Eyebright (Euphrasia officinalis)

Category

Herbs & Supplements

Synonyms

Adhib, ambrosia, augentrost, Augentrostkraut (German), Augstenzieger, briselunettes (French), casse-lunette (French), clary, clary wort, clear eye, eufragia, eufrasia (Italian), Euphraise, Euphraisiaeherba, Euphraisiae herbal (eyebright herb), Euphrasia, Euphrasia mollis, Euphrasia officinalis, Euphrasia rostkoviana, Euphrasia sibirica, euphrasy, ewfras, frasia, herbed euphraise, herbe d'euphraise officinale, hirnkraut, laegeojentrost (Danish), luminella, meadow eyebright, muscatel sage, red eyebright, sage, salvia sclarea, schabab, Scrophulariaceae (family), see bright, Weisses Ruhrkraut, Wiesenaugetrost, Zwang-kraut.

Background

Eyebright's genus name, Euphrasia, is derived from the Greek "euphrosyne," the name of one of the three Graces who was distinguished for joy and mirth. Eyebright was used as early as the time of Theophrastus (Greek philosopher and biologist, student of Plato and Aristotle) and Dioscorides (Greek philosopher (circa AD 64) who authored a pharmacological account of plants), who prescribed infusions for topical applications in the treatment of eye infections. During the middle ages, eyebright was widely prescribed by medical practitioners as an eye medication, as a cure for "all evils of the eye."

In Europe, the herb eyebright (Euphrasia officinalis) has been used for centuries as a rinse, compress, or bath against eye infections and other eye-related irritations (a use reflected in many of its vernacular names). When taken by mouth, eyebright has been used to treat inflammation of nasal mucous membranes and sinusitis.

Eyebright is high in iridoid glycosides such as aucubin. In several laboratory studies, this constituent has been found to possess hepatoprotective (liver protecting) and antimicrobial activity. There is limited clinical research assessing the efficacy of eyebright in the treatment of conjunctivitis (pink eye), and the use of eyebright for other indications has not been studied in clinical trials.

Little data exists regarding the safety and toxicity of eyebright. A concern regarding the opthamalogic (eye) use of eyebright is the potential for contamination. The U.S. Food and Drug Administration (FDA) has not evaluated eyebright for a generally recognized safe (GRAS) status.

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.

Anti-inflammatory: Several iridoid glycosides isolated from eyebright, particularly aucubin, possess anti-inflammatory properties comparable to those of indomethacin (a nonsteroidal anti-inflammatory drug). Although early evidence is promising, there is currently insufficient evidence to recommend for or against eyebright as an anti-inflammatory agent.
Grade: C

Conjunctivitis (pinkeye): Eyebright has been used in ophthalmic (eye) solutions for centuries, in the management of multiple eye conditions. Currently, there is insufficient scientific evidence to recommend for or against the use of eyebright in the treatment of conjunctivitis.
Grade: C

Hepatoprotection: Aucubin, a constituent of eyebright, may aid in liver protection. However, there is currently insufficient evidence to recommend for or against the use of eyebright as a hepatoprotective agent.
Grade: C

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.
Allergies, antibacterial, antihelmintic (expels worms), antiviral, appetite stimulant, asthma, astringent, blepharitis (inflammation of the eyelid), bronchitis (chronic), cancer, cataracts, catarrah (inflammation of the mucous membranes) of the eyes, common cold, congestion, cough, digestive aid, earaches, epilepsy, expectorant, flavoring agent, gastric acid secretion stimulation, hay fever, headache, hoarseness, jaundice, liver disease, measles, memory loss, middle ear problems, ocular (eye) compress, ocular (eye) fatigue, ocular inflammation (acute, subacute, blood vessels of eye, eyelids), ocular (eye) rinse, ophthalmia (eye infection), respiratory infections, rhinitis (inflammation of nasal mucosa), sinusitis, skin conditions, sneezing (chronic), sore throat, sties, visual disturbances.

Dosing

Adults (over 18 years old)

There is no proven safe or effective dose of eyebright. Traditionally, 2-4 grams of dried herb three times daily has been suggested for multiple indications. For conjunctivitis (pinkeye), one drop of eyebright 1-5 times daily for 3-17 days has been studied.

Children (under 18 years old)

There is no proven safe or effective dose of eyebright in children. However, children have tolerated 4-5 homeopathic pills of Euphrasia 30C daily for three days for prevention of viral conjunctivitis.

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.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to eyebright. Hypersensitivity to members of the Scrophulariaceae family may lead to a cross-sensitivity reaction.

Side Effects and Warnings

Systematic study of clinical safety and tolerability has been limited. Both children and adults have tolerated short-term ophthalmologic use of eyebright for conjunctivitis (pinkeye). However, the potential exists for contamination of ophthalmologic preparations of eyebright, and eyebright tincture has been associated with pruritus (severe itching), redness and swelling of the eye, vision changes, and photophobia (intolerance or fear of light). Other adverse effects reported include toothache, confusion, headache, sneezing, yawning, insomnia, raised ocular pressure, lacrimation (tears), cough, dyspnea (difficulty breathing), nasal congestion, hoarseness, nausea, constipation, expectoration, polyuria (excessive urination) and diaphoresis (excessive sweating).

Eyebright is possibly safe when used in amounts commonly found in foods, or when eyebright is used as a flavoring agent.

Eyebright is likely unsafe when "home-made" preparations are used for ophthalmic indications, due to the likelihood of microbial contamination; when used in greater than studied doses or duration due to lack of safety data; and when used during pregnancy and breastfeeding, or in pediatric patients.

Although not well-studied in humans, eyebright may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

Pregnancy & Breastfeeding

Eyebright is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

Interactions

Interactions with Drugs

Eyebright may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be altered in the blood, and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Eyebright may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Interactions with Herbs & Dietary Supplements

Eyebright may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

Theoretically, eyebright may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Ivo Foppa, MD, ScD (Harvard University); Paul Hammerness, MD (Harvard Medical School); Mary McGarry, RPh (University of Kansas); George Papaliodis, MD (Massachusetts Eye and Ear Infirmary); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern University); 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.

Bartholomaeus A, Ahokas J. Inhibtion of P-450 by aucubin: is the biological activity of aucubin due to its glutaraldehyde-like aglycone? Toxicol Lett 1995;80(1-3):75-83.

Bermejo BP, Diaz Lanza AM, Silvan Sen AM, et al. Effects of some iridoids from plant origin on arachidonic acid metabolism in cellular systems. Planta Med 2000;66(4):324-328.

Chang I, Yamaura Y. Aucubin: a new antidote for poisonous amanita mushrooms. Phytother Res 1993;7:53-56.

Chang I. Antiviral activity of Aucubin against Hepatitis B virus replication. Phytother Res 1997;11(3):189-192.

Chang IM. Liver-protective activities of aucubin derived from traditional oriental medicine. Res Commun Mol Pathol Pharmacol 1998;102(2):189-204.

Ersoz T, Berkman MZ, Tasdemir D, et al. An iridoid glucoside from Euphrasia pectinata. J Nat Prod 2000;63(10):1449-1450.

Hattori M, Kawata Y, Inoue K, et al. Transformation of aucubin to new pyridine monoterpene alkaloids, aucubinines A and B, by human intestinal bacteria. Phytother Res 1990;4(2):66-70.

Lee DH, Cho IG, Park MS, et al. Studies on the possible mechanisms of protective activity against alpha- amanitin poisoning by aucubin. Arch Pharm Res 2001;24(1):55-63.

Mokkapatti R. An experimental double-blind study to evaluate the use of Euphrasia in preventing conjunctivitis. Brit Homoeopath J 1992;1(81):22-24.

Porchezhian E, Ansari SH, Shreedharan NK. Antihyperglycemic activity of Euphrasia officinale leaves. Fitoterapia 2000;71(5):522-526.

Recio MC, Giner RM, Manez S, et al. Structural considerations on the iridoids as anti-inflammatory agents. Planta Med 1994;60(3):232-234.

Salama O, Sticher O. Iridoid glucosides from Euphrasia rostkoviana. Part 4. Glycosides from Euphrasia species. Planta Med 1983;47:90-94.

Stoss M, Michels C, Peter E, et al. Prospective cohort trial of Euphrasia single-dose eye drops in conjunctivitis. J Altern Complement Med 2000;6(6):499-508.

Suh NJ, Shim CK, Lee MH, et al. Pharmacokinetic study of an iridoid glucoside: aucubin. Pharm Res 1991;8(8):1059-1063.

Ulubelen A, Topcu G, Eris C, et al. Terpenoids from Salvia sclarea. Phytochemistry 1994;36(4):971-974.

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.