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Pak. J. Pharm. Sci., 2007, Vol.20(1), 83-92
83
REVIEW
THE BERBERIS STORY: BERBERIS VULGARIS IN THERAPEUTICS
M. SAEED ARAYNE, NAJMA SULTANA* AND SAIMA SHER BAHADUR
Department of Chemistry, University of Karachi, Karachi-75270, Pakistan
*Research Institute of Pharmaceutical Sciences, Department of Pharmaceutical Chemistry,
Faculty of Pharmacy, University of Karachi, Karachi-75270, Pakistan
ABSTRACT
Barberry has played a prominent role in herbal healing for more than 2,500 years. Berberis vulgaris is a
common garden bush, native to Europe and the British Isles, naturalized in North America, seems to have
history as old as human race. Anthropologists believe in a ritual practice or sacred object, especially by Native
Americans that it works as a supernatural power or as preventive or remedy of illness.
It is a deciduous shrub having yellow flowers and scarlet colored fruit in the form of berries. Twenty two
alkaloids have been reported so far from root, stem leaves and fruit of this plant, which are of medicinal
importance. As a herbal remedy it has no match in serving human race since ancient times. It is the most widely
used drug in Homeopathic system of medicine for kidney pain and for removal of kidney stones. In this article,
we present countless blessings of nature encountered through this herb which are worthy of recording.
Keywords: Berbery, berberis, berberis vulgaris.
INTRODUCTION
The history of berberis vulgaris might be as old as
barbarians but it is rather a sophisticated plant and is
serving human in one way or the other. The Italians call
the barberry Holy Thorn, because it is thought to have
formed part of the Crown of Thorns.
There is accumulating evidence suggesting medicinal
plants are unlimited reservoirs of drugs. The amazing
structural diversity among their active components make
them a useful source of novel therapeutic compounds.
Researchers with interest in natural products have
intensified their efforts towards scientific evaluation of
traditional medicines.
Berberis is the Arabic name of the fruit that signify a
shell and many authors believe that the name is derived
from this word because the leaves are glossy like the
inside of an oyster shell. The name berbery seems to have
been first applied to this fruit by Averroes (an Arabic
writer on medicines) is not only a food, a food additive, a
herb but also a homeopathic remedy for countless illness
(the research in this respect is still going on all over the
world). As Eastern and Bulgarian folk medicine it is used
in rheumatic and other chronic inflammatory disorders
(Ivanovska and Philipov, 1996) and as an ayurvadic
medicine in India. The anticancer property of berberis
vulgaris is known and the research in this regard is still in
progress. Barberry became unpopular with farmers when
it was discovered to be a host plant for the wheat rust
fungus that decimated crops in the 19th century.
The Plant
Berberis vulgaris is the most significant European
representative of Barberdaceae (Webb and Akeroyd,
1993). The common name Barberry includes Berberis
repens, Berberis aqilfolia, Berberis nervosa, Berberis
pinnata, and other Berberis species, which are used
interchangeably with Berberis vulgaris. Also known as
European barberry, jaundice berry, pepperidge,
pepperidge bush, sowberry, Barberry, berberis,
Daruharidra, Daruhaldi, Kingor, Barberry etc. The plant
prefers light (sandy), medium (loamy) and heavy (clay)
soils and can grow in heavy clay and nutritionally poor
soils. The plant prefers acid, while can also grow in
neutral and basic (alkaline) soils. It can grow in semi-
shade (light woodland) or no shade. It requires dry or
moist soil. It is a thorned, deciduous shrub growing up to
3 meters (10 feet) in height, common to most areas of
Central and Southern Europe and the Northeastern
regions of the United States. It is generally distributed
over the greater part of Europe, Northern Africa and
temperate Asia. As an ornamental shrub, it is fairly
common in gardens. A closely related species, Oregon
grape (Berberis aquifolium), is native to North America.
It grows well in dry, sunny locations, flowers (fig. 1)
appear in mid-spring to early summer and produces a fruit
(Fructis Berberidis) that can be harvested in early autumn
or fall.
The leaves of the barren shoots are alternate, they become
transformed in spines the succeeding year. The secondary
leaves are in fascicles from the axil of these spines and
are simple, oval, tapering at the base into a short foot-
stalk, the margins finely serrate, with the teeth terminating
in small spines. The stem is branched, smooth, grooved
Corresponding author: Email: arayne@gawab.com
The Berberis Story: Berberis vulgaris in therapeutics
Pak. J. Pharm. Sci., 2007, Vol.20(1), 83-92
84
and brittle. The stems, growing from 3 to 8 feet high, are
reddish when young but turn dirty gray with age. Roots
are deciduous and are grey or brown in color. The root is
usually 1/5 inch thick. The bark has bitter taste and slight
odour. Barberry has yellow, unpleasant smelling flowers.
Flowers are small, pale yellow and sassile with broad
stigma. The petals are entire; the stamens irritable,
springing violently against the stigma when touched.
Flowers are arranged in pendulous racemes that form
hanging clusters.
Fig. 1: Berberis Vulgaris plant showing leaves flowers
and fruit. Figure: Enlarged view of Berberis vulgaris
fruits.
The fruit of Berberis (fig. 1) is long scarlet colored berries
(Drofler and Roselt, 1989). Berries are oblong, slightly
curved, about ½ inches long and edible. The berries
become red on ripening. The taste of berries is pleasantly
acidulous. The leaves are also acidic. Leaves are used to
season the meat with instead of salad. Berries are sourer
but less bitter than cranberries. Both the berries and the
bark are used for medicinal purposes (Bergner, 1996).
Overview
Barberry has played a prominent role in herbal healing for
more than 2,500 years. The ancient Egyptians used it with
fennel seed to prevent plagues. India's Ayurveda healers
used it for dysentery. During the early middle ages,
European herbalists used it to treat liver and gallbladder
ailments. Russian healers used it for inflammations, high
blood pressure, and for abnormal uterine bleeding.
American Indians recognize barberry as similar to Oregon
grape.
It is said to make excellent preserves; was highly
esteemed by the ancients, and probably would be now, if
other fruits had not been cultivated to such a degree of
excellence. In traditional folk medicine, barberry has been
used to treat diarrhea, reduce fever, improve appetite,
relieve upset stomach, and promote vigor as well as a
sense of well being (Bergner, 1996). Today, it is widely
used to fight the infection of the throat, urinary tract,
gastrointestinal tract, lungs, yeast infection and diarrhea.
Mostly the bark of the stem and root are used as medicine.
Native Americans also used it as yellow dye.
In folk medicine, European barberry root bark has been
used for various conditions including liver dysfunction,
gallbladder disease, diarrhea, indigestion and urinary tract
diseases (Foster and Tyler, 1999; Jellin et al., 2000 and
Gruenwals, 1998). It has been applied in many cultures to
treat malaria, and leishmaniasis (Jellin et al., 2000;
Gruenwals, 1998 and Hostettmann et al., 1995).
American Indians used Barberry to improve appetite, a
function that was soon picked up by early American
settlers. It was also reportedly used for treating stomach
problems such as ulcers and heartburn (Foster and Tyler,
1999), and is listed in the American Medical Ethnobotany
Reference Dictionary as being effective in reducing fever
(Moerman, 1977).
In short almost every civilization had used barbery in one
way or the other.
What's It Made of?
The stem, root bark, and fruit of barberry contain
isoquinoline alkaloids (e.g. berberine), which are the main
active ingredients of barberry (Gorval and Grishkovets,
1999). The amount of berberine fractions in the stem was
2: 3 times higher than the amount in the leaves. The
following alkaloids have been isolated and characterized
from Berberis vulgaris species.
O
O
N
+
OMe
OMe
Fig. 2: Berberine
M. Saeed Arayne et al.
Pak. J. Pharm. Sci., 2007, Vol.20(1), 83-92
85
O
O
N
OCH
3
OCH
3
O
Fig. 3: Berlambine
N
MeO
HO
+
OMe
OMe
Fig. 4: Columbamine
NMe
MeO
MeO
H
HO
MeO
Fig. 5: Isocorydine
O
O
N
OMe
OMe
Fig. 6: Lambertine
NMe
2
MeO
HO
HO
MeO
+
H
Fig. 7: Magniflorine
O
O
OMe
OMe
N
O
Fig. 8: Oxyberberine
MeN
2
2
NMe
H
OMe
OH
MeO
MeO
O
O
Fig. 9: Oxycanthine
The alkaloid, berberine, received the most research and
widest acclaim as the active component of barberry and
its relatives. It is yellow crystalline bitter alkaloid. Other
constituents are oxyacanthine, berbamine and related
alkaloidal matter, a little tannin, wax, resin, fat, albumin,
gum and starch. Berberine and its related constituents
(such as oxyacanthine) are antibacterial (Amin et al.,
1969) have been shown to kill amoebae (Subbaiah et al.,
1967) in vitro and inhibits the growth of many
microorganisms, including fungi, protozoa, and bacteria
(Hahn and Ciak, 1976; Lesnau et al., 1990 and Amin et
al., 1969). Berberine inhibits bacteria from attaching
human cells that helps prevent infection (Sun et al.,
1988). This component treats diarrhea caused by bacteria,
such as E. coli (Rabbani et al., 1987). Berberine also
stimulates some immune system cells to function better
(Kumazawa et al., 1984) and is an antioxidant (Wong et
al., 1992 and Ju et al., 1990).
The bitter compounds in barberry, including alkaloids,
stimulate digestive functions following meals. Barberry
and goldenseal (Bergner, 1996) (Hydrastis canadensis)
have very similar therapeutic uses because both contain
active substances (berberine alkaloids). These substances
have been shown to combat infection and bacteria,
stimulate the activity of the immune system, and lower
fever. Laboratory studies suggest that these substances
have antimicrobial (for example, antibacterial and
antiparasitic), anti-inflammatory (Ivanovska and Philipov,
1996), immune-stimulant, fever reducing, hypotensive
(causing a reduction in blood pressure), and sedative,
anticonvulsant, and smooth muscle effects. Smooth
muscles line the gastrointestinal tract; therefore, this last
The Berberis Story: Berberis vulgaris in therapeutics
Pak. J. Pharm. Sci., 2007, Vol.20(1), 83-92
86
effect may help improve digestion and reduce stomach
pain. Oxyacanthine was less effective than berberine
(Ivanovska and Philipov, 1996). Common barberry leaves
contain a small but diverse polysaccharide fraction which
afforded an α-glucan, a β-xylan, and three neutral, and
two galacturonic acid containing glucoxylans. Only the α-
glucan was devoid of protein. The α-glucan is primarily
(1→4)-linked, but some residues are branched through C-
3 or C-6. The flowers contain sugar and an essential oil
while malic acid is present in the berries.
Edible uses
Fruit - raw or cooked (Hedrick, 1972; Simmons, 1972;
Mabey, 1974; Chiej, 1984; Launert, 1981; Bean, 1981;
Saunders, 1976 and Facciola, 1990). Rich in vitamin C
(Staurt, 1979), has a very acid flavor and is mainly used
in preserves (Polunin, 1969), though children and some
adults like it raw when it is fully ripe. A refreshing lemon-
like drink can be made from the fruit (Facciola, 1990).
The fruits are about 10mm long (Huxley, 1992). Young
leaves are used as flavouring or as an acid nibble (Kunkel,
1984 and Facciola, 1990). They can be used in much the
same way as sorrel (Rumex acetosa). The dried young
leaves and shoot tips make a refreshing tea (Launert, 1981
and Facciola, 1990).
Medicinal uses
Barberries have long been used as a herbal remedy for the
treatment of a variety of complaints. The main chemical
constituent berberine possesses a wide
range of
biochemical and pharmacological activities, viz.
antidiarrheal,
antiarrhythmic anti-inflammatory, fever-
reducing, analgesic (pain-reducing) effects (Kupeli et al.,
2002 and Yesilada and Kupeli, 2002) and antitumor
activities (Takase et al., 1993; Huang et al., 1989; Fukuda
et al., 1999a, 1999b). Barberry fruit may have anti-
hypertensive and antihistaminic effects (Shamsa et al.,
1999 and Fatehi-Hassanabad et al., 2005).
All parts of the plant can be used though the yellow root
bark which is the most concentrated source of active
ingredients. Extracts obtained from the roots of
Berberidaceae species have been used in Eastern and
Table 1: Compounds isolated from Berberis vulgaris
Compound Nature Structure Reference
Aromoline alkaloid —
(Bick et al., 1953 & 1960), (Saa′ et al., 1976), (Koike et al., 1982),
(Wu et al., 1980), (Akasu et al., 1976)
Berbamine alkaloid — (Akasu et al., 1976), (Yang et al., 1960), (Gasparec et al., 1968)
Berbamunine alkaloid — (Yang et al., 1960), (Gasparec et al,. 1968), (Cassels et al., 1987),
(Ahmed et al., 1977), (Kametani et al., 1969), (Tses’ko et al.,
1974), (Martindale, 1982/1989)
Berberine Alkaloid Figure 2 (Yang et al., 1960), (Gasparec et al., 1968), (Perkin et al., 1925),
(Wu et al., 1977), (Tses’ko and Ladygina, 1974)
Berlambine Alkaloid Figure 3 (Yang et al., 1960), (Gasparec et al., 1968)
Bervulcine Alkaloid — (Werner, 1963)
Chlorogenic acid Acid phenol —
Columbamine Alkaloid Figure 4
(Pavelka and Sme′kal, 1976)
Hydroxycanthine Alkaloid — (Ohmoto et al., 1981), (Hagen et al., 1989)
Isocorydine Alkaloid Figure 5 (Comin and Deulofeu, 1954), (Kuck and Faydman, 1961), (Saxena
and Bhakuni, 1979), (Marsaioli et al., 1979)
Jatrorrhizine Alkaloid —
(Yang et al., 1960), (Pavelka and Sme′kal, 1976)
Lambertine Alkaloid Figure 6 (Chatterjee and Maiti, 1955)
Magniflorine Alkaloid — (Rumbero et al., 1991)
Magnoflorine Alkaloid Figure 7 (Ivanovska and Philipov, 1996), (Yang et al., 1960), (Nakano,
1954), (Slavik and Dolejs′, 1973), (Dominguez, 1974)
Oxyberberine Alkaloid Figure 8 (Yang et al., 1960), (Gasparec et al., 1968), (Pavelka and Kovar,
1976), (Cushman and Dekow, 1979)
Oxycanthine Alkaloid Figure 9 (Gasparec et al., 1968), (Baldas et al., 1972), (Kuroda et al.,
1976), (Bhakuni et al., 1978), (Hearth et al., 1987)
Palmatine Alkaloid —
(Yang et al., 1960), (Gasparec et al., 1968), (Pavelka and Sme′kal,
1976), (Skerl and Gros, 1971)
Anthocyanin Pigment —
Quercentin Flavonoid — (Gasparec et al., 1968), (Wu et al., 1977)
Rutin Flavonoid — (Gasparec et al., 1968)
(-)-tejedine Alkaloid — (Kametani et al., 1969)
Yatrorizine Alkaloid — (Gasparec et al., 1968)
M. Saeed Arayne et al.
Pak. J. Pharm. Sci., 2007, Vol.20(1), 83-92
87
Bulgarian folk medicine in rheumatic and other chronic
inflammatory disorders. The total ethanol extract (TEE)
of berbrine and oxacanthine showed the heighest reducing
effect when applied against acute inflammation
(carrageenan- and zymosan- induced paw edema). TEE
was also most effective in a chronic inflammatory model
of adjuvant arthritis. The proto-berberine fractions Bv2,
Bv3 and berberine suppressed a delayed type
hypersensitivity (DHT) reaction.
Barberry may also be an effective treatment for diarrhea
(Kaneda et al., 1991) (including traveler's diarrhea and
diarrhea caused by food poisoning). A few studies have
suggested that barberry improves symptoms faster than
antibiotics (Rabbani et al., 1987 and Shamsa et al., 1999)
but may be less effective than the drugs in clearing
bacterial organisms out of the intestines. Because of the
serious consequences associated with bacterial diarrhea, if
barberry is used to ease symptoms, it is best to take the
herb along with standard antibiotic therapy for this
condition.
It is used in pitta detoxification, congestion of abdomen
and in pelvic cavities. It is an excellent herb in scarlet
fever, brain disorders, heat, thirst, nausea; periodic
neuralgia, fevers, vomiting in pregnancy; blood purifier.
Gastric and duodenal ulcers; sores. Used in diabetes. It is
prescribed for renal calculi, abdominal and pelvic
congestion. It acts as a G.I. stimulant and Barberry tends
to dilate the blood vessels, thereby lowering blood
pressure.
Barberry is one of the best remedies for correcting liver
function and promoting the flow of bile. When jaundice
occurs due to a congested state of the liver, Barberry is
also indicated. It is proved as excellent remedy for
dyspepsia and functional derangement of the liver. It is an
excellent herb to treat enlarged liver and spleen and
regulates liver function. It destroys toxins and reduces
body fat (with turmeric). It is used in all cases of jaundice,
generally debility and biliousness. Berberine has been
reported to interfere with normal liver function in infants,
raising a concern that it might worsen jaundice (Chan,
1993). For this reason, berberine- containing plants,
including barberry, goldenseal and Oregon grape should
be used with caution during pregnancy and breast-feeding
(Blumenthal et al., 1998).
A tea made from the bark of barberis is taken during the
spring months as a blood purifier. A strong decoction is
employed as an application to the sores, which sometimes
afflict children's lips. The berries form an agreeable
acidulous draught, useful as a refrigerant in fevers. It
possesses febrifuge powers and is used as a remedy for
intermittent fevers.
Berberidaceae roots have been used in European folk
medicine for inflammation. Total ethanol extract inhibited
induced paw edema. Berberine suppressed delayed type
hypersensitivity more than oxyacanthine (Ivanovska and
Philipov, 1996). It helps in regulating the digestive
powers and if given in large doses it acts as a mild
purgative and removes constipation. Barberry is also
claimed to have anti-viral activities, and as a treatment for
chronic candidiasis, indigestion and parasites (USDA,
2003).
Herbalists recommend barberry as a stimulating tonic for
liver. It influences the mucosa generally, removing
mucoid accumulations and controlling excess secretion.
Improves appetite, digestion and assimilation. Indicated
for gouty constitutions.
Berberine and its related constituents (such as
oxyacanthine) are antibacterial (Amin et al., 1969) and
have been shown to kill amoebae in a test tube study
(Subbaiah and Amin, 1967). Berberine inhibits bacteria
from attaching to human cells, which helps prevent
infection (Sun et al., 1988). This compound treats
diarrhea caused by bacteria, such as E. coli (Rabbani et
al., 1987). Berberine also stimulates some immune system
cells to function better (Kumazawa et al., 1984)
Berbamine is another alkaloid found in barberry. It may
help reduce inflammation (Wong et al., 1992) and is an
antioxidant (Ju et al., 1990).
Laboratory studies have shown that berberine has some
activity against E. histolytica in mice (Hostettman et al.,
1995). The astringent property makes it useful against
bilious disorders.
Barberis contain citric acid and malic acid and due to
these possesses astringent, and anti scorbutic properties
useful in inflammatory fevers, especially typhus, and
scurvy, and in the form of a jelly, are very refreshing for
irritable sore throat; syrup of berberis made with water is
used as an excellent astringent gargle. The fresh juice of
the fruit is also said to strengthen the gums and relieve
pyorrhea when brushed on or applied directly to the gums.
A decoction of the bark or berries has been found of
service as a wash in aphthous sore mouth, and in chronic
ophthalmia.
In distilled water, barbery fruit extract showed 73.62%
(higher than in ethanol) free radical scavenging activity.
Another study shows that it has anti-inflammatory
properties, useful for treating arthritis. More work is
needed in this case. It forms a good lotion for application
to cutaneous eruptions and a reliable treatment for acne. It
also act as a stimulant for the circulatory and respiratory
systems (Blumenthal, 1998). It is used for treating
pinkeye and conjunctivitis.
It acts against malaria. Pyrimethamine effect on
cholroquine-resistant malaria was increased more by
berberine (74%) than by tetracycline (67%) or
The Berberis Story: Berberis vulgaris in therapeutics
Pak. J. Pharm. Sci., 2007, Vol.20(1), 83-92
88
cotrimoxazole (48%) in a randomized clinical trial with
215 patients (Sheng et al., 1997).
Strong standardized extracts may cause stomach upset
and should be used for no more than two weeks
continuously. Other symptoms of excessive berberine
intake include lethargy, nosebleed, skin, and eye and
kidney irritation (Blumenthal, 1998).
Berberine chloride had a higher bacteriostatic activity
against Staphylococcus epidermidis, Neisseria
meningitidis, Escherichia coli, and other bacteria than did
chloramphenicol.
The constituents berberine, columbamine, and oxy-
acanthine show evidence of antibacterial activity, with
some suggestion that berberine sulfate might be
amebicidal and trypanocidal (Foster and Tyler, 1999 and
Lueng and Foster, 1996). Research indicates that
berberine is specifically effective against cholera, giardia,
shigella, salmonella and E. coli (Chevallier, 2001).
Berberis vulgaris (Berberis Vulgaris-Q) is very useful in
treatment of stones in the urinary tract. The main
constituent of this stone is calcium oxalate. Recent studies
show that calcium oxalate is precipitated out in the
presence of berberis vulgaris and some citrus fruit juices
(Das et al., 2004).
Isocorydine is adrenosytic, sedative and cholineragic
agent shows virtually no antitussive activity.
Anti arrhythmic, antihypertensive and cardiovascular
affects of the extract of berberis fruit
Berberis vulgaris fruit (barberry) is known for its
antiarrhythmic and sedative effects in Iranian traditional
medicine. The aqueous extract of barberry has beneficial
effects on both cardiovascular and neural system
suggesting a potential use for treatment of hypertension,
tachycardia and some neuronal disorders, such as epilepsy
and convulsion.
In a study to evaluate the cardiovascular effects of the
extract of Berberis vulgaris fruit it is found that it has a
potent hypotensive effect and was an opener of potassium
channels activated by cell membrane depolarization.
Experimental evidence exists for sedative effects of the
Berberis vulgaris fruit extract (Fatehi et al., 2005). It has
been reported that berberine blocked potassium currents
in acutely isolated CA1 pyramidal neurons of rat
hippocampus (Wang et al., 2004).
It has been shown that berbamine also prevented
ventricular fibrillation probably through inhibition of
sodium and calcium overload (Zhang et al., 1992).
Augmentation of potassium currents caused by the extract
may contribute to its vasodilatory and antiarrhythmic
effects. There is evidence that phenolic compounds are
present in barberry (Pozniakovskii et al., 2003). It has
been shown that phenolic compounds increase potassium
channels activity. Vasorelaxation induced by some
polyphenolic compounds were inhibited by potassium
channel blockers (Kim et al., 2000).
As anticancer agent
Berberis vulgaris can also act as an anticancer agent.
Research in this regard is still going on. The following
studies have been done in this regard which clearly
indicate that berberis vulgaris can act as an anticancer
agent.
Coptidis
rhizoma, containing abundant berberine, is
shown to inhibit
the proliferation of esophageal cancer
cells (Iizuka et al., 2000). Berberine
inhibits cyclo-
oxygenase-2 transcriptional activity in human
colon
cancer cells (Fukuda et al., 1999 and Lin et al., 1999) and
preliminary studies have shown
that berberine sulfate
inhibits tumor promoting activity of
teleocidin in two-
stage chemical carcinogenesis on mouse skin
(Nishino et
al., 1986). Berberine also inhibits DNA topoisomerase I
and II in
biochemical system (Wang et al., 1996 and Kim
et al., 1998) and in fact, several classes of
compounds that
inhibit eukaryotic topoisomerase I or II have
antitumor
activity (Liu, 1989).
Berberine has
been shown to possess anti-inflammatory
and antitumor properties
in some in vitro systems. The in
vitro treatment
of androgen-insensitive (DU145 and PC-3)
and androgen-sensitive
(LNCaP) prostate cancer cells
with berberine inhibited cell
proliferation and induced cell
death in a dose-dependent (10–100
µmol/L) and time-
dependent (24–72 hours) manner.
Treatment of non-
neoplastic human prostate epithelial cells (PWR-1E)
with
berberine under identical conditions did not significantly
affect their viability. The
effectiveness of berberine in
checking the growth of androgen-insensitive,
as well as
androgen-sensitive, prostate cancer cells without
affecting
the growth of normal prostate epithelial cells indicates
that it may be a promising candidate for prostate cancer
therapy (Sudheer et al., 2006).
One study shows that the herb might shrink some tumors.
Another study indicates that berberine inhibits growth,
induces G
1
arrest and apoptotic cell death of human
epidermoid
carcinoma A431 cells. It also provide
mechanistic evidences
that berberine-induced apoptosis in
human epidermoid carcinoma
cells is mediated through
disruption of mitochondrial membrane
potential and
activation of caspase 3 pathway, although other
pathways
may have a role and that require further investigation.
Moreover, further in vivo studies are required to
determine
whether berberine could be an effective
chemotherapeutic agent
for the prevention of non-
melanoma skin cancers (Sudheer et al., 2006).
M. Saeed Arayne et al.
Pak. J. Pharm. Sci., 2007, Vol.20(1), 83-92
89
Available dosage formulations
Barberry is available in capsules, fluid extracts, tinctures,
and as a topical ointment. Dried roots of barberry can also
be used in tea. Barberry extracts are standardized to
contain 8% to 12% isoquinoline alkaloids.
Related species
Berberis Canadensis is only indigenous species of the
Berberis proper and very closely resembles the berberis
vulgaris, but a smaller shrub, with smaller leaves, berries,
and smaller and fewer flower racemes. Its locality is
farther South than the introduced species, being a native
of the Southern States. The acidity of the fruit and leaves
and the yellow color of the wood are also observed in this
species. It closely resembles the berberis in medicinal
properties. Doubtless, it contains much the same
principles, as the two species closely resemble each other
and are used commonly for the same purpose
Precautions
The use of herbs is a time-honored approach in
strengthening the body and treating disease. Herbs,
however, contain active substances that can trigger side
effects and that can interact with other herbs,
supplements, or medications. Barberry is generally
considered safe when consumed orally and appropriately
for medicinal purposes, but due to its moderately toxic
properties, cannot be recommended for consumption in
quantities over 500 mg. Those using normal and
appropriate doses of barberry do not generally report side
effects. In high doses, barberry can cause nausea,
vomiting, convulsions, hazardous drops in blood pressure,
and depression of the heart rate and breathing. People
suffering from heart disease or chronic respiratory system,
should not take large doses of this herb and should use it
only with the approval of doctor.
Due to the lack of reliable studies on the use of Barberry
during periods of lactation, it is not recommended for use
while breast-feeding (Jellin et al., 2000). Use only in
medicinal amounts. If the herb causes dizziness or
faintness, stop using the herb immediately. It is not
recommended for children under 2 years of age. For older
children and those above 65, a low strength is
recommended.
Barberry has been classified as unsafe to take during
pregnancy due to its uterine stimulant properties that may
cause uterine contractions and trigger miscarriage.
Berberine-containing herbs should not be used by
pregnant women because berberine may increase levels of
bilirubin (Chan, 1993) potentially damaging the fetus, and
might also cause genetic damage(Pasqual et al., 1993).
One study suggests that topical use of berberine could
cause photosensitivity, an increased tendency to react to
sun exposure (Inbaraj et al., 2001). Individuals who
already have elevated levels of bilirubin (jaundice), or any
other form of liver disease, should also avoid berberine-
containing herbs. One study hints that berberine may
decrease the efficacy of the drug tetracycline (Khin-
Maung, 1985).
Berberine has been reported to interfere with normal liver
function in infants, raising a concern that it might worsen
jaundice (Chan, 1993). For this reason, berberine-
containing plants, including barberry, goldenseal, and
Oregon grape should be used with caution during
pregnancy and breast-feeding. Strong standardized
extracts may cause stomach upset and should be used for
no more than two weeks continuously. Other symptoms
of excessive berberine intake include lethargy, nose bleed,
skin and eye irritation, and kidney irritation.
Barbery should be used only in medicinal amounts if the
herb causes dizziness or faintness it should de
discontinued immediately.
Possible interactions
One double-blind study found that giving 100 mg of
berberine at the same time as 500 mg of tetracycline four
times daily led to a reduction of the efficacy of
tetracycline in people with cholera (Maung et al., 1985).
Berberine may have decreased the absorption of
tetracycline in this study. Another double-blind trial did
not find that berberine interfered with tetracycline in
cholera patients (Rabbani et al., 1987). Until more studies
are completed to clarify this issue, berberine-containing
herbs should not be taken simultaneously with
tetracycline (Maung et al., 1985).
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Received: 23-11-2006 – Accepted: 14-02-2007