DRUGS AND SUPPLEMENTS

Eyebright (Euphrasia officinalis)

March 22, 2017

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Eyebright (Euphrasia officinalis)

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • 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.

Scientific Evidence

Uses

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.

Grade*

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.

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.

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.

C

*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Tradition/Theory

The below uses are based on tradition or scientific theories. 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 health care professional.

  • 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

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

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

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

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 and Breastfeeding

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

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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 and 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.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

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.

  1. Bartholomaeus A, Ahokas J. Inhibition 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. View Abstract

  2. 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. View Abstract

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

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

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

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

  7. 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.

  8. 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. View Abstract

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

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

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

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

  13. 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. View Abstract

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

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

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Updated:  

March 22, 2017