Drugs A - Z
Star anise (Illicium verum)
Generic Name: Star Anise
CategoryHerbs & Supplements
Anice stellato, anis de la Chine (French), anis estrellado, anise étoilé (French), anise stars, aniseed, Anisi stellati fructus, ba chio, badain, badaine, badian, badiana, ba(ht) g(h)ok, bart gok, bunga lawang, Chinese anise, Chinese star anise, eight-horned anise, eight horns, I. anisatum, Illicium anisatum L (Japanese star anise), Illicium verum, Illicium religiosum, Illicium verum Hook f, pa-chiao, pak kok, peh kah, star anise, sternanis, Tamiflu®.
Chinese star anise (Illicium verum) should not be confused with anise (Pimpenella anisum), a member of the carrot family, or with Japanese star anise (Illicium anisatum). Chinese star anise (star anise) is native to China and Vietnam and has been used for its carminative (reduces gas), stomachic (digestive aid), stimulant, and diuretic medicinal properties. Star anise is used by the Malays to combat stomachache due to the accumulation of intestinal gas, headache, and to promote vitality.
Shikimic acid extracted from the pods (which wraps the seeds) of star anise is the starting material of Tamiflu®. Tamiflu® (Roche Laboratories) is an antiviral drug which has gained popularity with the recent spread of the bird flu (H5N1). Roche Laboratories and its partners mainly use the shikimic acid extracted from Chinese star anise. However, they are developing new technologies that use an E. coli bacteria that produces shikimic acid when overfed glucose.
In September 2003, the U.S. Food and Drug Administration (FDA) advised consumers not to consume teas containing star anise. Such teas have been linked with serious neurological effects such as seizures, vomiting, jitteriness and rapid eye movement. Some reports have found Chinese star anise (Illicium verum) to be contaminated with Japanese star anise (Illicium anisatum), which is a known neurotoxin. Chinese star anise is recognized as safe for food use by the FDA, as acknowledged in the FDA's advisory. Chinese star anise is believed to help with colic in infants; however, the FDA is unaware of scientific evidence to support this claim. In addition, the FDA has not identified the specific type of star anise associated with the adverse effects. Similar reports of adverse effects have been found in Florida, Illinois, New Jersey and Washington in the United States as well as the Netherlands, Spain, and France.
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.
Analgesia (inability to feel pain), antibacterial, antimicrobial (bacteria, yeast, fungus), appetite stimulant, arthritis, bronchitis, child birth, cough, cramps (intestinal), digestive aid, diuretic, emmenagogue (promotes menstruation), flatulence (gas), flavoring agent, galactogogue (promotes lactation), gastrointestinal distress, indigestion, insecticide, libido, male climacteric symptoms, paralysis (facial), respiratory congestion (inhaled), respiratory tract infections, rheumatism, stimulant, stomachache.
Adults (18 years and older):
There is no proven safe or effective dose for star anise. Products containing 5-10% of essential oil have been inhaled. Typical doses of star anise may include one cup of tea, or 0.5-1 grams of the coarsely ground seed boiled in 150 milliliters water for 120 minutes and then straining. Ground star anise has been taken in a dose of 3 grams daily. The essential oil of star anise in a dose of 300 milligrams daily has also been reported.
Children (younger than 18 years):
There is no proven safe or effective dose for star anise in children, and use is not recommended. There have been many case reports of neurologic and gastrointestinal toxicities in infants with home administration of star anise tea. In some of the cases, adulteration or contamination of Chinese star anise with Japanese star anise may have caused the poisoning. Avoidance or extreme caution is recommended before using Chinese star anise to treat infant colic due to the possible contamination with Japanese star anise.
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.
Avoid in individuals with a known allergy or hypersensitivity to Chinese star anise. There are reports of allergy to star anise and its constituents (anethole, alpha-pinene, limonene and safrole); patients have had positive skin patch tests to star anise.
Side Effects and Warnings
Chinese star anise is recognized by the U.S. Food and Drug administration (FDA) as GRAS (generally recognized as safe); however, patients should use caution when using Chinese star anise as a tea, and verify its contents. In 2003, the FDA issued a consumer warning about consumption of teas containing Chinese star anise (Illicium verum) due to reports of contamination with the toxic Japanese star anise (Illicium anisatum). There are reports of allergy to star anise and its constituents (anethole, alpha-pinene, limonene and safrole). Nausea, vomiting, tremors, spasms, hypertonia (muscle tension), seizures, convulsions, rapid eye movement, general malaise and hypothermia have been reported after taking star anise herbal tea. It is not clear whether these toxic effects are caused by Chinese star anise, or Japanese star anise, which may contaminate some of the herbal teas.
In patients with convulsive disorders, such as epilepsy, Chinese star anise should be avoided based on its theoretical convulsive effects.
Star anise may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking agents that may increase the risk of bleeding. Dosing adjustments may be necessary.
Pregnancy and Breastfeeding
Interactions with Drugs
Star anise 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 (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Interactions with Herbs and Dietary Supplements
Star anise 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.
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): Dana A. Hackman, BS (Northeastern University); Lisa Scully, 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.
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Garzo Fernandez C, Gomez Pintado P, Barrasa Blanco A, et al. [Cases of neurological symptoms associated with star anise consumption used as a carminative]. An.Esp.Pediatr. 2002;57(4):290-294.
Gil Campos M, Perez Navero JL, Ibarra De La Rosa I. [Convulsive status secondary to star anise poisoning in a neonate]. An.Esp.Pediatr. 2002;57(4):366-368.
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Ize-Ludlow D, Ragone S, Bernstein JN, et al. M. Chemical composition of Chinese star anise (Illicium verum) and neurotoxicity in infants. JAMA 2-4-2004;291(5):562-563.
Ize-Ludlow D, Ragone S, Bruck IS, et al. Neurotoxicities in infants seen with the consumption of star anise tea. Pediatrics 2004;114(5):e653-e656.
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Minodier P, Pommier P, Moulene E, et al. [Star anise poisoning in infants]. Arch Pediatr. 2003;10(7):619-621.
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Park IK, Shin SC. Fumigant activity of plant essential oils and components from garlic (Allium sativum) and clove bud (Eugenia caryophyllata) oils against the Japanese termite (Reticulitermes speratus Kolbe). J Agric.Food Chem 6-1-2005;53(11):4388-4392.
Sy LK, Brown GD. Novel phenylpropanoids and lignans from Illicium verum. J Nat Prod 1998;61(8):987-992.
Zhou J, Lu G, Zhong X, et al. [Quantitative determination of anethole in the fruit of Illicium verum from various places of Guangxi province]. Zhong Yao Cai 2005;28(2):106-107.
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.