Glycyrrhizae radix (Herbal raw material) Instructions for Use

ATC Code

V03AX (Other therapeutic agents)

Active Substance

Liquorice (Ph.Eur. European Pharmacopoeia)

Clinical-Pharmacological Group

Herbal preparation with expectorant and anti-inflammatory effects

Pharmacotherapeutic Group

Herbal expectorant

Pharmacological Action

Herbal medicinal product. Liquorice root contains glycyrrhizin (from 6 to 12%), glycyrrhizic acid and its salts, flavone glycosides (liquiritin, liquiritigenin, liquiritoside), isoflavonoids (formononetin, glabrene, glabridin, glabrol, 3-hydroxyglabrol, glycyrrhisoflavone), coumestan derivatives (glycyrol, isoglycyrol, licocoumarin), hydroxycoumarins (including herniarin, umbelliferone, glycycoumarin, licopyranocoumarin), steroids (sterols, including beta-sitosterol, sigmasterol), essential oils (in small amounts).

Glycyrrhizin stimulates the activity of the ciliated epithelium and enhances the secretory function of the mucous membranes of the upper respiratory tract, facilitating expectoration. It exerts an anti-ulcer and anti-inflammatory effect and reduces platelet aggregation.

Liquorice inhibits the enzyme 11-beta-hydroxysteroid dehydrogenase in the kidneys, which leads to a decrease in the conversion of cortisol to cortisone. The mineralocorticoid activity of cortisol causes a decrease in serum potassium concentration and an increase in sodium content, leading to fluid retention in the body, weight gain, and arterial hypertension. Glycyrrhizic acid and its metabolites inhibit the peripheral metabolism of cortisol and cause a pseudoaldosterone-like effect.

Liquiritoside exerts an antispasmodic effect on smooth muscles.

Indications

As part of combination therapy for infectious and inflammatory diseases of the respiratory tract (primarily in the presence of poorly separable, thick and viscous secretion). As part of combination therapy for chronic inflammatory diseases of the gastrointestinal mucosa.

ICD codes

Dosage Regimen

Administer orally as an herbal raw material for decoction or infusion preparation.

Prepare the decoction immediately before use. Do not store the prepared decoction for more than 48 hours.

For adults and adolescents over 12 years, use approximately 1/2 to 1 teaspoon (1.5-3 grams) of chopped root per 150-200 mL of boiling water.

Infuse the mixture for 10-15 minutes, then strain. The typical single dose of the prepared liquid extract is 100-150 mL.

Take the prepared dose 2-4 times daily between meals.

The total daily dose of glycyrrhizic acid should generally not exceed 100-200 mg.

Limit the duration of continuous use to a maximum of 4-6 weeks without medical supervision.

For children under 12 years, use only if explicitly indicated for a specific dosage form and strictly follow pediatric dosing instructions.

Adjust the dose and regimen individually based on the clinical indication and patient response.

Discontinue use and consult a physician if edema, significant weight gain, or hypertension occurs.

Adverse Reactions

Possible allergic reactions; with prolonged use of liquorice preparations – increased blood pressure, appearance of edema, disorders of the reproductive system.

Contraindications

Hypersensitivity to liquorice preparations, chronic hepatitis, liver diseases with cholestasis, liver cirrhosis, exacerbation of gastric and duodenal ulcer, severe renal failure, diabetes mellitus, cardiac arrhythmias, arterial hypertension, hypokalemia; pregnancy, breastfeeding period; childhood – depending on the dosage form.

Use in Pregnancy and Lactation

Liquorice preparations are contraindicated for use during pregnancy and lactation (breastfeeding).

Use in Hepatic Impairment

Contraindicated in chronic hepatitis, liver diseases with cholestasis, liver cirrhosis.

Use in Renal Impairment

Contraindicated in severe renal failure.

Pediatric Use

Use in children of appropriate age categories is possible strictly according to indications, in recommended doses and dosage forms. It is necessary to strictly follow the instructions in the leaflets of liquorice preparations regarding contraindications for use in children of different ages for specific dosage forms of liquorice.

Special Precautions

Should not be used concomitantly with preparations containing codeine and other antitussive medicinal products, as this makes it difficult to cough up liquefied sputum.

Drug Interactions

Concomitant use of liquorice with thiazide diuretics is not recommended due to the risk of hypokalemia.

Hypokalemia, caused by prolonged use of liquorice, may potentiate the toxic effect of cardiac glycosides.

With concomitant use of liquorice and corticosteroids, an increase in the T_1/2 of cortisol is possible.

Storage Conditions

Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.

Dispensing Status

Over-the-Counter

Important Safety Information

This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.