Note: This monograph does not include Indian buchu (Myrtus communi), which is an unrelated plant.
Background
Buchu (Agathosma betulina) leaves and oil of buchu were used by the indigenous people of the Cape area of South Africa for hundreds of years. Although its original use is unclear, it appears to have been applied topically on the skin, possibly as an insect repellant, and also used internally for stomach problems, rheumatism, and bladder problems. Buchu's original genus was Barosma, which was changed to Agathosma.
Buchu contains both diosmin and hesperidin, which indicates it may have anti-inflammatory, hypolipidemic (blood cholesterol lowering), and vasoprotective actions.
Most of the plants are still grown in South Africa where the government exercises strict control over the gathering of the leaves to prevent destruction of wild plants.
Evidence
DISCLAIMER:
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Tradition
WARNING:
DISCLAIMER:
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below. Abortifacient (induces abortion), AIDS, anti-inflammatory, antimicrobial, antiseptic (anti-bacterial), antispasmodic, appetite stimulant, astringent, bloody urine, bruises, carminative (reduces gas), cholera, colds, colon inflammation, congestive heart failure, cough, cystitis (bladder infection), diabetes, diaphoretic (promotes sweating), digestive, diuretic, edema, flavoring agent, fragrance, gout (foot inflammation), gum inflammation, hangovers, hypertension (high blood pressure), improving urine flow, incontinence, influenza, insect repellent, kidney function, kidney infection, kidney stones, muscle aches, nephritis (kidney inflammation), premenstrual syndrome, prostate disorders, respiratory disorders, rheumatism, sinus problems, sprains and strains, stimulant, stomachache, tonic, urethritis (inflamed uretha), urinary tract tonic, urolithiasis (kidney stones), uterine stimulant, vaginal irritation, sexually transmitted diseases.
Dosing
Adults (18 years and older)
There is no proven safe or effective dose for buchu. Historically, dried buchu leaf 1-2 grams has been taken in capsules three times a day. As a fluid extract, 0.125-0.25 fluid ounces has been used. Also, 1-2 teaspoons of buchu leaves, infused for 5-10 minutes in a cup of boiling water (leaves should not be boiled), and ingested two or three times a day, has been used. A tincture of 1-4 milliliters daily for three times a day, or 10-20 drops of tincture in water three times a day after meals, has been used.
Children (younger than 18 years)
There is no proven safe or effective dose for buchu in children, and use is not recommended.
Safety
DISCLAIMER:
Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
There is little available data on the safety of buchu. In general, buchu may cause upset stomach, diarrhea, or kidney irritation. Traditional experts recommend monitoring liver function when using buchu, due to its potentially hepatotoxic (liver damaging) effects.
Buchu may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Although not well studied in humans, high concentrations of buchu oil appeared to block calcium channels, which could lead to cardiac arrest. Buchu may also increase menstrual flow and may also induce abortion.
Use cautiously in patients with seizure disorders, as buchu might cause spasmogenic action followed by spasmolysis.
Pregnancy and Breastfeeding
Buchu is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. According to traditional use, buchu may be an abortifacient (induce abortion) and may stimulate uterine contractions.
High concentrations of buchu oil may block calcium channels. Patients taking calcium channel blocker medications should consult with a qualified healthcare professional, including a pharmacist.
Buchu may additively interact with cardiac glycoside drugs.
Buchu may also interact additively with diuretic (increasing urine flow) drugs, such as chlorothiazide (Diuril®) or bumetanide (Bumex®). Caution is advised.
Interactions with Herbs and Dietary Supplements
Buchu may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Buchu may interact additively with diuretic herbs, or cardiac glycoside herbs, such as foxglove.
Attribution
This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Nicole Giese, MS (Natural Standard Research Collaboration); Wendy Diem Che, PharmD (Massachusetts College of Pharmacy); Faisal Khanzada, PharmD (Massachusetts College of Pharmacy); John Markowitz, PharmD (Medical University of South Carolina); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Wendy Weissner, BA (Natural Standard Research Collaboration).
Bibliography
DISCLAIMER:
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
El Shafae AM, El Domiaty MM. Improved LC methods for the determination of diosmin and/or hesperidin in plant extracts and pharmaceutical formulations. J Pharm Biomed.Anal. 2001;26(4):539-545.
Ernst E. Interactions between synthetic and herbal medicinal products Part 1: a systematic review of the indirect evidence. Perfusion 2000;13:4-15.
Lis-Balchin M, Hart S, Simpson E. Buchu (Agathosma betulina and A. crenulata, Rutaceae) essential oils: their pharmacological action on guinea-pig ileum and antimicrobial activity on microorganisms. J Pharm.Pharmacol. 2001;53(4):579-582.
Simpson D. Buchu--South Africa's amazing herbal remedy. Scott.Med J 1998;43(6):189-191.
Remember, keep this and all other medicines out of the reach of children,
never share your medicines with others, and use this medication only for the indication prescribed.
