Rhamni cathartici fructus

Rhamni cathartici fructus, also called buckthorn berry, is a drug used in herbal medicines for the treatment of constipation or anal fissure, among other conditions.

HMPC: not refereed

ESCOP: not edited

Commission E-monograph: Constipation

Rhamni cathartici fructus contains up to 5% anthraglycosides (according to DAB at least 4% calculated as glucofrangulin A), predominantly of the emodin type (especially frangulin and glucofrangulin). Furthermore the flavonoids rhamnecitin, quercentin and kaempferol.

Buckthorn berries stimulate peristalsis and also have a laxative, hydragogic and anti-absorptive effect.

Hawthorn berries are used, according to Commission E, for the treatment of constipation or for diseases where a slightly laxative effect is desired (e.g. anal fissure, haemorrhoids.

The daily dose is 20 to 30 mg hydroxyanthracene derivatives, calculated as glucofrangulin A. The individually correct dosage is the lowest required to produce a soft stool. The drug can be taken in the form of infusions, elixirs, decoctions or cold macerations.

Since buckthorn berries irritate the intestinal mucosa, they should not be taken for more than 1 to 2 weeks.

In individual cases, cramp-like gastrointestinal complaints may occur, at which point the dose should be reduced. Long-term use may also lead to albuminuria, haematuria or electrolyte loss, which may result in cardiac dysfunction (especially if diuretics or cardiac glycosides are taken at the same time) or muscle weakness. Melanosis coli usually resolves after the drug is discontinued.

If the following disease is present, the patient should refrain from taking it:

ileus of any origin, acute inflammatory bowel disease, Crohn's disease, ulcerative colitis, appendicitis, abdominal pain of unknown cause, pregnancy, lactation (due to insufficient toxicological studies), children under 12 years of age.

In long-term use, a potassium deficiency can lead to an increase in the effect of cardiac glycosides and influence the effect of antiarrhythmics. Potassium losses can be intensified by thiazide diuretics, adrenal cortex steroids or liquorice root.

Hawthorn berries should only be used if no therapeutic effects have been achieved through a change in diet or on a swelling agent.
Since an effect is often difficult to regulate, an application can only be recommended to a limited extent. Even a moderately high dosage can cause strong reactions such as cramp-like abdominal pain or vomiting; this is especially true for tea infusions.

1. Mühlemann H et al.(1970) Anthraquinones and anthraquinone glycosides. 19.
2. Synthesis of alpha and beta frangulin and frangula-emodin-9-anthrone-10-C-glycoside. Pharm Acta Helv 45:728-753.
3. Rosenthal I et al.(2014) Validated method for the analysis of
4. frangulins A and B and glucofrangulins A and B using HPLC and UHPLC. J Nat Prod. 77:489-496.
5. Schilcher H (ed.) in, Leitfaden Phytotherapie, Urban & Fischer Verlag (2016) Munich, pp. 194 f.
6. https://arzneipflanzenlexikon.info/kreuzdorn.php