Drugs A - Z
Juniper (Juniperus communis)
Generic Name: Juniper Extract
CategoryHerbs & Supplements
Cade oil, cedar, cedarwood, cedron, common juniper berry, Cupressaceae (family), empyreumatic oil, enebro, Geniévre, ginepro, juniper bark, juniper berry, juniper bush, juniper oil, juniper tar, juniper wood, Juniperi Fructus, Juniperus californica, Juniperus communis, Juniperus deppeana, Juniperus mexicana, Juniperus occidentalis, Juniperus oxycedrus, Juniperus phoenicea, Juniperus scopulorum, Juniperus therifera, Juniperus virginiana, pencil cedar, Pinaceae, red cedar, Sabina, Wacholderbeeren, zimbro.
Juniperus species have been used by many people around the world, but have also been recognized as toxic plants. Juniper is a flavoring in gin and other drinks and is used as a spice in small amounts. The plant displays significant toxicity to the kidneys and skin, which limits its use in medicine, except in small amounts. Juniper is safely used as a fragrance in soaps, shampoos, cosmetics, sachets and other products.
Juniper has been used in dyspepsia (upset stomach) as a berry tea, in eczema and other skin diseases as cade oil or juniper oil. Juniper is thought to be more effective and less irritating when combined with uva ursi, manzanita or pipsissewa. There is a long history of juniper use in Europe and China, but no published clinical trials.
EvidenceDISCLAIMER: 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.
TraditionWARNING: 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.
Abortions, analgesic, anti-rheumatic, arthritis, astringent (leaves), bladder infections, bladder stones, bloating, blood purification, cancer, carminative, colds, constipation, cosmetics, cystitis (bladder infection), disinfectant (berries), diuretic, dyspepsia (upset stomach), eczema, flatulence (gas), fumigant (pesticide), gastrointestinal infections, heartburn, hypoglycemia (low blood sugar), inflammation (volatile oil), intestinal worms, kidney infections, kidney stones, loss of appetite, plague, regulate menstruation, snakebites, stimulate stomach secretions, soaps, urethritis (inflammation of the urethra), urinary tract infections (UTIs), wounds.
Adults (over 18 years old)
There is no proven safe or effective dose for juniper. Tinctures, tablets, capsules and other forms of berry extracts are commercially available. As an infusion, 2-3 grams of dried berries in 150mL of hot water, has been taken by mouth 3-4 times daily. For dyspepsia, 20-50 milligrams of the berry essential oil has been taken twice daily (for up to a maximum of 100 milligrams). This is usually taken as juniper berry tea.
Cade oil (juniper tar) or juniper oil has been typically used pure or partially diluted. It should be noted that application to the skin may be irritating or toxic to the skin. Volatile oil has been applied on the skin three or more times per day.
Children (under 18 years old)
There is no proven safe or effective dose for juniper in children, and use is not recommended
SafetyDISCLAIMER: 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.
Side Effects and Warnings
The juniper berry has generally recognized as safe (GRAS) status in the United States. The maximum level used in food is 0.006% for the oil and 0.01% for the extract.
Overdose may lead to kidney and skin damage. Overdose symptoms include albuminuria (excessive protein), hematuria (blood in the urine), purplish urine, tachycardia (increased heart rate), hypertension (high blood pressure), convulsions, and metrorrhagia (non-menstrual bleeding from the uterus).
Juniper may also lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia (low blood sugar), 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.
Although not well studied in humans, juniper may also 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.
Pregnancy & Breastfeeding
Interactions with Drugs
Juniper may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Juniper 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
Juniper 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.
Juniper 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.
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): Tracee Abrams, PharmD (University of Rhode Island); James David Adams, Jr., PhD (USC School of Pharmacy); Chi Dam, PharmD (Northeastern University); Catherine DeFranco Kirkwood, MPH, CCCJS-MAC, (MD Anderson Cancer Center); Nicole Giese, MS (Natural Standard Research Collaboration); Dana A. Hackman, BS (Northeastern University); Kristopher Swinney, PharmD (Massachusetts College of Pharmacy); Brian Szczechowski, PharmD (Massachusetts College of Pharmacy); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Shannon Welch, PharmD (Northeastern University).
BibliographyDISCLAIMER: 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.
Adams RP. Systematics of Juniperus section Juniperus based on leaf essential oils and random amplified polymorphic DNAs (RAPDs). Biochem.Syst.Ecol. 7-1-2000;28(6):515-528.
Argento A, Tiraferri E, Marzaloni M. [Oral anticoagulants and medicinal plants. An emerging interaction]. Ann Ital.Med Int 2000;15(2):139-143.
Asakura K, Matsuo Y, Oshima T, et al. omega-agatoxin IVA-sensitive Ca(2+) channel blocker, alpha-eudesmol, protects against brain injury after focal ischemia in rats. Eur.J Pharmacol. 4-7-2000;394(1):57-65.
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Buckle J. Use of aromatherapy as a complementary treatment for chronic pain. Altern.Ther.Health Med 1999;5(5):42-51.
Cool LG, Adams RP. A pregeijerene isomer from Juniperus erectopatens foliage. Phytochemistry 2003;63(1):105-108.
Gardner DR, Panter KE, James LF, et al. Abortifacient effects of lodgepole pine (Pinus contorta) and common juniper (Juniperus communis) on cattle. Vet.Hum.Toxicol. 1998;40(5):260-263.
Johnson W. Final report on the safety assessment of Juniperus communis extract, Juniperus oxycedrus extract, Juniperus oxycedrus tar, Juniperus phoenicia extract, and Juniperus virginiana extract. Int J Tox 2001;20 (sup 2):41-56.
Johnston WH, Karchesy JJ, Constantine GH, et al. Antimicrobial activity of some Pacific Northwest woods against anaerobic bacteria and yeast. Phytother Res 2001;15(7):586-588.
Koruk ST, Ozyilkan E, Kaya P, et al. Juniper tar poisoning. Clin.Toxicol.(Phila) 2005;43(1):47-49.
Leitner J, Hofbauer F, Ackerl M. [Poisoning with a podophyllin-containing wart-treating tincture]. Dtsch.Med Wochenschr. 7-12-2002;127(28-29):1516-1520.
Martin AM, Queiroz EF, Marston A, et al. Labdane diterpenes from Juniperus communis L. berries. Phytochem.Anal. 2006;17(1):32-35.
Nakanishi T, Iida N, Inatomi Y, et al. Neolignan and flavonoid glycosides in Juniperus communis var. depressa. Phytochemistry 2004;65(2):207-213.
Salido S, Altarejos J, Nogueras M, et al. Chemical studies of essential oils of Juniperus oxycedrus ssp. badia. J Ethnopharmacol 2002;81(1):129-134.
Sanchez de Medina F, Gamez MJ, Jimenez I., et al. Hypoglycemic activity of juniper "berries". Planta Med 1994;60(3):197-200.
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.