Scotch Broom Herb and Flower, Sparteine : Part 2

by MedlinePlus

(Page 2 of 2)

Adults (18 years and older)

Note: It is not clear what dose(s) of scotch broom are safe or effective for any medical condition, and use should only be under medical supervision. Storage of the flower or herb should be in a cool, dry location.

Flower: A juice has been made by pressing the bruised, fresh tops and adding one-third volume alcohol, allowing to sit for seven days, followed by filtration and taken daily as needed. An infusion has been made by adding 1 ounce of dried tops to a pint of boiling water (or 1 teaspoon in 200mL boiling water), and taken as a cup-full once or twice daily as needed.

Herb (above-ground parts): As a tea , 1-2 grams (1 level teaspoon) of herb can be steeped in 150-200mL of boiling water, then strained after 5-10 minutes and taken as a cup-full, up to three times daily as needed. As a decoction , 1-2 grams of herb have been used in preparations. As a liquid extract , a 1:1 preparation in 25% ethanol (v/v) has been prepared and taken as 1-2mL daily as needed. As a tincture , a 1:5 preparation in 45% ethanol (v/v) has been taken at a dose of 0.5-2mL daily. The herb may also be available as an aqueous-ethanol preparation (1:1:5) or as an aqueous essential oil extract.

Children (younger than 18 years)

Avoid due to potentially life-threatening toxicity.

Safety

Allergy

Avoid if hypersensitive to scotch broom or any of its constituents, including sparteine.

Toxicity

Oral ingestion or smoking of either the flower or above-ground parts of scotch broom may not be safe, particularly in large amounts due to the presence of the toxic alkaloids sparteine and isosparteine. Poisoning of livestock grazing on scotch broom has been reported, and nausea/vomiting has developed in children from sucking on the flowers of the related species, French broom. It has been suggested that serious toxicity may occur in adults with ingestion of more than 300mg of sparteine, which may be present in approximately 30 grams of the above-ground parts of the plant. Although small amounts of scotch broom may be safe in otherwise healthy individuals, and use in foods as a flavoring or coloring agent is generally considered safe, the German Commission E recommends medical supervision when using this herb.

Signs of toxicity may include nausea, vomiting, diarrhea, dizziness, confusion, headache, and gastrointestinal distress. Sparteine ingestion has been associated with respiratory arrest, circulatory collapse, and death, although scotch broom itself has not. Other symptoms of toxicity may include weakness, palpitations, fatigue, sleepiness, dilation of the pupils, and eye muscle weakness (ocular palsy). Medical attention should be sought immediately, with management including gastric lavage and activated charcoal, as well as cardiorespiratory support as appropriate.

Scotch broom seeds have been used as a coffee substitute, which may carry a significant risk of toxicity. Toxicity can also occur when scotch broom is smoked in cigarette form, due to sparteine present in the inhaled smoke.

Adverse Effects

Central Nervous System: High doses of scotch broom taken by mouth may cause toxicity symptoms including dizziness, headache, weakness, fatigue, sleepiness, blurry vision, sweating, and confusion. When smoked in cigarette form, headache, confusion, relaxation, and euphoria may occur, and driving or operating heavy machinery should be avoided.

Cardiovascular: Scotch broom contains sparteine, and alkaloid with anti-arrhythmic properties and potential cardiac toxicity (reported as similar to class 1A antiarrhythmics such as quinidine). Blood pressure changes and circulatory collapse may occur with large doses taken in any form, including by mouth or smoked in cigarettes. There is a possibility of abnormal heart rhythms, heart attack, and worsening of heart failure. Therefore, use of this herb should only be under medical supervision, and extreme caution is warranted in individuals with a history of heart disease, abnormal heart rhythms, high blood pressure, or those taking heart medications.

Respiratory: Smoking cigarettes containing scotch broom carries a risk of inhalation of fungal contaminants (aspergillus), with a possibility of resulting fungal pneumonia.

Gastrointestinal: High doses of scotch broom may cause toxicity symptoms including nausea, vomiting, gastrointestinal distress, and diarrhea.

Dermatologic: Topical (skin) use may cause irritation due to the presence of saponins.

Pregnancy and Breastfeeding

Scotch broom should be avoided during pregnancy. Scotch broom contains the alkaloid sparteine which is known to cause uterine contractions, and carries a risk of inducing abortion (abortifacient properties).

Scotch broom should be avoided during breastfeeding due to insufficient evidence and a hypothetical risk of serious toxicity.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Cytochrome P450 2D6 Inhibiting Drugs: Scotch broom contains the toxic alkaloid sparteine, which is metabolized (broken down) by the liver's cytochrome P450 2D6 (CYP2D6) isoenzyme system. Therefore, drugs which inhibit CYP2D6 can increase the potential toxicity of scotch broom, including a risk of life-threatening adverse events such as cardiovascular collapse. This includes the drugs amiodarone, celecoxib, chlorpheniramine, cimetidine, clomipramine, cocaine, doxorubicin, halofantrine, haloperidol, methadone, mibefradil, meclobemide, nefazodone, quinidine, ranitidine, ritonavir, terbinafine, venlafaxine, and multiple antidepressants in the selective serotonin reuptake inhibitor (SSRI) class, particularly fluoxetine and paroxetine. In particular, the drug haloperidol (Haldol) has been shown to increase blood levels of sparteine.

Antiarrhythmic Drugs: Scotch broom contains the alkaloid sparteine which may affect cardiac conductivity. Use in individuals taking other heart medications that affect heart rhythm such as digoxin, beta-blockers, calcium channel blockers or other antiarrhythmics may be hazardous and should be avoided unless under strict medical supervision.

Blood Pressure Medications: Scotch broom contains the alkaloid sparteine which can potentially increase (or decrease) blood pressure. Use is not recommended in patients with a history of abnormal blood pressure or taking blood pressure medications.

Monoamine Oxidase Inhibitor (MAOI) Drugs: Scotch broom contains small amounts of tyramine, which can lead to hypertensive crisis in individuals taking MAOI drugs. Therefore, this combination should be avoided. MAOI drugs include Isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate).

Interactions with Herbs/Supplements

Cytochrome P450 2D6 Inhibiting Herbs/Supplements: Scotch broom contains the toxic alkaloid sparteine, which is metabolized (broken down) by the liver's cytochrome P450 2D6 (CYP2D6) isoenzyme system. Therefore, herbs which inhibit CYP2D6 can increase the potential toxicity of scotch broom, including a risk of life-threatening adverse events such as cardiovascular collapse. Herbs which may inhibit CYP2D6 based on laboratory and animal experiments include black tea; cat's claw (Uncaria tomentosa, Uncaria guianensis); chamomile (Matricaria chamomilla); chaparral; clove; ginger; gotu kola; kava (weak); nordihydroguairetic acid (NDGA); oregano; sage; St. John's wort; thyme; and turmeric (weak).

Cardiac Glycoside Herbs/Supplements: Herbs with potential effects on heart rhythm similar to digoxin may pose a risk of heart block or abnormal cardiac rhythms when used with scotch broom, which contains the cardioactive constituent sparteine. Examples of herbs with possible cardiac glycoside properties include adonis (Adonis vernalis); Adonis microcarpa ; balloon cotton (Asclepias friticosa); black hellebore root/melampode (Helleborus niger); black Indian hemp (Apocynum cannabinum); bushman's poison (Carissa acokanthera); cactus grandifloris (Selenicerus grandiflorus); convallaria (Convallaria majalis); eyebright (Euphrasia spp.); figwort (Scrophulariaceae); foxglove/digitalis (Digitalis purpurea); frangipani (Plumeria rubra); hedge mustard (Sisymbruim officinale); Helleborus viridus ; hemp root/Canadian hemp root; king's crown (Calotropis procera); lily-of-the-valley; motherwort (Leonurus cardiaca); oleander leaf (Nerium oleander L.); pheasant's eye plant (Adonis aestivalis); plantain leaf (Plantago lanceolata); pleurisy root; psyllium husks (Plantago psyllium); redheaded cotton-bush (Asclepias currassavica); rhubarb root (Rheum palmatum); rubber vine (Cryptostegia grandifolia); sea-mango (Cerebra manghas); senna fruit (Cassia senna); squill (Urginea maritima); strophanthus (Strophanthus hispidus , Strophanthus kombe); uzara (Xysmalobium undulatum); wallflower (Cheirantus cheiri); wintersweet (Carissa spectabilis); yellow dock root (Rumex crispus); and yellow oleander (Thevetia peruviana).

Monoamine Oxidase Inhibitor (MAOI) Herbs/Supplements: Scotch broom contains small amounts of tyramine, which can lead to hypertensive crisis in individuals taking MAOI agents. Therefore, this combination should be avoided. Herbs/supplements with possible MAOI properties include 5-HTP (5-Hydroxytryptophan); adrenal extract; California poppy (Eschscholtzia californica); chromium; DHEA (Dehydroepiandrosterone); DLPA (DL Phenylalanine); ephedra; evening primrose oil (Oenothera biennis); fenugreek (Trigonella foenum-graecum); Ginkgo biloba ; hops (Humulus lupulus); mace (Myristica fragrans); SAMe (S-adenosylmethionine); sepia; St. John's wort (Hypericum perforatum); valerian (Valeriana officinalis); Vitamin B6; and yohimbe bark extract.

Blood Pressure Agents: Scotch broom contains the alkaloid sparteine which can potentially decrease or increase blood pressure. Use is not recommended in patients with a history of abnormal blood pressure or taking agents with significant effects on blood pressure. Other agents which theoretically may lower blood pressure include aconite/monkshood (Aconitum columbianum); alpha-linolenic acid, arnica (Arnica montana); baneberry (Actaea spp.); betel nut (Areca catechu); bilberry (Vaccinium myrtillus); black cohosh (Cimicifuga racemosa); bryony (Bryonia alba); calendula (Calendula officinalis); California poppy (Eschscholzia californica); coleus (Coleus forskohlii); curcumin; eucalyptol; eucalyptus oil (Eucalyptus globulus); evening primrose oil (Oenothera biennis); fish oils, flaxseed/flaxseed oil (Linum usitatissimum); garlic (Allium sativum); Ginkgo biloba ; ginger (Zingiber officinale Roscoe); goldenseal (Hydrastis canadensis); green hellebore (Veratrum alba); hawthorn (Crataegus oxyacantha); Indian tobacco (Lobelia inflata); jaborandi (Pilocarpus jaborandi); maitake mushroom (Grifola frondosa); mistletoe (Viscum album); night blooming cereus (Cactus grandiflorus); oleander (Nerium oleander , Thevetia peruviana); omega-3 fatty acids, pasque flower (Anemone pulsatilla); periwinkle (Vinca major); pleurisy root (Asclepias tuberosa); Polypodium vulgare ; shepherd's purse (Capsella bursa-pastoris); Texas milkweed (Asclepias asperula); turmeric (Curcuma longa); and wild Cherry (Prunus serotina). In contrast, agents which theoretically may raise blood pressure include American ginseng (Panax quinquifolium); Arnica (Arnica chamissonis, Arnica cordifolia, Arnica fulgens, Arnica latifolia, Arnica montana, Arnica sororia); bayberry (Myrica cerifera); betel nut (Areca catechu); blue cohosh (Caulophyllum thalictroides); broom (Sarothamnus scoparius); cayenne (Capsicum annum); cola (Cola spp.); coltsfoot (Tussilago farfara); ephedra (Ephedra sinica); ginger (Zingiber officinalis Roscoe); licorice (Glycyrrhiza glabra); and yerba mate (Ilex paraguariensis).

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