BLACK PSYLLIUM

OTHER NAME(S):

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, &OElig;il-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.<br/><br/>

Overview

Overview Information

Black 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 used for chronic constipation and for softening stools in conditions such as hemorrhoids, cracks in the skin around the anus (anal fissures), surgery on the rectum, and pregnancy. It is also used for diarrhea, dysentery, irritable bowel syndrome (IBS), cancer, high cholesterol, and reducing the risk of coronary heart disease.

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

Uses & Effectiveness?

Effective for

  • Constipation. Black psyllium is safe and effective for short-term, over-the-counter use for treating constipation.

Likely Effective for

  • Coronary heart disease. Foods containing black psyllium can help reduce the risk of coronary heart disease. The daily intake of psyllium must be at least 7 grams and it must be combined with a diet low in saturated fat and cholesterol.

Insufficient Evidence for

  • Diabetes. Early research suggests that taking black psyllium by mouth might help control blood sugar in people with type 2 diabetes by reducing how quickly sugars are absorbed from food.
  • Obesity. Early research shows that taking black psyllium by mouth can slightly decrease body weight and body mass index in people with non-alcoholic fatty liver disease (NAFLD) who are overweight. But it doesn’t work better than standard care for NAFLD.
  • Cancer.
  • Diarrhea.
  • Irritable bowel syndrome (IBS).
  • Other conditions.
More evidence is needed to rate the effectiveness of black psyllium for these uses.

Side Effects

Side Effects & Safety

Black psyllium, when taken by mouth with enough water, is LIKELY SAFE for most people. 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, you might choke. The concern is so important that the U.S. Food and Drug Administration (FDA) requires that black psyllium be labeled: "WARNING: Taking this product without adequate fluid may cause it to swell and block your throat or esophagus and may cause choking. Do not take this product if you have difficulty in swallowing. If you experience chest pain, vomiting, or difficulty in swallowing or breathing after taking this product, seek immediate medical attention.”

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.

Esophageal and swallowing disorders: People who have esophageal problems or 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.

Interactions

Interactions?

Moderate Interaction

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.<br /><br /> 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.

Dosing

Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • 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 coronary heart disease: Black psyllium is added to a diet low in saturated fat and cholesterol in a dose of at least 7 grams daily.
  • For diabetes: Black psyllium has been used in a dose of 15 grams daily.
Black psyllium should be taken 30-60 minutes after taking other drugs.

View References

REFERENCES:

  • 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.
  • 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).
  • Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
  • Frati Munari AC, Benitez Pinto W, Raul Ariza Andraca C, Casarrubias M. Lowering glycemic index of food by acarbose and Plantago psyllium mucilage. Arch Med Res 1998;29:137-41. View abstract.
  • 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.
  • Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. View abstract.
  • Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. View abstract.
  • Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416. View abstract.
  • Semen plantaginis in: WHO Monographs on Selected Medicinal Plants, volume 1. World Health Organization, Geneva, 1999. Available at http://apps.who.int/medicinedocs/en/d/Js2200e/. Accessed November 26, 1026.
  • Agha FP, Nostrant TT, Fiddian-Green RG. Giant colonic bezoar: a medication bezoar due to psyllium seed husks. Am J Gastroenterol 1984;79:319-21. View abstract.
  • Akbarian SA, Asgary S, Feizi A, Iraj B, Askari G. Comparative study on the effect of Plantago psyllium and Ocimum basilicum seeds on anthropometric measures in nonalcoholic fatty liver patients. Int J Prev Med 2016;7:114. 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.
  • Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. View abstract.

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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2018.