![]() officinale is veno-occlusive disease, a non-thrombotic obliteration of small hepatic veins leading to cirrhosis and eventually liver failure (3). The main type of liver damage caused by S. Sometimes there is also damage to the lungs. They can produce veno-occlusive disease of the liver with clinical features like abdominal pain with ascites, hepatomegaly, splenomegaly, anorexia, nausea, vomiting, and diarrhea. Certain representatives of this class and the plants in which they occur are hepatotoxic, as well as mutagenic and carcinogenic. ![]() Symphytum officinale contains pyrrolizidine alkaloids, which are the subject of a separate monograph. Herbal medicines that provide more than 1 mg internally or more than 100 mg externally per day, when used as directed, are not permitted herbal medicines that provide 0.1-1 mg internally or 10-100 mg externally per day, when used as directed, may be applied only for a maximum of 6 weeks per year, and they should not be used during pregnancy or lactation. ![]() The German Federal Health Office has restricted the availability of botanical medicines containing unsaturated pyrrolizidine alkaloids (1,2). Symphytum officinale (black wort, boneset, bruise wort, comfrey, knitback, knitbone, slippery root) contains pyr-rolizidine alkaloids, such as lasiocarpine and symphytine, and their N-oxides, and has repeatedly been associated with hepatotoxicity.Ĭomfrey products have been withdrawn from the market in several countries, including the USA and the UK. ![]()
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