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Baikal skullcap (Scutellaria baicalensis)

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Also listed as: Scutellaria baicalensis
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • 1-Octen-3-ol, 2',3',5,7-tetrahydroxy flavone, 2',5,6',7-tetrahydroxyflavanonol (THF), 3,7,11,15-tetramethyl-2-hexadecen-1-ol (7.8%), 5,6,7,3',4'-pentahydroxy flavanone-7-O-glucuronide, 5,6,7-trimethylbaicalein, 5,7,2',6'-tetrahydroxyflavone, 5,7,2'-trihydroxyflavone, 6,7-di-O-nicotinoylscutebarbatine G, 6-O-(2-carbonyl-3-methylbutanoyl)scutehenanine A, 6-O-acetylscutehenanine A, 6-O-methyl-baicalin-7-O-beta-glucopyranuronoside, 6-O-nicotinoyl-7-O-acetylscutebarbatine G, 6-O-nicotinoylscutebarbatine G, (6S,9R)6-hydroxy-4,4,7a-trimethyl-5,6,7,7a-tetrahydro-1-benzofuran-2(4H)-one, 7-D-glucuronic acid-5,6-dihydroxy-flavone, (11E)-6alpha-acetoxy-7beta,8beta-dihydroxy-ent-clerodan-3,11,13-trien-15,16-olide (6-acetoxybarbatin C, 2), (13R)-6alpha,7beta-dihydroxy-8beta,13-epoxy-11beta-nicotinyloxy-ent-clerodan-3-en-15,16-olide (scutelinquanine D, 1), amino acids, Antoksyd S (C/E/XXI), Antoxid, apigenin, baicalein, baicalein 6-O-beta-glucopyranuronoside, baicalein 7-D-beta-glucuronate, baicalin, ban-ji-ryun (Korean), banjiryun (Korean), ban-zhi-lian (Chinese), berberine, BZL101, caicalin, carthamidin, Chinese skullcap, chrysin, chrysin-6-C-alpha-L-arabinopyranosyl-8-C-beta-D-glucopyranoside, cinnamate 4-hydroxylase (SbC4H), ethyl-7-O-apigenin-glucuronate, flavonoidglycoside, flavonoids, glucan S b RP-1?, herba Scutellariae barbatae, hexahydrofarnesylacetone, huang-qin, huangqin, isocarthamidin, Lamiaceae (family), luteolin, menthol, minerals, neobaicalein, neoclerodane diterpenoids, neoderodane diterpenoids, organic acids, oroxylin A, oroxylin A-7-O-glucuronide, PC-SPES, phenylalanine ammonia-lyase isoforms (SbPAL1, SbPAL2, and SbAPL3), (S)-2-(4-hydroxyphenyl)-6-methyl-2,3-dihydro-4H-pyran-4-one, SBJ, Scutelleria baicalensis spp., Scutellaria barbata spp., Scutellaria rivularis Wall., scute, scute root, skullcapflavone, trihydroxyflavone, viscidulin III, water-soluble polysaccharides (WSPS'-1, WSPS'-2, and WSPS'-3), wogoninglucuronide, wogonoside.

Background
  • Baikal skullcap (Scutellaria baicalensis) is a perennial herb native to southern China and throughout Korea. Scutellaria baicalensis is one of approximately 350 Scutellaria species.
  • Scutellaria baicalensis root is widely used in China as an adjuvant to chemotherapy for lung cancer. It is also commonly used in herbal medicine in Japan. Early studies have found that Scutellaria baicalensis may have anticancer properties. However, there is little clinical evidence. In Western herbalism, Baikal skullcap is also known as an ingredient in PC-SPES, used for prostate cancer.
  • Traditional uses include antibacterial, anticancer antifungal, anti-inflammatory, antiviral, and neuroprotective. Strong supportive evidence for Scutellaria baicalensis for any use is lacking at this time.
  • Warning: Scutellaria baicalensis is an ingredient in PC-SPES, which has been recalled from the U.S. market due to possible contamination; PC-SPES should not be used.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Traditional uses of Baikal skullcap include pain and inflammation. Preliminary research suggests no effect from a product for arthritis containing Baikal skullcap. Further research is required.

C


Traditional uses of Baikal skullcap include brain protection. Preliminary research suggests no effect from a product for minimal brain dysfunction containing Baikal skullcap. Additional research is needed before a conclusion can be drawn.

C


Traditional uses of Baikal skullcap include cancer treatment. It is a common ingredient in traditional Chinese medicine products. Preliminary research suggests some immunological changes with use in cancer patients. Further research is required.

C


Traditional uses of Baikal skullcap include liver protection. Preliminary research suggests that some preliminary benefit was associated with a product containing Baikal skullcap with respect to hepatitis B. Additional research is needed before a conclusion can be drawn.

C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Allergies, Alzheimer's disease, anemia, antibacterial, antifungal, anti-inflammatory, antioxidant, antiseptic, antiviral, asthma, atherosclerosis (hardening of the arteries), bone marrow suppression (drug-induced), bronchitis, candidal infection, chemotherapy adverse effects, cognition, dental conditions, diabetes, estrogenic agent, fever, , hearing impairment, heart disease, HIV, high blood pressure, high cholesterol, immunomodulation (affects the immune system), jaundice, kidney disorders, laxative, liver protection, menopause, methicillin-resistant (MRSA), mitochondrial disorders, myocardial ischemia (insufficient blood and oxygen flow to heart), neurological trauma (physical injury to the brain or spinal cord), neuroprotection (nerve protection), obesity, osteoporosis, pain, pain relief, Parkinson's disease, platelet aggregation inhibition (blood thinner), pneumonia, prostate cancer, pulmonary conditions (lung conditions), sedative, sepsis, skin conditions, stress, stroke, thrombosis (blood clots).

Dosing

Adults (18 years and older)

  • In general, a typical dose of toasted Baikal skullcap is 6-15 grams.
  • For cancer (adjunct to chemotherapy), one tablet of Baikal skullcap extract (the amount of extract per tablet is unknown) has been taken by mouth three times daily, starting 5-6 days before chemotherapy and every day thereafter.

Children (under 18 years old)

  • There is no proven safe or effective dose for Baikal skullcap in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid with known allergy or hypersensitivity to Baikal skullcap (Scutellaria baicalensis), its constituents, or members of the Lamiaceae family.

Side Effects and Warnings

  • Baikal skullcap may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
  • Baikal skullcap may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs (such as metformin), herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Baikal skullcap may cause low blood pressure. Caution is advised in patients taking drugs, herbs, or supplements that lower blood pressure.
  • Baikal skullcap may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased or decreased in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
  • Use cautiously in patients using central nervous system (CNS) depressants. Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.
  • Use cautiously in patients taking rosuvastatin (Crestor®), according to pharmacokinetic research that baicalin, a constituent of Baikal skullcap, can decrease concentrations of rosuvastatin, likely by promoting the transportation of rosuvastatin into the liver.
  • Use cautiously in patients with autoimmune disorders or those receiving immunosuppressants, as Baikal skullcap and its constituents may have effects on the immune system.
  • Avoid in patients who are pregnant or breastfeeding, as Scutellaria baicalensis has the potential to cause maternal toxicity and uterine relaxation.
  • Avoid in patients with known allergy or hypersensitivity to Scutellaria baicalensis, its constituents, or members of the Lamiaceae family.
  • Baikal skullcap may also cause fever, liver damage, pneumonia, and reduced white cell count.
  • Note: Baikal skullcap is an ingredient in PC-SPES, a product that has been recalled from the U.S. market; PC-SPES should not be used.

Pregnancy and Breastfeeding

  • Avoid in patients who are pregnant or breastfeeding, as Scutellaria baicalensis has the potential to cause maternal toxicity and uterine relaxation.

Interactions

Interactions with Drugs

  • Baikal skullcap may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar, including metformin. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Baikal skullcap may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
  • Baikal skullcap may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.
  • Baikal skullcap may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
  • Baikal skullcap may increase the amount of drowsiness caused by some drugs. Examples include CNS depressants, benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
  • Because Baikal skullcap contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
  • Baikal skullcap also interacts with 5-fluorouracil, Alzheimer's agents, analgesics, antiasthmatics, antibiotics, anticancer drugs, antifungals, antihistamines (allergy medicine), anti-inflammatories, antivirals, cholesterol-lowering drugs (including rosuvastatin), cisplatin, cyclophosphamide, drugs that weaken the immune system, HIV/AIDS drugs, osteoporosis drugs, p-glycoprotein-regulated agents, and weight loss drugs.

Interactions with Herbs and Dietary Supplements

  • Baikal skullcap may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
  • Baikal skullcap may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
  • Baikal skullcap may cause low blood pressure. Caution is advised in patients taking herbs or supplements that lower blood pressure.
  • Baikal skullcap may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.
  • Baikal skullcap may increase the amount of drowsiness caused by some herbs or supplements.
  • Because Baikal skullcap contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
  • Baikal skullcap also interacts with Alzheimer's agents, analgesics, antibacterials, anticancer herbs and supplements, antifungals, antihistamines (herbs and supplements for seasonal allergies), anti-inflammatories, antioxidants, antivirals, berberine, cholesterol-lowering agents, Coptis, garlic, grape seed, herbs and supplements for osteoporosis, herbs and supplements that affect the immune system, PC-SPES, p-glycoprotein-regulated agents, vitamin C, vitamin C-containing foods, and weight loss agents.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Cao H, Jiang Y, Chen J, et al. Arsenic accumulation in Georgi and its effects on plant growth and pharmaceutical components. J Hazard Mater 2009;171(1-3):508-513.
  2. Chang HH, Yi PL, Cheng CH, et al. Biphasic effects of baicalin, an active constituent of Georgi, in the spontaneous sleep-wake regulation. J Ethnopharmacol 2011;135(2):359-368.
  3. Chen S, Yuan Y, Luo Y, et al. [Effects of light on flavonoids accumulation and related gene expression in suspension cultures of ]. Zhongguo Zhong Yao Za Zhi 2010;35(6):682-685.
  4. Chien CF, Wu YT, Tsai TH. Biological analysis of herbal medicines used for the treatment of liver diseases. Biomed Chromatogr 2011;25(1-2):21-38.
  5. Enomoto R, Koshiba C, Suzuki C, et al. Wogonin potentiates the antitumor action of etoposide and ameliorates its adverse effects. Cancer Chemother Pharmacol 2011;67(5):1063-1072.
  6. Gao J, Morgan WA, Sanchez-Medina A, et al. The ethanol extract of and the active compounds induce cell cycle arrest and apoptosis including upregulation of p53 and Bax in human lung cancer cells. Toxicol Appl Pharmacol 2011;254(3):221-228.
  7. Guo HX, Liu DH, Ma Y, et al. Long-term baicalin administration ameliorates metabolic disorders and hepatic steatosis in rats given a high-fat diet. Acta Pharmacol Sin 2009;30(11):1505-1512.
  8. Himeji, M, Ohtsuki, T, Fukazawa, H, et al. Difference of growth-inhibitory effect of -producing flavonoid wogonin among human cancer cells and normal diploid cell. Cancer Lett 2007;245(1-2):269-274.
  9. Jiang RH, Su WC, Liu HF, et al. Opposite expression of securin and gamma-H2AX regulates baicalein-induced cancer cell death. J Cell Biochem 2010;111(2):274-283.
  10. Linnebur SA, Rapacchietta OC, Vejar M. Hepatotoxicity associated with Chinese skullcap contained in Move Free Advanced dietary supplement: two case reports and review of the literature. Pharmacotherapy 2010;30(7):750, 258e-750, 262e.
  11. Morgan SL, Baggott JE, Morel L, et al. The safety of flavocoxid, a medical food, in the dietary management of knee osteoarthritis. Journal of Medicinal Food 2009;12(5):1143-8.
  12. Shih HC, Hsu CS, Yang LL. study of the tocolytic effect of oroxylin A from root. J BiomedSci 2009;16:27.
  13. Tian XY, Cheung, LM, Leung K, et al. The effects of extract on embryonic development in mice. Birth Defects Res B Dev Reprod Toxicol 2009;86(2):79-84.
  14. Wu J, Hu D, Wang KX. [Study of and Baicalin against antimicrobial susceptibility of strains in vitro]. Zhong Yao Cai 2008;31(5):707-710.
  15. Yuan Y, Liu YJ, Luo YJ, et al. High temperature effects on flavones accumulation and antioxidant system in Georgi cells. African Journal of Biotechnology 2011;10(26):5182-5192.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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