Pycnogenol : Dosing and Safety

by MedlinePlus

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Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Standardization

Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. Pycnogenol is a proprietary patented formula.

Adults (18 years and older)

Note: Pycnogenol appears to be absorbed into the bloodstream in about 20 minutes. Once absorbed, therapeutic effects are purported to last for approximately 72 hours, followed by excretion in the urine. Because of its astringent taste and occasional minor stomach discomfort, it may be best to take Pycnogenol with or after meals.

Antioxidant/cholesterol reduction: 150-360mg/day for 4-6 weeks has been used.

Antiparasitic: 30mg/kg/day has been used.

Asthma (chronic therapy): 1mg/lb/day (max 200mg/day) for up to four weeks has been used.

Chronic Venous Insufficiency (CVI): 100-360mg/day in divided doses for 1-2 months has been used.

Diabetes:Supplementation with 100mg Pycnogenol for 12 weeks, during which a standard anti-diabetic treatment was continued, significantly lowered plasma glucose levels as compared to placebo.

Dysmenorrhea (menstrual pain): 30mg of Pycnogenol (2 capsules) was taken orally twice a painful day, beginning on the eighth day of the first menstrual cycle and continued until the seventh day of the third menstrual cycle.

Erectile Dysfunction: A regimen combining Pycnogenol and L-arginine that has been used involves 1.7 grams of L-arginine/day during month #1; 1.7 grams of L-arginine/day and 40mg of Pycnogenol 2 times/day during month #2; 1.7 grams of L-arginine/day and 40mg of Pycnogenol 3 times/day during month #3.

Gum health (gingival bleeding/plaque): 5mg Pycnogenol in chewing gum for 14 days has been used.

Male Infertility: 200mg/day Pycnogenol for 90 days has been used.

Melasma (chloasma): 25mg tablet with meals 3 times a day (75 mg /day) for 30 days has been used.

Platelet aggregation reduction:100-200mg/day has been used.

Prevention of blood clots during long airplane fights:In one study, 100 mg Pycnogenol capsules were studied in people received two 100mg Pycnogenol capsules were taken between two and three hours before flights with 250mL of water; two capsules were taken six hours later with 250mL of water and one capsule the next day.

Retinopathy: 50mg taken three times a day for 2 months has been used.

Sunburn: 1.10mg/kg/day for four weeks, followed by 1.66 mg/kg/day for four weeks has been used.

Children (younger than 18 years)

Due to insufficient data, Pycnogenol in not recommended for use by children.

Safety

Allergies

Individuals should not take pycnogenol if allergic to it or any of its components.

Side Effects and Warnings

Pycnogenol is generally reported as being well tolerated. Low acute and chronic toxicity with mild unwanted effects may occur in a small percentage of patients following oral administration. Because of its astringent taste and occasional minor stomach discomfort, it may be best to take Pycnogenol with or after meals. To date, no serious adverse effects have been reported in the available scientific literature, although systematic study of safety is not available.

In theory, pycnogenol may alter blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.

In theory, pycnogenol 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.

Pregnancy & Breastfeeding

Pycnogenol is not recommended during pregnancy or breastfeeding due to lack of scientific evidence.

Interactions

Interactions with Drugs

Based on mechanism of action, there are potential interactions with other antihypertensive medications, specifically angiotensin converting enzyme inhibitors (ACE-I) such as benazepril (Lotensin®), captopril (Capoten®), enalapril (Vasotec®), fosinopril (Monopril®), lisinopril (Prinivil®), moexipril (Univasc®), perindopril (Aceon®), quinapril (Accupril®), ramipril (Altace®), trandolapril (Mavik®), or angiotensin converting enzyme receptor blockers such as losartan (Cozaar®), irbesartan (Avapro®), candesartan, cilexetil (Atacand®), or valsartan (Diovan®).

Based on mechanism of action, Pycnogenol may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth (such as metformin, glyburide, glipizide) or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.

Based on mechanism of action, Pycnogenol 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, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Due to proposed immunomodulating activity, pycnogenol may interfere with immunosuppressant or immunostimulant drugs.

In theory, pycnogenol and antioxidants may have additive effects.

In a laboratory study, Pycnogenol (PYC) prevented fluoride induced kidney damage.

Pycnogenol may have protective effects against alcohol's effects on brain neurons, further research is needed to confirm these results.

Interactions with Herbs and Dietary Supplements

Although data has yet to confirm this claim, it has been proposed that Pycnogenol may increase vitamin C levels.

Based on mechanism of action, Pycnogenol 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. Possible examples include Aloe vera , American ginseng, bilberry, bitter melon, burdock, dandelion, devil's claw, fenugreek, fish oil, gymnema, horse chestnut seed extract (HCSE), maitake mushroom, marshmallow, melatonin, milk thistle, Panax ginseng, rosemary, shark cartilage, Siberian ginseng, stinging nettle and white horehound.

In theory, pycnogenol 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. Some examples include: alfalfa, American ginseng, angelica, anise, Arnica montana , asafetida, aspen bark, bilberry, birch, black cohosh, bladderwrack, bogbean, boldo, borage seed oil, bromelain, capsicum, cat's claw, celery, chamomile, chaparral, clove, coleus, cordyceps, danshen, devil's claw, dong quai, EPA (eicosapentaenoic acid, found in fish oils), evening primrose oil, fenugreek, feverfew, fish oil, flaxseed/flax powder (not a concern with flaxseed oil), ginger, grapefruit juice, grapeseed, green tea, guggul, gymnestra, horse chestnut, horseradish, licorice root, lovage root, male fern, meadowsweet, nordihydroguairetic acid (NDGA), omega-3 fatty acids, onion, papain, Panax ginseng, parsley, passionflower, poplar, prickly ash, propolis, quassia, red clover, reishi, Siberian ginseng, sweet clover, rue, sweet birch, sweet clover, turmeric , vitamin E, white willow, wild carrot, wild lettuce, willow, wintergreen, and yucca.

In theory, pycnogenol may interact with herbs and supplements that effect blood pressure. Potential hypotensive herbs include aconite/monkshood, arnica, baneberry, betel nut, bilberry, black cohosh, bryony, calendula, California poppy, coleus, curcumin, eucalyptol, eucalyptus oil,flaxseed/flaxseed oil, garlic, ginger, ginkgo, goldenseal, green hellebore, hawthorn, Indian tobacco, jaborandi, mistletoe, night blooming cereus, oleander, pasque flower, periwinkle, pleurisy root, Polypodium vulgare, shepherd's purse, Texas milkweed, turmeric, wild cherry. Potential hypertensive herbs: American ginseng, arnica, bayberry, betel nut, blue cohosh, broom, cayenne, cola, coltsfoot, ephedra/Ma huang, ginger, licorice, and yerba mate.

Due to proposed immunomodulating activity, pycnogenol may interfere with immunosuppressant or immunostimulant herbs and supplements.

In theory, pycnogenol and other antioxidants may have additive effects.

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