Fixed Combinations of Anise seed, Marshmallow root, Iceland Moss, and Licorice root

Published April 4, 1992.
List of German Commission E Monographs (Phytotherapy)

Composition of Drug

Fixed combinations consisting of:

Anise seed corresponding to B. Anz. 122, July 6, 1988;
Marshmallow root corresponding to B. Anz. 43, March 2, 1989;
Iceland moss corresponding to B. Anz. 43, March 2, 1989;
Licorice root corresponding to B. Anz. 90, May 15, 1985;

and their preparations in effective dosage.

Uses

Catarrhs of the upper respiratory tract with dry cough.

Contraindications

For a daily dosage up to 100 mg glycyrrhizin:

Oversensitivity to anise and anethole. For a daily dosage of more than 100 mg glycyrrhizin:

Cholestatic liver diseases, liver cirrhosis, hypertonia, hypokalemia, severe kidney insufficiency, pregnancy. Allergies to anise and anethole. Side Effects For a daily dosage up to 100 mg glycyrrhizin:

Occasionally, allergic reactions of the skin, respiratory tract, and gastrointestinal tract. For a daily dosage of more than 100 mg glycyrrhizin:

Extended use and higher dosages may cause mineralocorticoid effects in the form of sodium and water retention, potassium loss with hypertonia, edema, and hypokalemia with muscular asthenia, and, in rare cases, myoglobinuria. Occasionally, allergic reactions of the skin, respiratory tract, and gastrointestinal tract may occur. Interactions with Other Drugs For a daily dosage up to 100 mg glycyrrhizin:

None known. Warning: The absorption of other, simultaneously taken medications may be delayed.

For a dosage above 100 mg glycyrrhizin:

Loss of potassium can be increased through other drugs, e.g., thiazide and loop diuretics. Sensitivity to digitalis glycosides is increased through loss of potassium. Warning: The absorption of other, simultaneously taken medications may be delayed.

Dosage

Unless otherwise prescribed:

Marshmallow and Iceland moss must each be at the concentration equivalent to 50 - 75 percent of the daily dosage given in the monographs for individual herbs. Also, licorice root and anise must be present at concentrations corresponding to 50 - 75 percent of the daily dosage recommended in the monographs for the individual herbs.

Mode of Administration

Comminuted drug and galenical preparations for oral intake.

Duration of Use

Not longer than 4 - 6 weeks without medical advice.

Actions

An expectorant action is documented for preparations of licorice root and anise. A secretolytic effect has been shown for licorice root. Anise also has an antibacterial and mildly spasmolytic action. Marshmallow and Iceland moss have a soothing effect; Iceland moss has, in addition, a mild antibacterial action. Pharmacological tests for the effectiveness of fixed combinations are not available.