HERBAL
MEDICINAL
PLANT
H O P S
Humulus
lupulus L. (Cannabaceae/Moraceae)
By
RETTODWIKART THENU
H O P S
(hahps)
Humulus
lupulus L. (Cannabaceae/Moraceae)
SUMMARY AND PHARMACEUTICAL COMMENT
The chemistry of
hops is well documented and is characterised by the bitter acid components of
the oleo-resin. Documented pharmacological activities support the herbal uses,
although evidence from robust clinical studies is limited. Excessive use of
hops and use during pregnancy and lactation should be avoided in view of the
limited toxicity data.
DESCRIPTION
Medicinal Parts: The medicinal parts are the
glandular hairs separated from the infructescence, the whole dried female flowers,
the fresh cones (preferably with few seeds) collected before the seeds ripen
and the fresh or dried female inflorescence.
Flower and Fruit: The male flowers are
yellowish-greenish, inconspicuous and about 5 mm in diameter. The female flowers
are in richly blossomed, heavily branched inflorescence. The ovary, which has 2
long downy stigma, is surrounded at the base by a round compressed nutlet. A yellowish
fruit cone grows from the female flower. The inside of the bracts is covered
with small, glossy, light yellow glandular scales, which contain hop bitter
(Lupulin).
Leaves, Stem and Root: The hop plant is a perennial. The
annual shoots reach a height of 6 m (12 m when cultivated). The stems are
pencil-thick, green and do not tum woody. They are covered in 6 rows of
climbing barbs. The leaves are 3 to 5 Iobed, serrate and opposite.
Characteristics: Lupulin has a very strong odor
and an extremely bitter taste.
Habitat: Indigenous to Europe, cultivated
in Asia, U.S. and elsewhere.
Production: Hop cones consist of the whole
dried female inflorescence of Humulus lupulus. After the harvest, the hops are
dried on racks at temperatures of 30 to 60° C.
Origin: The
hop plant is a perennial that is cultivated throughout the world.
SPECIES (FAMILY)
Humulus
lupulus L. (Cannabaceae/Moraceae)
SYNONYM(S)
Humulus,
Lupulus
PART(S) USED
Strobile
PHARMACOPOEIAL AND OTHER MONOGRAPHS
BHC
1992(G6)
BHP
1996(G9)
BP 2007(G84)
Complete
German Commission E(G3)
ESCOP
2003(G76)
Martindale
35th edition(G85)
Ph Eur
2007(G81)
LEGAL CATEGORY (LICENSED PRODUCTS)
GSL(G37)
CONSTITUENTS/COMPOUND
CONSTITUENTS
The following is
compiled from several sources, including General References G2, G6 and G52.
·
Flavonoids Astragalin, kaempferol, quercetin, quercitrin and rutin.
·
Chalcones Isoxanthohumol, xanthohumol, 6-isopentenylnaringenin, 30-(isoprenyl)-20,
4-dihydroxy-40, 60-dimethoxychalcone, 20,60-dimethoxy-4, 40-dihydroxychalcone.(1)
·
Oleo-resin 15-30%. Bitter principles (acylphloroglucides) in a soft
and hard resin. The lipophilic soft resin consists mainly of aacids (e.g.
humulone, cohumulone, adhumulone, prehumulone, posthumulone), b-acids (e.g. lupulone,
colupulone, adlupulone), and their oxidative degradation products including
2-methyl-3- buten-2-ol(2, 3, G52) The hard resin contains a hydrophilic d-resin
and _-resin.
·
Tannins 2–4%. Condensed; gallocatechin identified.(4)
·
Volatile oils 0.3–1.0%. More than 100 terpenoid components identified;
primarily (at least 90%) b-caryophyllene, farnescene and humulene
(sesquiterpenes), and myrcene (monoterpene).
·
Other constituents Amino acids, phenolic acids, gamma-linoleic acids,
lipids and oestrogenic substances (disputed).(5) It has been stated that only
low amounts of 2-methyl-3-buten-2- ol, the sedative principle identified in
hops, are present in sedative tablets containing hops.(2) However, it is
thought that 2-methyl-3- buten-2-ol is formed in vivo by metabolism of the a-bitter
acids and, therefore, the low amount of 2-methyl-3-buten-2-ol in a preparation
may not indicate low sedative activity.(6) Interestingly, relatively high
concentrations of 2-methyl-3-buten-2-ol were found in bath preparations,
suggesting that high concentrations of 2- methyl-3-buten-2-ol may be achieved
in both tea and bath products containing hops.(2)
COMPOUNDS
·
Acylphloroglucinols
(10%)
·
Alpha-bitter
acids: including,
among others, humulone, cohumulone, adhumulone
·
Beta-bitter
acids: including,
among others, lupulone, colupulone, adlupulone
·
Volatile
oil (0.3-1.0%): very
complex in makeup, chief components myrcene, humulene, beta-caryophyllene,
undecane-2-on, furthermore 2-methyl-but-3-en-ol (particularly following storage,
as breakdown product of the acylphloroglucinols)
·
Resins
(oxidation products of the bitter acids)
·
Phenolic
acid: including,
among others, ferulic acid, caffeic acid and their derivatives, for example,
chlorogenic acid
·
Tannins:
oligomeric
proanthocyanidines
·
Flavonoids:
including, among
others, xanthohumole
ACTIVITIES (HOPS)
—
Allergenic (f;
CRC); Analgesic (1; BGB; CRC; MAD; PNC; WAM); Anaphrodisiac (1; APA; CRC; MAD);
Antibacterial (1; APA; CAN; WAM); Antiseptic (1; CRC; FAD); Antispasmodic (1;
APA; BGB; WAM); Antitumor (1; APA); Aperitif (1; PH2; SKY); Bitter (1; CRC;
PNC); Diaphoretic (f; CRC); Digestive (1; APA; WAM); Diuretic (f; CRC; PNC);
Emmenagogue (f; MAD); Emollient (f; APA); Estrogenic (1; APA; FNF; PH2; WAM);
Expectorant (f; PED); Fungicide (1; APA; PH2); Hypnotic (1; CAN; CRC);
Lactagogue (1; WAM); Laxative (f; MAD); Litholytic (f; MAD); Myorelaxant (1;
APA; CAN); Narcotic (1; CAN; CRC); Nervine (f; CRC); Secretagogue (f; PH2);
Sedative (2; APA; KOM; WAM); Soporific (1; BGB; CRC); Stomachic (f; CRC; PH2);
Tonic (f; CRC; MAD); Tranquilizer (1; KOM; SHT); Uterotonic (f; MAD); Vermifuge
(f; CRC).
ACTIONS
Hops
have been used by the food and liquor industries as a fl avoring for food and beer.
Medicinal uses for hops are described here, although little reliable research exists
for any uses or actions.
Estrogenic Action
Hops are believed to possess
estrogen-like activity due to the phytoestrogen components of the hop plant and
its ability to exert direct estrogenic effects (Zava et al, 1998). One older
study demonstrated estrogenic activity in an acid fraction of the plant
(Zenisek et al, 1960). However, many of the other available studies contain confl
icting information regarding the estrogenic action. At this point it is
uncertain whether the hop plant does exert estrogen-like activity.
Sedative/Hypnotic Action
The sedative/hypnotic effects
of hops may be due to the volatile oils present in the plant. The same volatile
oils may also be responsible for the antispasticity effect. Hops possess a
pentobarbital sleep-enhancing effect without infl uencing motor behavior and an
antideppresant action, when studied in the laboratory (Zanoli et al, 2005).
Antimicrobial Action
One small study shows that the
antimicrobial effects of hops result from the bitter acid components (volatile
oils) lupulone, humulene, and linalool (Leung, 1980).
Other Actions
Hops did not improve bone
parameters in laboratory animals (Figard et al, 2007).
INDICATIONS
INDICATIONS (HOPS)
—
Adenopathy (f;
JLH); Anemia (f; MAD); Angina (f; MAD); Anorexia (1; APA; BGB; SKY); Anxiety
(2; APA; BGB; WAF; SHT); Arthrosis (f; MAD); Asbestosis (2; BGB); Asthma (f;
MAD); Atony (f; MAD); Bacteria (1; APA; CAN; CRC; WAM); Boil (f; CRC; FAD);
Bruise (f; CRC; FAD; MAD); Calculus (f; CRC); Cancer (1; APA; JLH); Cancer,
breast (f; JLH); Cancer, face (f; JLH); Cancer, liver (f; JLH); Cancer, lymph
(f; JLH); Cancer, spleen (f; JLH); Cancer, stomach (f; JLH); Cancer, uterus (f;
CRC); Cardiopathy (f; MAD); Catarrh (f; MAD); Chlorosis (f; MAD); Climacteric
(1; HHB); Colitis (f; CAN); Constipation (f; MAD); Cough (f; CRC; FAD); Cramp
(1; APA; BGB; FAD; WAM); Crural Ulcer (f; CAN); Cystosis (f; APA; CRC; MAD);
Debility (f; CRC); Delirium (f; CRC); Depression (f; CAN); Dermatosis (f; PH2);
Diabetes (f; MAD); Diarrhea (1; APA; CRC); Dysentery (2; BGB; CRC);
Dysmenorrhea (f; APA); Dyspepsia (1; APA; BGB; WAM); Earache (f; CRC); Edema
(f; MAD); Enterosis (f; MAD; PH2); Enuresis (f; MAD); Fever (f; CRC; FAD); Fit
(f; CRC); Fungus (1; APA; PH2); Gas (f; MAD); Gastrosis (f; JLH); Gonorrhea (f;
MAD); Gravel (f; BGB); Headache (1; BGB; PH2; WAM); Hepatosis (f; JLH; MAD);
Hyperactivity (1; WAM); Hypochondria (f; MAD); Hysteria (f; CRC; MAD);
Impotence (f; MAD); Induration (f; JLH); Infection (1; APA; CRC; PH2);
Inflammation (f; CRC; FAD; PH2); Insomnia (2; APA; CRC; KOM; SHT; WAM);
Jaundice (f; CRC; MAD); Leprosy (2; APA; BGB; CRC); Mastosis (f; BGB; JLH);
Menopause (f; HHB); Morning Sickness (f; MAD); Mucososis (f; PH2); Mycosis (1;
APA; PH2); Nephrosis (f; BGB); Nerve (f; CRC); Nervousness (2; APA; KOM; PHR; PH2; SHT; WAM); Neuralgia
(1; CAN; CRC); Neurasthenia (f; MAD); Neurosis (f; APA); Nymphomania (f; MAD);
Oligolactea (1; WAM); Onanism (f; MAD); Pain (1; BGB; CRC; MAD; PNC; WAM);
Priapism (f; CAN; PH2); Prostatosis (f; MAD); Pulmonosis (f; CRC); Restlessness
(2; KOM; SHT; WAM) (with tension headache and/or dyspepsia) (1; CAN);
Rheumatism (f; BGB; CRC; FAD; MAD); Satyriasis (f; MAD); Scirrhus (f; JLH); Scrofula
(f; MAD); Silicosis (2; BGB); Sore (f; JLH; PH2); Splenosis (f; JLH; MAD); Spermatorrhea
(f; MAD); Stomachache (f; MAD); Stone (f; MAD); Stress (1; APA); Swelling (f;
JLH); Toothache (f; CRC); Tuberculosis (1; APA; BGB; CRC); Tumor (1; APA; CRC);
Ulcer (f; CRC); Ulcus cruris (f; PH2); Uterosis (f; BGB); VD (f; MAD); Water
Retention (f; CRC; MAD; PNC); Worm (f; CRC).
INDICATIONS AND
USAGE
Approved by Commission E:
• Nervousness and insomnia
Unproven Uses: Used as a bitter and stomachic to
stimulate the appetite and increase the secretion of gastric juices. In folk
medicine, Hops has been used internally for nerve pain, priapism, inflammation
of the intestinal mucous membrane and tension headaches and used externally for
ulcus cruris, ulcers and skin abrasions.
Homeopathic Uses: Humulus lupulus is found in
preparations for treating nervousness and insomnia.
PRECAUTIONS AND
ADVERSE REACTIONS
No health hazards or side effects
are known in conjunction with the proper administration of designated
therapeutic dosages. The fresh plant has a sensitizing effect (hoppicker's disease),
which may occur, more rarely, with the dust of the drug as well.
USES
USES
Hops
traditionally have been used as an analgesic, an anthelmintic, a sedative/ hypnotic
to treat insomnia, and for attention defi cit–hyperactivity disorder. It is
also used to treat menopausal symptoms and to wean patients off conventional
sedative prescriptions.
FOOD USE
Hops are listed by
the Council of Europe as a natural source of food flavouring (category N2). This
category indicates that hops can be added to foodstuffs in small quantities,
with a possible limitation of an active principle (as yet unspecified) in the
final product.(G16) Previously, hops has been listed as GRAS (Generally Recognised
As Safe).(G65)
HERBAL USE
Hops are stated to
possess sedative, hypnotic and topical bactericidal properties. Traditionally,
they have been used for neuralgia, insomnia, excitability, priapism, mucous
colitis, topically for crural ulcers, and specifically for restlessness associated
with nervous tension headache and/or indigestion. The German Commission E approved
use for mood disturbances such as restlessness and anxiety as well as sleep
disturbances.(G3) Hops are used in combination with valerian root for nervous sleeping
disorders and conditions of unrest.(G3)
PRODUCT AVAILABILITY
Cut herb, dry extract, extract, powdered dry herb, tea
Plant Part
Used: Whole hops
DOSAGE
DOSAGES
•
Adult PO infusion: pour 8 oz
boiling water over 0.4 g (1 tsp) ground hops cone, let stand 15 min
•
Adult PO extract: 2-4 mg
•
Adult PO cut herb: 0.5 g as a
single dose (Blumenthal, 1998)
•
Adult PO topical: apply to
affected area as needed
DOSAGE
Dosages for oral
administration (adults) for traditional uses recommended in contemporary standard
herbal reference texts are given below.
•
Dried strobile 0.5 g as an infusion two to four times daily.(G76)
•
Liquid extract 0.5–2.0 mL (1 : 1 in 45% alcohol) up to three
times daily.(G76)
•
Tincture 1–2mL (1 : 5 in 60% alcohol) up to three times daily.(G76)
DOSAGE
Mode of Administration: Comminuted drug, powdered drug or
dry extract powder for infusions or decoctions or other preparations; liquid
and solid preparations for internal use and externally for bath additives. Hops
is often found in combination with other sedatives.
How Supplied:
•
Liquid
extract — drug: 1:1 45% ethanol (V/V) (BHP83).
•
Tincture
— drug 1:5 60% ethanol (V/V) (BHP83)
Preparation: To prepare an infusion, boiling
water is poured over the ground hop cones and left to draw for 10 to 15 minutes
(1 teaspoonful is equal to 0.4 gm drug).
Daily Dosage: For most indications, a single
dose of 0.5 gm is given.
To promote sleep, a single dose
of 1 to 2 gm drug is given; liquid extract: single dose: 0.5 to 2 ml; tincture:
single dose: 1 to 2 ml.
Tea: 1 cup before bedtime for 2
to 3 days.
^ Homeopathic Dosage: 5 drops, 1 tablet or 10 globules
every 30 to 60 minutes (acute) or 1 to 3 times daily (chronic); parenterally: 1
to 2 ml sc acute, 3 times daily; chronic: once a day (HAB1).
Storage: Protect from light and moisture
in well-sealed containers.
DOSAGES
(HOPS) —
500 mg/day (SF);
2–6 tsp fresh flower (PED); 1–3 g dry flower (PED); 2 g dry flower:10 ml
alcohol/10 ml water (PED); 1–2 tsp inflorescence/cup water (SKY; WIC); 0.5–1 (–2
as hypnotic) g hops, or in tea (CAN; SKY); 0.5–1 g powdered herb;
0.5–15 g cones
(PNC); 1 tsp (0.4 g) cone cup (PH2); 0.5–2.0 ml liquid hops extract (1:1 in 45%
ethanol) (CAN); 0.5–4 ml liquid inflorescence extract (PNC);
1–2 ml hops
tincture (1:5 in 60% ethanol) 1–3 ×/day (CAN; SKY); 2–4 ml inflorescence
tincture (PNC); 2–4 g inflorescence tincture (MAD); 120–300 mg lupulin (PNC).
Cones = flowers = dry infloresences.
DOSAGE
RANGE
• Infusion or decoction: 0.5 g in
150 mL water.
• Fluid extract (1:1) (g/mL): 0.5
mL/day; 0.5–1 mL three times daily.
• Tincture (1:5) (g/mL): 1–2.5
mL/day.
• Also used as a bath additive (4
g hops in a concentrated extract) and in pillows.
PHARMACOLOGICAL ACTIONS
IN VITRO AND ANIMAL STUDIES
Antibacterial
activity, mainly against Gram-positive bacteria, has been documented for hops,
and attributed to the humulone and lupulone constituents.(7) The activity of
the bitter acids against Gram-positive bacteria is thought to involve primary
membrane leakage. Resistance of Gram-negative bacteria to the resin acids is attributed
to the presence of a phospholipid-containing outer membrane, as lupulone and humulone
are inactivated by serum phospholipids.(7) Structure–activity studies have
indicated the requirement of a hydrophobic molecule and a six-membered central
ring for such activity.(8)
Figure 1. Hops (Humulus
lupulus).
The humulones and lupulones are thought to possess little activity
towards fungi or yeasts. However, antifungal activity has been documented for
the bitter acids towards Trichophyton, Candida, Fusarium and Mucor species.(9) Flavonone
constituents have also been documented to possess antifungal activity towards Trichophyton
and Mucor species, and antibacterial activity towards Staphylococcus aureus.(10)
Antispasmodic activity has been documented for an alcoholic hops extract on
various isolated smooth muscle preparations.(11) Hops have been reported to
exhibit hypnotic and sedative properties.(G41) 2-Methyl-3-buten-2-ol, a bitter
acid degradation product, has been identified as a sedative principle in hops.(2,
3) 2-Methyl-3-buten-2-ol has been shown to possess narcotic properties in mice
and motility depressant activity in rats, with the latter not attributable to a
muscle-relaxant effect.(12) It has also been suggested that isovaleric acid
residues present in hops may contribute towards the sedative action. In mice,
hops extract administered intraperitoneally (100, 250, 500 mg/kg) 30 minutes prior
to a series of behavioural tests, resulted in a dose-dependent suppression of
spontaneous locomotor at doses of 250 mg/kg for up to one hour.(13) The time
for mice to be able to remain on a rota rod was decreased by 59% and 65% at doses
of 250 mg/kg and 500 mg/kg, respectively. The time of onset of convulsions and survival
time after administration of pentylenetetrazole (100 mg/kg) was significantly
lengthened. Hops extract (35 mg/kg, intraperitoneal administration) produced a
dose-dependent increase in sleeping time in mice treated with pentobarbitol. An
antinociceptive effect was noted by increased latency of licking forepaws in
hotplate tests and hypothermic activity observed from a time-dependent fall of
rectal temperature at a dose of 500 mg/kg.(13)
Hops have previously been reported to possess oestrogenic constituents.(5)
However, when a number of purified components, including the volatile oil and
the bitter acids, were examined using the uterine weight assay in immature
female mice, no oestrogenic activity was found.(5)
CLINICAL STUDIES
Clinical research assessing the effects of hops is limited and rigorous
randomised controlled clinical trials are required. Clinical studies have
generally assessed hops given in combination with one or more additional herbs.
For example, hops has been reported to improve sleep disturbances when given in
combination with valerian (see Valerian, Clinical studies).(14)
Figure 2. Hops – dried drug substance (strobile).
Hops, in combination with chicory and peppermint, has been documented
to relieve pain in patients with chronic cholecystitis (calculous and
non-calculous).(15) A herbal product containing a mixture of plant extracts,
including hops and uva-ursi, and alphatocopherol acetate was reported to
improve irritable bladder and urinary incontinence.(16) However, these
observations require confirmation in robust clinical studies.
EXTRACTS (HOPS) —
The LD50 for orally administered hop extract or lupulones in
mice is ~500–3500 mg/kg (roughly 1/2 to 20th as toxic as caffeine). Ethanol
extract antispasmodic and myorelaxant. Antibacterial activity has been
documented for hops, humulone, and lupulone against Gram positive bacteria. The
bitter acids exhibit antifungal activity against Candida, Fusarium,
Mucor, and Trichophyton. The flavanones are antistaphylococcic and
antifungal (Mucor and Trichophyton). Hops sedative and hypnotic, and motility-depressant
properties are attributed to 2-methyl-3-buten-2-ol. Isovaleric acid may
contribute to the sedativity. Hops reportedly contain several sedative,
analgesic, anesthetic, and anodyne compounds as well. Piperidine, quercitrin,
and ursolic acid may depress the CNS. Hops improve human sleep performance in combination
with valerian and the hops are apparently effective in baths (I’d suggest in
combination with dilute lavender and lemonbalm). With uva ursi and alpha-tocopherol
acetate, hops gave excellent results for 772 of 915 patients with irritable bladder
and urinary incontinence. Combined with the Biblical chicory and peppermint,
hops documentably relieves pain in chronic cholecystosis (calculous and noncalculous).
CONTRAINDICATIONS,
INTERACTIONS, AND SIDE EFFECTS
CONTRAINDICATIONS,
INTERACTIONS, AND SIDE EFFECTS
Class 2d (AHP). “Hazards and/or side effects not known for proper therapeutic
dosages” (PH2). None reported (KOM; PHR; PIP). Some caution against use in
depression (AHP). Mild allergies or dermatosis may result from contact.
Oleo-resin reported to be allergenic, possibly causes dermatosis (CAN).
Respiratory allergy caused by handling of hop cones (fresh hops oil, humulone,
lupulone, and myrcene produce positive skin patch tests). Pollen can cause
contact dermatosis. They suggest that hops be contraindicated in depressive
states as the sedative effect of hops may aggravate or accentuate symptoms.
“The sedative effect may potentiate the effects of existing sedative therapy
and alcohol” (CAN). In vitro antispasmodic activity on the uterus has
been documented. Because of uterine activity, its use in pregnancy and
lactation is to be avoided. “Excessive use should be avoided in view of the
limited toxicity data” (CAN). Avoid if pregnant (WAM). Do not use if suffering
estrogen-dependent disorders (WAM).
CONTRAINDICATIONS
Pregnancy
category is 3; breastfeeding category is 3A.
Hops
should not be used by persons who are hypersensitive to this product; persons who
have breast, uterine, or cervical cancers; or those who suffer from a depressive
condition. Hops are for short-term or intermittent use only. Use caution to
avoid sedation in infants.
SIDE
EFFECTS/ADVERSE REACTIONS
CNS: Sedation,
dizziness, decreased reaction time
GI: Nausea,
vomiting, anorexia
INTEG: Hypersensitivity
reactions, including dermatitis and anaphylaxis
INTERACTIONS
Drug
Antidepressants, antipsychotics,
antihistamines, alcohol, CNS depressants: Hops
may cause increased central nervous system effects when taken concurrently with
antidepressants, antipsychotics, antihistamines, alcohol, CNS depressants.
Cytochrome P450 (carbamazepine, bupropion, orphenadrine,
cyclophosphamide, citalopram, azole antifungals, macrolide antibiotics, omeprazole,
warfarin, theophylline): Hops may decrease the levels of
these drugs.
Estrogens: Hops
may cause increased hormonal levels when taken in conjunction with estrogen
(theoretical).
Iron salts: Hops
tea may decrease the absorption of iron salts; separate by at least 2 hours.
Herb
Sedative herbs: Hops
may increase sedation when used with other sedating herbs (theoretical) (Jellin
et al, 2008).
SIDE-EFFECTS, TOXICITY
There is a lack of
clinical safety and toxicity data for hops and further investigation of these
aspects is required. Respiratory allergy caused by the handling of hop cones
has been documented;(17) a subsequent patch test using dried, crushed flowerheads
proved negative. Positive patch test reactions have been documented for fresh hop
oil, humulone, and lupulone. Myrcene, present in the fresh oil but readily
oxidised, was concluded to be the sensitising agent in the hop oil.(G51) Contact
dermatitis to hops has long been recognised(G51) and is attributed to the
pollen.(G41) Small doses of hops are stated to be non-toxic.(G42) Large doses administered
to animals by injection have resulted in a soporific effect followed by death,
with chronic administration resulting in weight loss before death.(G39)
EFFECTS
The drug is a sedative and
therefore has sleep-inducing effect. This effect, however, strongly depends on
the quality of the extract used. In animal experiments, the 2-methyl-3-buten-2-ol
exhaled by the plant caused a long and deep narcotic sleep after a short period
of excitation. The hop bitter acids are antibacterial and antimycotic. They stimulate
the secretion of gastric juices. In animal experiments, a strong spasmolytic
effect on the smooth muscle of the intestinal tract has been reported. An
estrogenic principle is considered plausible.
CONTRA-INDICATIONS,
WARNINGS
Allergic reactions
have been reported for hops, although only following external contact with the
herb and oil. Drug interactions None documented. However, the potential for preparations
of hops to interact with other medicines administered concurrently,
particularly those with similar or opposing
effects, should be
considered. There are some conflicting data on the oestrogenic activity of
hops,(5) although 8-prenylnaringenin, documented as a constituent of hops, has
been shown to have oestrogenic activity in preclinical studies.(G76) Concern
has been expressed that herbs with oestrogenic effects may stimulate breast cancer
growth and oppose action of competitive oestrogen
receptor
antagonists such as tamoxifen.(18) However, this requires confirmation.
Pregnancy and
lactation In vitro antispasmodic activity on the uterus has been documented. In
view of this and the lack of toxicity data, the use of hops during pregnancy
and lactation should be avoided.
CLIENT CONSIDERATIONS
ASSESS
·
Assess the reason the client is
using hops.
·
Assess for hypersensitivity
reactions and dermatitis. If present, discontinue the use of hops and
administer an antihistamine or other appropriate therapy.
·
Assess for anaphylaxis.
·
Assess for central nervous
system reactions: sedation, dizziness, and decreased reaction time.
·
Assess for medications used
(see Interactions).
ADMINISTER
·
Instruct the client to store
hops in a cool, dry place, away from heat and moisture.
TEACH CLIENT/FAMILY
·
Inform the client that
pregnancy category is 3 and breastfeeding category is 3A.
·
Caution the client to avoid
sedation in the infant.
·
Advise the client not to
perform hazardous tasks such as driving or operating heavy machinery if
sedation, dizziness, or decreased reaction time occurs.
PREPARATIONS
PROPRIETARY SINGLE-INGREDIENT PREPARATIONS
Russia:
Novo-Passit (Ново-Пассит). Switzerland: Klosterfrau Nervenruh Dragees.
PROPRIETARY MULTI-INGREDIENT PREPARATIONS
Australia: Extralife
Sleep-Care; Humulus Compound; Natural Deep Sleep; Pacifenity; Passiflora
Complex; Passionflower Plus; Prosed-X; Relaxaplex. Austria: Baldracin; Baldrian
AMA; Hova; Montana; Nervenruh; Nerventee St Severin; Sedadom; Wechseltee St
Severin. Canada: Herbal Sleep Aid; Herbal Sleep Well. Chile: Valupass. Czech
Republic: Baldracin; Detsky Caj s Hermankem; Fytokliman Planta; Novo-Passit;
Sanason; Schlaf- Nerventee N; Species Nervinae Planta; Valofyt Neo; Visinal. France:
Nostress. Germany: Ardeysedon; Avedorm duo; Baldrian-Dispert Nacht; Baldriparan
N Stark; Biosedon; Boxocalm; Cefasedativ; Dormeasan; Dormoverlan; Gutnacht; Ilja
Rogoff; Klosterfrau Beruhigungs Forte; Kytta-Sedativum; Leukona-Beruhigungsbad;
Luvased; Moradorm S; Nervendragees; Nervenkapseln; Nervinfant N; Nervoregin forte;
Pascosedon; Schlaf- und Nerventee; Sedacur; Sedaselect D; Selon; Sensinerv
forte; Valdispert comp; Valeriana mild; Valverde Baldrian Hopfen bei Einschlafstorungen
und zur Beruhigung; Vivinox Day. Hungary: Hova. Israel: Nerven-Dragees. Italy: Emmenoiasi.
Mexico: Nervinetas. Russia: Doppelherz Vitalotonik (Доппельгерц Виталотоник); Sanason
(Санасон). South Africa: Avena Sativa Comp. Switzerland: Baldriparan;
Dormeasan; Dragees pour le coeur et les nerfs; Dragees pour le sommeil; Dragees
sedatives Dr Welti; Hova; Hyperiforce comp; Nervinetten; ReDormin; Relaxo;
Soporin; Tisane calmante pour les enfants; Tisane pour le sommeil et les nerfs;
Valverde Coeur; Valverde Sommeil; Zeller Sommeil. UK: Anased; Avena Sativa
Comp; Boots Alternatives Sleep Well; Boots Sleepeaze Herbal Tablets; Calmanite
Tablets; Fenneherb Newrelax; Gerard House Serenity; Gerard House Somnus; HRI
Calm Life; HRI Night; Kalms Sleep; Kalms; Napiers Sleep Tablets; Napiers
Tension Tablets; Natrasleep; Newrelax; Nodoff; Nytol Herbal; Quiet Days; Quiet
Life; Quiet Nite; Quiet Tyme; Relax Bþ; Sleepezy; Slumber; Sominex Herbal;
Stressless; Unwind Herbal Nytol; Valerina Night-Time; Ymea. Venezuela: Lupassin;
Nervinetas.
REFERENCE
Barnes, J.,
Anderson, L. A., and Phillipson, J. D. 2007. Herbal Medicines Third
Edition. Pharmaceutical Press. Auckland and London.
Duke, J. A.
with Mary Jo Bogenschutz-Godwin, Judi duCellier, Peggy-Ann K. Duke. 2002. Handbook
of Medicinal Herbs 2nd Ed. CRC Press LLC. USA.
Gruenwald,
J., Brendler, T., Jaenicke, Ch. 2000. PDR for Herbal
Medicines. Medical Economics Company, Inc. at Montvale, NJ
07645-1742. USA
Linda
S-Roth. 2010. Mosby’s Handbook Of Herbs & Natural Supplements,
Fourth Edition. Mosby Elsevier. USA.
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