Liquiritiae radix

Licorice root, drug from the unpeeled or peeled, dried root of Glycyrrhiza glabra the licorice shrub. Positive monographs from Commission E and ESCOP are available.

The active ingredients are: 2-15% glycyrrhizin (according to PH.Eur. at least 4% of the dry weight), glycyrrhetinic acid, mannitol, glucose, sucrose, flavone glycosides (e.g. liquiritin).

The quality of licorice root (Liquiritiae radix) and dry licorice root extract as a flavoring agent (Liquiritiae extractum siccum ad saporandum) is specified in the European Pharmacopoeia (Ph. Eur.).

Quality of "Standardized licorice dry extract" (Liquiritiae extractum siccum normatum) is defined in the German Pharmacopoeia Codex (DAC).

• HMPC monograph: Traditional-use: dyspeptic complaints, heartburn, expectorant for cold-related coughs
• ESCOP monograph: gastric and duodenal ulcers, gastritis; expectorant for coughs and bronchial catarrh.
• Commission E monograph: Catarrh of the upper respiratory tract, ulcus ventriculi/duodeni
• Empirical medicine: heartburn, gastric complaints due to hyperacidity, productive cough, bronchial asthma, dermatitis

Dyspeptic complaints, heartburn, expectorant for coughs caused by colds, bronchitis, ulcus ventriculi/duodeni, aphthae.

An extract of licorice can also be used successfully for chloasma.

In a double-blind, placebo-controlled study by Abramowitz et al. 2006 with 216 patients over 50 days, a significant improvement in erythema, edema and itching was demonstrated. This was followed 2 years later by a study with 142 children aged 6 months to 12 years, which also showed effective and safe therapy for the treatment of mild to moderate atopic dermatitis in infants and children. These results were confirmed by another multicenter, randomized, double-blind, vehicle-controlled study in 2008 by Patrizi A et al. on 60 children with atopic dermatitis aged 2-17 years over 43 days. An improvement of almost 80 % in the IGA was already evident on day 22. IGA = Investigator's Global Assessment, a five-point scale that provides a global clinical assessment of AD severity ranging from 0 to 4, where 0 is clear, 2 is mild, 3 is moderate and 4 is severe atopic dermatitis. The statistically significant improvement in erythema, edema and pruritus remained detectable until the end of the study.

Atopiclair reduced itching (four studies, 396 participants, MD -2.65, 95% CI -4.21 to -1.09) and achieved more frequent satisfaction (two studies, 248 participants, RR 2.14, 95% CI 1.58 to 2.89), fewer relapses (three studies, 397 participants, RR 0.18, 95% CI 0.11 to 0.31) and a lower EASI (four studies, 426 participants, MD -4.0, 95% CI -5.42 to -2.57), but the MID (6.6) was not achieved. The number of participants reporting adverse events was not statistically different (four studies, 430 participants, RR 1.03, 95% CI 0.79 to 1.33).

Average daily dose: approx. 5-15 g drug corresponding to 200-800 mg glycyrrhizin; Succus Liquiritiae: 0.5-1 g for catarrhal symptoms of the upper respiratory tract; 1.5-3 g for ulcus ventriculi/duodeni.

Tea infusion: Add 150 mL cold water to 1 to 1.5 g finely chopped or coarsely powdered licorice root, bring to the boil, strain after 10 to 15 minutes. Alternatively, use boiling hot water; drink 1 cup 3 to 4 times a day.

With prolonged use and higher dosage: mineralocorticoids effects: sodium and water retention, potassium loss with hypertension, edema (water accumulation in tissues), rarely myoglobinuria.

Due to the blood pressure-increasing effect, do not prescribe at the same time as diuretics, cardiac glycosides, corticosteroids, laxatives or drugs that interfere with the electrolyte balance, caution in particular potassium loss!

Severe liver disease, hypertension, existing angina pectoris, terminal renal failure, pregnancy (see also explanations under glycyrrhizin), potassium deficiency. Pregnancy.
No knowledge of the use of liquorice root in children and adolescents under 18 years of age.
Allergy to one of the ingredients

Various tea blends are usually offered as combination preparations for the different indications:

Bladder-Kidney-Tea ^Stada® N, Bladder-Kidney-Tea _Uroflux® Tea Infusion Powder, ^{Bronchostad®}, Chest and ^Cough Tea Stada® N, ^{Buccotean®TF}, Dr. Klinger's Stomach Tea, Fugacid® Bladder Tea, Fugacid® Neurogast-Tea, Urinary Tea. Klinger's stomach tea, ^Fugacid® bladder tea, ^Fugacid® neurogast tea, Harntee 400, skin and blood cleansing tea, Heumann bronchial tea ^Solubifix® N, Heumann stomach tea ^Solu-Vetan® NG, ^{Kneipp®Gastropressan}, Gastrointestinal tea, Nieron® bladder and kidney tea VI, ^Orbis® bladder and kidney tea, ^Orbis® cough and bronchial tea, ^Renob® bladder and kidney tea, Solu-Vetan® NG cum Belladonna, Warando® ^laxative tea

Lakriment ^Pastilles® (monopreparation): Dosage: 1-1-1 or 2-2-2/day

External: ^Atopiclair®

About 20% of the licorice sugar contained in licorice is found in licorice. Glycyrrhizin is hydrolyzed in the intestine to glycyrrhizinic acid and glycyrrhetinic acid with resulting affinity to the receptors of mineralocorticoids, glucocorticoids and estrogen. Furthermore, inhibition of 5-ß-steroid reductase and 11-ß-hydroxy-steroid dehydrogenase. This blocks the conversion of cortisol to cortisone and prolongs the half-life of cortisol! Possible reversal of the spironolactone effect!

1. Abramovits W et al. (2006) A multicenter, randomized, vehicle-controlled clinical study to examine the efficacy and safety of MAS 063 DP (Atopiclair) in the management of mild to moderate atopic dermatitis in adults. J Drugs Dermatol 5: 236-244
2. Boguniewicz M et al. (2008) MAS063DP is effective monotherapy for mild to moderate atopic dermatitis in infants and children: a multicenter, randomized, vehicle-controlled study. J Pediatr.152:854-9. doi: 10.1016/j.jpeds.2007.11.031. PMID: 18492531.
3. Jung JC et al. (2016) Hepatoprotective effect of licorice, the root of Glycyrrhiza uralensis Fischer, in alcohol-induced fatty liver disease. BMC Complement Altern Med 16:19.
4. Kamei J et al. (2005) Pharmacokinetic and pharmacodynamic profiles of the antitussive principles of Glycyrrhizae radix (licorice), a main component of the Kampo preparation Bakumondo-to (Mai-men-dong-tang). Eur J Pharmacol 507:163-168.
5. Patrizi A et al. (2008) A double-blind, randomized, vehicle-controlled clinical study to evaluate the efficacy and safety of MAS063DP (ATOPICLAIR) in the management of atopic dermatitis in paediatric patients. Pediatr Allergy Immunol.19:619-25. doi: 10.1111/j.1399-3038.2008.00724.x. PMID: 18298424.
6. Patrizi A et al (2009) Atopiclair. Expert Opin Pharmacother. 10:1223-30. doi: 10.1517/14656560902926106. PMID: 19405795.
7. https://www.ema.europa.eu/en/documents/herbal-monograph/final-community-herbal-monograph-glycyrrhiza-glabra-l/glycyrrhiza-inflata-bat/glycyrrhiza-uralensis-fisch-radix-first-version_en.pdfhttps://arzneipflanzenlexikon.info/suessholz.php
8. Sun C et al. (2008) Analysis of glycyrrhizic acid and liquiritin in liquorice root with microwave-assisted micellar extraction and pre -concentration. Phytochem Anal 19:160-163.
9. Yang XL et al. (2013) Study on in vitro anti-inflammatory activity of total flavonoids from Glycyrrhizae Radix et Rhizoma and its ingredients. Zhongguo Zhong Yao Za Zhi 38:99-104.
10. Wenigmann M.(2017) Phytotherapie Arzneidrogen Phytopharmaka Anwendung. Urban & Fischer: 5.108 Meliloti herba S 200-201
11. van Zuuren EJ et al. (2017) Emollients and moisturizers for eczema. Cochrane Database Syst Rev 2:CD012119.