Sage echter

A spice and medicinal plant of the labiates family, native to the Mediterranean region, introduced to Central and Northern Europe by monks in the Middle Ages. Salvia officinalis is the parent plant of Salviae officinalis folium, the sage leaves (Ph.Eur.8, Commission E).

Besides the true sage, there is the three-lobed or Greek sage (Salvia triloba = Salvia fruticosa). The composition of the essential oil of the triloba sage varies.

Ingredients of the drug are: 1%-2.5% essential oil, sage oil, a,b-thujone, isothujone, 1,8-cineole, camphor, borneol, bornyl acetate, 7% tannins and bitters, rosmarinic acid, flavonoids, flavone glycosides.

Quality is specified in the European Pharmacopoeia (Ph. Eur.).

Phytotherapeutic use is sage leaves(Salviae folium):

HMPC- monograph: traditional herbal medicinal product for oral and cutaneous use
ESCOP monograph: positive for dyspeptic complaints. Heartburn, flatulence, hyperhidrosis, hot flushes; supportive for hyperglycemia and hyperlipidemia; externally for inflammations and infections of the oral mucosa, gums and pharyngeal mucosa.
Commission E: internally for dyspeptic complaints, increased sweating; externally for inflammations of the oral and pharyngeal mucosa.

Empirical medicine: externally: herpes simplex.

Sage oil should not be used internally, according to HMPC, because the risk outweighs the benefit due to the high content of thujone, a neurotoxin.

Sage is also used as a seasoning, e.g. for meat, soups, stews and vegetable dishes, sage prolongs the shelf life of food.

Due to the high content of essential oils (contain thujonine, cineole, camphor, canusole, diterpenes, flavonoids, bitter substances) in various species of sage, there are different uses.

Sage as a kitchen spice: The true sage (S. officinalis) is used as a kitchen spice in meat preparation.

Sage in medicine: Sage extracts are antibacterial against gram-positive and gram-negative bacteria, questionably virostatic, fungistatic against yeasts, Candida albicans; furthermore astringent, antioxidant and antihidrotic.

Applications used as an infusion for sore throat or gingivitis. In a randomized, placebo-controlled, double-blind study, topical application of a 2% sage cream showed greater inhibition of UV-induced erythema compared to vehicle, comparable to a 1% hydrocortisone cream.

Furthermore, sage lozenges can be used to treat excessive sweating.

Sage in cosmetics:

• Salvia offcinalis extract is a drug obtained from the dried leaves and parts of the stem.
• Salvia officinalis oil is the essential oil obtained by steam distillation of the dried leaves.

Indication (traditional use) according to HMPC: 1) Relief of mild dyspeptic complaints such as heartburn and flatulence. 2) Relief of excessive sweating. 3) Relief of inflammation of the mouth or throat. 4) Traditional herbal medicinal product for the relief of mild skin inflammations.

Internal use according to Commission E: Dyspeptic complaints such as bloating and heartburn, hyperhidrosis.

Topically for inflammations of the oral and pharyngeal mucosa, mild skin inflammations.

Empirical medicine also uses sage extracts locally for herpes simplex .

I

InfectoGingi® Oral Gel, Aperisan® Oral Mucosa Therapeutic Gel, Bronchial Tea 400, Gerner Antibronchiticum N, Gerner Nervinum N, Pernionin® N Ointment, Slavia Thymol®, Salvysat® Bürger Film Tablets and Drops, Sweatosan Dragees N®, Trauma-cyl Ointment, Varicylum® S Ointment, Rephaderm® Balm

1. Beheshti-Rouy M et al. (2015) The antibacterial effect of sage extract (Salvia officinalis) mouthwash against Streptococcus mutans in dental plaque: a randomized clinical trial. Iran J Microbiol 7:173-177.
2. Felšöciová S et al. (2015) Antifungal activity of essential oils against selected terverticillate penicillia. Ann Agric Environ Med 22:38-42.
3. Fournomiti M et al. (2015) Antimicrobial activity of essential oils of cultivated oregano (Origanum vulgare), sage (Salvia officinalis), and thyme (Thymus vulgaris) against clinical isolates of Escherichia coli, Klebsiella oxytoca, and Klebsiella pneumoniae. Microb Ecol Health Dis 26:23289.
4. Ghorbanpour M et al.(2016) Phytochemical Variations and Enhanced Efficiency of Antioxidant and Antimicrobial Ingredients in Salvia officinalis as Inoculated with Different Rhizobacteria. Chem Biodivers 13:319-330.
5. Soares IH et al. (2015) In vitro activity of essential oils extracted from condiments against fluconazole-resistant and -sensitive Candida glabrata. J Mycol Med 25:213-217.
6. Reuter J et al. (2007) Sage extract rich in phenolic diterpenes inhibits ultraviolet-induced erythema in vivo. Planta Med 73: 1190-1191
7. https://www.ema.europa.eu/en/documents/herbal-monograph/draft-european-union-herbal-monograph-salvia-officinalis-l-folium_en.pdf
8. https://arzneipflanzenlexikon.info/salbei.php.
9. Wenigmann M. (2017) Phytotherapy medicinal drugs, phytopharmaceuticals, application. Urban & Fischer, pp. 187-188.
10. https://pflanzen.fnr.de/industrialplants/medicinalplants/pflanzen-datenbank.