Lady’s Slipper

Summary and Pharmaceutical Comment

Virtually no phytochemical or pharmacological data are available for lady’s slipper to justify its use as a herbal remedy. In view of the lack of toxicity data, excessive use and use during pregnancy and lactation should be avoided.

Species (Family)

Cypripedium parviflorum var. pubescens (Willd.) O.W. Knight (Orchidaceae)

Synonym(s)

American Valerian, Cypripedium, Cypripedium calceolus var. pubescens (Willd.) Correll, Cypripedium pubescens Willd., Nerve Root

Part(s) Used

Rhizome, root

Pharmacopoeial and Other Monographs

BHP 1983(G7)

Legal Category (Licensed Products)

GSL (Cypripedium)(G37)

Constituents

Little chemical information has been documented. Lady's slipper is stated to contain glycosides, resin, tannic and gallic acids (usually associated with hydrolysable tannins), tannins and a volatile oil.

Several quinones have been reported including cypripedin, stated to belong to a group of rare non-terpenoid phenanthraquinones and not previously isolated from natural sources.(1)

Food Use

Lady's slipper is not used in foods.

Herbal Use

Lady's slipper is stated to possess sedative, mild hypnotic, antispasmodic and thymoleptic properties. Traditionally, it has

Figure 1 Selected constituents of lady’s slipper.

L

Figure 2 Lady’s slipper (Cypripedium parviflorum var. pubescens).

been used for insomnia, hysteria, emotional tension, anxiety states, and specifically for anxiety states with insomnia.(G7, G64)

Dosage

Dosages for oral administration (adults) for traditional uses recommended in standard herbal reference texts are given below.

Dried rhizome/root 2–4 g as an infusion three times daily.(G7)

Liquid extract 2–4 mL (1 : 1 in 45% alcohol) three times daily.(G7)

Pharmacological Actions

None documented.

Figure 3 Lady’s slipper – dried drug substance (root).

404 Lady’s Slipper

Clinical studies

There is a lack of clinical research assessing the effects of lady's slipper and rigorous randomised controlled clinical trials are required.

Side-effects, Toxicity

There is a lack of clinical safety and toxicity data for lady's slipper and further investigation of these aspects is required.

It has been stated that the roots may cause psychedelic reactions and large doses may result in giddiness, restlessness, headache, mental excitement and visual hallucinations.(G22) Lady's slipper is stated to be allergenic and contact dermatitis has been documented.(G51) The sensitising property of lady's slipper has been attributed to the quinone constituents.(1)

Contra-indications, Warnings

Lady's slipper may cause an allergic reaction in sensitive individuals.

Drug interactions None documented. However, the potential for preparations of lady's slipper to interact with other medicines administered concurrently should be considered.

Pregnancy and lactation The safety of lady's slipper has not been established. In view of the lack of phytochemical, pharmacological and toxicological information the use of lady's slipper during pregnancy and lactation should be avoided.

Reference

1Schmalle H, Hausen BM. A new sensitizing quinone from lady slipper (Cypripedium calceolus). Naturwissenschaften 1979; 66: 527–528.

Summary and Pharmaceutical Comment

Limited information is available on lemon verbena. Some of the traditional uses may be attributable to the volatile oil, for which many components have been identified, and to the flavone constituents. In the UK, lemon verbena is mainly used as an ingredient of herbal teas.

Species (Family)

Aloysia triphylla (L'Her.) Britton (Verbenaceae)

Synonym(s)

Aloysia citriodora (Cav.) Ort., Lippia citriodora (Ort.) HBK, Verbena citriodora Cav., Verbena triphylla L'Her.

Part(s) Used

Flowering top, leaf

Pharmacopoeial and Other Monographs

Martindale 35th edition(G85)

Legal Category (Licensed Products)

Lemon verbena is not included in the GSL.(G37)

Constituents

Flavonoids Flavones including apigenin, chrysoeriol, cirsimaritin, diosmetin, eupafolin, eupatorin, hispidulin, luteolin and derivatives, pectolinarigenin and salvigenin.(1)

Volatile oils Terpene components include borneol, cineol, citral, citronellal, cymol, eugenol, geraniol, limonene, linalool, b-pinene, nerol, and terpineol (monoterpenes), and a-caryophyllene, b- caryophyllene, myrcenene, pyrollic acid and isovalerianic acid (sesquiterpenes).(2)

Figure 2 Lemon verbena (Aloysia triphylla).

Previously, lemon verbena has been listed as GRAS (Generally

Recognised As Safe) for human consumption in alcoholic beverages. Lemon verbena is also used in herbal teas.(G57)

Herbal Use

Lemon verbena is reputed to possess antispasmodic, antipyretic, sedative and stomachic properties. It has been used for the

treatment of asthma, cold, fever, flatulence, colic, diarrhoea and

indigestion. (G38, G57, G64)

Dosage

Dosages for oral administration (adults) for traditional uses recommended in older pharmaceutical reference texts are given below.

406 Lemon Verbena

Decoction 45 mL taken several times daily.(G34)

Pharmacological Actions

None documented.

Clinical studies

There is a lack of clinical research assessing the effects of lemon verbena and rigorous randomised controlled clinical trials are required.

Side-effects, Toxicity

None documented. However, there is a lack of clinical safety and toxicity data for lemon verbena and further investigation of these aspects is required. Terpene-rich volatile oils are generally regarded as irritant and may cause kidney irritation during excretion.

Contra-indications, Warnings

Individuals with existing renal disease should avoid excessive doses of lemon verbena in view of the possible irritant nature of the volatile oil.

Drug interactions None documented. However, the potential for preparations of lemon verbena to interact with other medicines administered concurrently should be considered.

Pregnancy and lactation In view of the lack of pharmacological and toxicity data, and the potential irritant nature of the volatile oil, excessive doses of lemon verbena are best avoided during pregnancy and lactation.

Preparations

Proprietary multi-ingredient preparations

Spain: Agua del Carmen.

References

1Skaltsa H, Shammas G. Flavonoids from Lippia citriodora. Planta Med 1988; 54: 465.

2Montes M et al. Sur la composition de l'essence d'Aloysia triphylla (Cedron). Planta Med 1973; 23: 119–124.