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Boldo - Uses and Side Effects

Boldo is derived from the dried leaves of Peumus boldus. It contains boldine, an isoquinoline alkaloid of the aporphine type, and a volatile oil that contains ascaridiole. Boldine may be effective as an antispasmodic, choleretic, and diuretic; it may also increase gastric secretions. The pharmacologic effects of the volatile oil are similar to those of boldine. Ascaridiole is an antihelminthic. Boldo is available as capsules, fluid extract, tablets, and tinctures of varying potencies.

Benefits And Uses of Boldo

Boldo is used to treat liver and gallbladder complaints, loss of appetite, dyspepsia, and mild spastic complaints. Boldo leaves, which are included in herbal teas for their diuretic and laxative effects, can cause significant diuresis.The oil is usedto treat genitourinary inflammation, gout, and rheumatism.

Administration

• Boldo oil: 5 gtt by mouth .
• Fluid extract (1:1 in 45% alcohol): 0.1 to 0.3 ml by mouth three times a day.
• Pulverized herb for infusions: 4.5 g by mouth daily .
• Tincture (1:10 in 60% alcohol): 0.5 to 2 ml by mouth three times a day.

Side Effects of Boldo

Ascaridiole is a known toxin, and preparations of the volatile oil or distillates of the leaf should be avoided.

Adverse effects associated with boldo include exaggerated reflexes, disturbed coordination, seizures, paralysis of motor and sensory nerves and muscle fibers, and respiratory depression.

Boldo may have additive effects when used with diuretics. Pregnant patients and patients with bile duct obstruction or severe liver diseases should avoid use.

Clinical considerations

• If patient has gallstones, advise him to consult his health care provider before using boldo.
• Caution patient that overdose may lead to neurologic symptoms, respiratory depression and, if severe enough, death.
• If female patient is pregnant, advise her not to use boldo.
• Advise patient to avoid preparations with the volatile oil of boldo or distillates of the leaf because of the toxic effects of ascaridiole.
• Inform patient that preparations with virtually no ascaridiole are available.
• Inform patient not to delay seeking appropriate medical intervention if symptoms persist after taking this herb.
• Tell patient to remind prescriber and pharmacist of any herbal or dietary supplement that he’s taking when obtaining a new prescription.
• Advise patient to consult his health care provider before using an herbal preparation because a treatment with proven efficacy may be available.

Research summary

Boldo taken alone has not been well evaluated as a treatment for dyspepsia; how ever, a combination herbal treatment containing boldo (along with other herbs thought to stimulate the gallbladder) has been studied. In a double-blind trial, 60 individuals given either an artichoke leaf/boldo/celandine combination or placebo found improvements in symptoms of indigestion after 14 days of treatment. How this combination might be effective for treating dyspepsia is unclear.

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