowing disorders: People who have trouble swallowing might be more likely to choke on black psyllium. If you have an esophageal problem or swallowing disorder, don't use black psyllium.
Be cautious with this combination
Carbamazepine (Tegretol) interacts with BLACK PSYLLIUM
Black psyllium contains large amounts of fiber. Fiber can decrease how much carbamazepine (Tegretol) the body absorbs. By decreasing how much carbamazepine (Tegretol) the body absorbs black psyllium might decrease the effectiveness of carbamazepine (Tegretol).
Digoxin (Lanoxin) interacts with BLACK PSYLLIUM
Black psyllium is high in fiber. Fiber can decrease the absorption and decrease the effectiveness of digoxin (Lanoxin). As a general rule, any medications taken by mouth should be taken one hour before or four hours after black psyllium to prevent this interaction.
Lithium interacts with BLACK PSYLLIUM
Black psyllium contains large amounts of fiber. Fiber can decrease how much lithium the body absorbs. Taking lithium along with black psyllium might decrease the effectiveness of lithium. To avoid this interaction take black psyllium at least 1 hour after lithium.
Medications for diabetes (Antidiabetes drugs) interacts with BLACK PSYLLIUM
Black psyllium might decrease blood sugar by decreasing how much sugar your body absorbs from foods. Diabetes medications are also used to lower blood sugar. Taking black psyllium with diabetes medications might cause your blood sugar to be too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
It's important to take enough water when taking black psyllium. Not taking enough fluid could lead to choking or obstruction of the gastrointestinal (GI) tract. Take at least 240 mL of fluid for every 5 grams of psyllium husk or 7 grams of psyllium seed. Black psyllium should be taken at least 30-60 minutes after taking other drugs.
The following doses have been studied in scientific research:
- For constipation: The typical dose of black psyllium is 10-30 grams per day in divided amounts. Take each dose with plenty of water. Otherwise, black psyllium might cause choking. The FDA labeling recommends at least 8 ounces (a full glass) of water or other fluid with each dose.
- For heart disease: At least 7 grams of psyllium husk (soluble fiber) daily, as part of a low-fat, low-cholesterol diet.
- Clark CCT, Salek M, Aghabagheri E, Jafarnejad S. The effect of psyllium supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials. Korean J Intern Med 2020 Feb 19. doi: 10.3904/kjim.2019.049. Online ahead of print. View abstract.
- Code of Federal Regulations, Title 21 (21CFR 101.17). Food labeling warning, notice, and safe handling statements. Available at www.ecfr.gov/cgi-bin/text-idx?SID=20f647d3b74161501f46564b915b4048&mc=true&node=se21.2.101_117&rgn=div8. Accessed December 3, 2016.
- Code of Federal Regulations, Title 21 (21CFR 101.81). Chapter IB, part 101E, section 101.81 "Health claims: soluble fiber from certain foods and risk of coronary heart disease (CHD)." Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=101.81. Accessed December 3, 2016.
- Code of Federal Regulations, Title 21 (21CFR 201.319). Specific labeling requirements - water-soluble gums, hydrophilic gums, and hydrophilic mucilloids. Available at www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.319. Accessed December 3, 2016.
- Cook IJ, Irvine EJ, Campbell D, et al. Effect of dietary fiber on rectosigmoid motility in patients with irritable bowel syndrome: A controlled, crossover study. Gastroenterology 1990;98:66-72. View abstract.
- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
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- Department of Health and Human Services, Food and Drug Administration. Laxative drug products for over-the-counter human use: psyllium ingredients in granular dosage forms. Final Rule. Federal Register; March 29, 2007: 72(60).
- Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17(1):298. View abstract.
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- Frati-Munari, A. C., Fernandez-Harp, J. A., Becerril, M., Chavez-Negrete, A., and Banales-Ham, M. Decrease in serum lipids, glycemia and body weight by Plantago psyllium in obese and diabetic patients. Arch Invest Med (Mex) 1983;14(3):259-268. View abstract.
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