Drug Interactions with Guggul

GUGGUL SIDE EFFECTS AND INTERACTIONS:

Known Hazards: Although the use of guggul in therapeutic doses appears to be safe and non-toxic, the following precautions are advised. Guggul is considered an emenogogue (an agent that promotes the menstrual discharge) and a uterine stimulant, and should not be used during pregnancy. Possible diarrhea, hiccups, restlessness, apprehension.

In addition, caution is recommended with patients currently on prescribed medications for cardiovascular disease. Due to the diuretic action of this herb the following drug interactions are possible: increased risk of toxicity with anti-inflammatory analgesics; if hypokalemia occurs possible antagonism with antiarrhythmics and potentiation of muscle relaxants; antagonizes antidiabetic (hypoglycemic) drugs; may potentiate and/or interfere with antihypertensives; may potentiate lithium therapy; when taken with corticosteroids there is a risk for hypokalemia; may potentiate other diuretics and increase the risk of hypokalemia.

Important points to be noted: When administering guggulu

1. Guggul resin is produced more abundantly and is stronger in potency during the season of autumn; hence, Ayurveda states that guggul resin must be collected in autumn.

2. Different selections of guggul resin have different therapeutic actions based on the age of the guggulu. Freshly collected guggulu has a Brumhana (weight increasing) quality, where as Purana guggul (guggul which is at least one year old) has an Atilekhana (weight reducing) quality.

3. Shuddha Guggul: Guggul has to be purified in cow's milk in order to remove toxic substances and render the guggulu easily absorbable. Ayurveda specifies Shodhana (purification) as one of the important procedures before oral administration of guggul. To purify guggul in this manner, it should be wrapped in a sack of cotton cloth and dipped in simmering cow's milk, which must be continuously stirred until all the pure substance of the guggul is absorbed into the milk. When this process is complete, the milk containing the pure guggul gum resin will be solidified and the cotton sack containing the impurities or toxins of the guggulu is to be discarded.

4. Classical Ayurvedic texts never recommend administering guggulu alone; it has to be given along with other herbs in compounds such as Triphala Guggul, Kaishore Guggul, Trayodashanga Guggul, Yogaraja Guggul, Kanchanara Guggul, etc. The administration of guggulu with other herbs has the effect of purging Ama (toxic, morbid substance) from the body.

5. Finally, during the course of using guggulu one should avoid the following: foods that are sour or bitter in taste, alcohol, excessive exercise, physical and mental strain, anger, and exposure to direct sunlight.

REFERENCES:
1. Satyavati GV. Gum guggul (Commiphora mukul)-The success of an ancient insight leading to a modern discovery. Indian J Med 1988;87:327-35.
2. Nityanand S, Kapoor NK. Hypocholesterolemic effect of Commiphora mukul resin (Guggal). Indian J Exp Biol 1971;9:367-77.
3. Singh K, Chander R, Kapoor NK. Guggulsterone, a potent hypolipidaemic, prevents oxidation of low density lipoprotein. Phytother Res 1997;11:291-4.
4. Mester L, Mester M, Nityanand S. Inhibition of platelet aggregation by guggulu steroids. Planta Med 1979;37:367–9.
5. Malhotra SC, Ahuja MMS, Sundarum KR. Long-term clinical studies on the hypolipidemic effect of Commiphora mukul (guggul) and clofibrate. Ind J Med Res 1977;65:390-5.
6. Nityanand S, Srivastava JS, Asthana OP. Clinical trials with gugulipid—a new hypolipidemic agent. J Assoc Phys India 1989;37:323-8.
7. Antonio J, Colker CM, Torina GC, et al. Effects of a standardized guggulsterone phosphate supplement on body composition in overweight adults: A pilot study. Curr Ther Res 1999;60:220-7.
8. Thappa DM, Dogra J. Nodulocystic acne: oral gugulipid versus tetracycline. J Dermatol 1994;21:729-31.
9. Brown D, Austin S. Hyperlipidemia and Prevention of Coronary Artery Disease. Seattle, WA: NPRC, 1997, 4-6.