Garlic

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

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Last updated on: 27.09.2023

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Synonym(s)

Allium sativum; Allium sativum L

Definition
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Spice and medicinal plant of the allium family (Alliaceae). The garlic bulb is a roundish to egg-shaped white bulb with a diameter of about 3.0cm and a pungent odor. The main bulb usually has several secondary bulbs. Allium sativum is the parent plant of Allii sativi bulbus , a drug that has been positively monographed by Commission E and WHO.

The EMA defines garlic as a traditional herbal medicinal product for the prevention of arteriosclerosis, also for the relief of symptoms of a cold.

The quality of garlic powder is defined in the European Pharmacopoeia (Ph. Eur.).

ESCOP - Monograph: preventive against atherosclerosis, in case of elevated blood lipid levels that can be insufficiently controlled by dietary measures, supportive in case of elevated blood pressure; also in case of infections and catarrh of the upper respiratory tract.

Commission E: Positive monograph: support of dietary measures in case of elevated blood lipid levels and for the prevention of age-related vascular changes.

Empirical medicine: adjuvant for lowering blood pressure, digestive problems, improving vigilance, anthelmintic for pinworms.

Ingredients
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Ingredients of fresh garlic bulb: sulfur-containing gamma-glutamyl peptides, odorless, water-soluble alliin (S-allylcysteine sulfoxide). Furthermore several enzymes like: oxidases, catalases, dehydrogenases, lyases as well as versch. Vitamins. After subsequent comminution, the degradation products allicin (unstable) and ajoene are formed from the alliin.

The different preparations result in different compositions of the preparations.

Garlic oil (Oleum Allii sativi), an essential oil, is obtained by steam distillation of the garlic bulb. Garlic oil contains mainly diallyl disulfide (60%), which is responsible for the characteristic odor, as well as tri-, polysulfides; furthermore alliiin and ajoene in variable composition.

Occurrence
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Garlic originally comes from East Asia. It was cultivated very early in Asia Minor and the Near East. Today it is used and cultivated worldwide.

Field of application/use
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One of the oldest medicinal and spice plants on earth. In India, China, Africa and the Balkan countries, its healing power has been well known for centuries, which explains its high consumption. Even folk medicine in our latitudes has been using garlic since ancient times for its antibacterial, fungicidal (the biologically active ingredient of garlic "Ajoen" has proven fungicidal properties), antiseptic, spasmolytic, carminative, anthelmintic and other effects in a wide variety of remedies for treating gastrointestinal complaints, various skin diseases, inflammations, rheumatism, ulcers, cramps, pain, etc.

Dosage
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Average daily dose 4 g of fresh garlic cloves.

EMA: for the prevention of arteriosclerosis. Single dose: in powder form: 300 mg to 750 mg , daily dose: 900-1380 mg divided into 3-5 single doses, in liquid form: single dose: 110-220 mg 4 times / day, daily dose: 440-880 mg .

for colds: single dose: 100-200 mg 1-2 times / day, daily dose: 100-400 mg

Undesirable effects
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Gastrointestinal symptoms or allergic reactions. Alteration of bleeding time, no combination with warfarin sodium.

Contraindication
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Patients on saquinavir/ritonavir therapy: risk of decrease in plasma concentration with loss of virological response and possible resistance to one or more components of the antiretroviral preparation.

As drug: children and adolescents under 18 years of age.

In the absence of sufficient data, use during pregnancy and lactation is not recommended.

Interactions
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Oral anticoagulation therapy and/or an antiplatelet agent: bleeding times may be prolonged

Patients on saquinavir/ritonavir therapy: risk of decrease in plasma concentration with loss of virological response and possible resistance to one or more components of the antiretroviral drug.

Trade names
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  • Beni-cur N® coated film-coated tablet
  • Kwai forte® 300 mg coated tablets (300mg garlic bulb powder). Dosage depending on tolerance up to 3x1 Drg./day
  • Kwai N Dragees® (100mg garlic bulb powder). Dosage depending on tolerance up to 3x3 dragees/day
  • Sapec® coated tablets (300mg garlic powder). Dosage: 3x1 daily 1 Drg.

Note(s)
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Garlic consumption should be avoided for 7 days prior to surgery due to the postoperative bleeding risk.

Literature
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  1. Ammon H et al (2014). Hunnius pharmaceutical dictionary. Walter de Gruyter GmbH Berlin/Boston pp 62-64.
  2. Hausen BM, Vieluf K (1997) Allergy plants, plant allergens. Ecomed Verlag Landsberg/Munich 65-67
  3. Ledezema E et al (1996) Efficacy of ajoene, an organsulphur derived from garlic, in the short-term therapy of tinea pedis. Mycoses 39: 393-395
  4. Loew D (2012) In: Beer A M et al [eds] Leitfaden Naturheilverfahren für die ärztliche Praxis, Urban und Fischer Verlag p 166f.
  5. https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-allium-sativum-l-bulbus_en.pdf
  6. https://arzneipflanzenlexikon.info/knoblauch.php
  7. Wenigmann M. (2017) Phytotherapy medicinal drugs, phytopharmaceuticals, application. Urban & Fischer, pp. 139-140
  8. https://pflanzen.fnr.de/industrial-plants/medicinal-plants/pflanzen-datenbank.
  9. Miller LG (1998) Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 9;158(20):2200-2211. doi: 10.1001/archinte.158.20.2200. PMID: 9818800.