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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Glycyrrhiza Glabra
Brand Name
Glycyrrhiza Glabra
Generic Name
Glycyrrhiza Glabra
Active Ingredient
Glycyrrhiza GlabraCategory
Non-Standardized Food Allergenic Extract [EPC]
Variants
8
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 30 [hp_C]/30[hp_C] | PELLET | ORAL | 0220-2305 |
| 30 [hp_C]/1 | PELLET | ORAL | 37662-0765 |
| 200 [hp_C]/1 | PELLET | ORAL | 37662-0767 |
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Glycyrrhiza Glabra, you must consult a qualified healthcare professional.
| 100 [hp_C]/1 | PELLET | ORAL | 37662-0766 |
| 1 [hp_M]/1 | PELLET | ORAL | 37662-0769 |
| 500 [hp_C]/1 | PELLET | ORAL | 37662-0768 |
| 6 [hp_C]/1 | PELLET | ORAL | 37662-0763 |
| 12 [hp_C]/1 | PELLET | ORAL | 37662-0764 |
Detailed information about Glycyrrhiza Glabra
Glycyrrhiza Glabra, commonly known as licorice, is a botanical active ingredient used clinically as a non-standardized allergenic extract and for its multi-systemic pharmacological properties including mineralocorticoid and anti-inflammatory activities.
The dosage of Glycyrrhiza Glabra varies dramatically based on the indication and the specific form of the extract being used.
Glycyrrhiza Glabra is generally not recommended for pediatric use except under the direct supervision of a specialist, such as a pediatric allergist for diagnostic testing. For gastrointestinal use, DGL may be used in children over the age of 12 at adult doses, but safety data for younger children is limited. Pediatric patients are particularly susceptible to electrolyte imbalances; therefore, any use of licorice containing glycyrrhizin is contraindicated in this population.
Patients with pre-existing renal disease should avoid Glycyrrhiza Glabra containing glycyrrhizin. The inhibition of 11β-HSD2 can exacerbate renal hypertension and lead to dangerous levels of potassium depletion. No adjustment is typically needed for DGL, but consultation with a nephrologist is advised.
Since glycyrrhizin is metabolized in the liver and undergoes enterohepatic circulation, patients with hepatic impairment (e.g., cirrhosis, hepatitis) may experience prolonged half-lives and increased systemic toxicity. Use should be avoided or strictly limited to very low doses under medical monitoring.
Elderly patients are at a significantly higher risk for the cardiovascular side effects of Glycyrrhiza Glabra, including hypertension and congestive heart failure. Dosage should be initiated at the lowest possible level, and blood pressure and serum potassium should be monitored weekly during the initial phase of treatment.
If you miss a dose of Glycyrrhiza Glabra, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and resume your regular schedule. Do not double the dose to catch up, as this increases the risk of acute mineralocorticoid side effects.
An overdose of Glycyrrhiza Glabra (specifically the glycyrrhizin-containing forms) can lead to a medical emergency known as acute pseudo-aldosteronism. Symptoms include:
In the event of a suspected overdose, contact your local poison control center or seek emergency medical attention immediately. Treatment typically involves the administration of potassium-sparing diuretics (like spironolactone) and aggressive potassium supplementation.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or extend the duration of use without explicit medical guidance.
When consuming Glycyrrhiza Glabra containing glycyrrhizin, the most common side effects are related to its mineralocorticoid-like activity. These include:
Glycyrrhiza Glabra is a pharmacologically active substance that can profoundly affect electrolyte balance and blood pressure. It is not merely a flavoring agent or a benign supplement. Patients must be aware that the "natural" origin of this ingredient does not preclude it from causing severe systemic toxicity. The most critical safety concern is the induction of Pseudohyperaldosteronism, which can occur even at doses previously thought to be safe if the duration of use is extended.
No FDA black box warnings for Glycyrrhiza Glabra. However, the FDA has issued consumer safety advisories (notably in 2017) warning that eating as little as 2 ounces of black licorice a day for two weeks could cause heart rhythm problems, especially for people over 40.
Glycyrrhiza Glabra (containing glycyrrhizin) must NEVER be used in patients with the following conditions:
Glycyrrhiza Glabra is not recommended during pregnancy. High consumption of glycyrrhizin during pregnancy has been linked in clinical studies (notably in Finland) to shorter gestation periods and an increased risk of preterm delivery. Furthermore, there are concerns regarding the long-term neurodevelopmental effects on the fetus, including lower IQ and increased behavioral problems, potentially due to the overexposure of the fetus to maternal cortisol (as licorice inhibits the protective 11β-HSD2 enzyme in the placenta).
There is limited data on the excretion of glycyrrhetinic acid into human breast milk. However, due to the potential for the infant to experience electrolyte imbalances or hormonal effects, the use of Glycyrrhiza Glabra is generally discouraged while breastfeeding. If use is deemed necessary, the infant should be closely monitored for adequate weight gain and normal muscle tone.
Safety and effectiveness in children have not been established for most indications. Children are at a higher risk for developing severe hypokalemia and hypertension from licorice ingestion. Use in children should be limited to diagnostic allergenic testing by a specialist or the use of DGL forms for short durations under pediatric supervision.
The primary pharmacological activity of Glycyrrhiza Glabra is the inhibition of 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2). In the renal tubule, this enzyme normally converts cortisol into cortisone. Cortisol has an equal affinity for mineralocorticoid receptors as aldosterone. By blocking 11β-HSD2, Glycyrrhiza Glabra causes a localized increase in cortisol, which then binds to mineralocorticoid receptors, leading to sodium reabsorption, water retention, and potassium excretion (pseudohyperaldosteronism).
Additionally, Glycyrrhiza Glabra contains Glabridin, which acts as a phytoestrogen and has been shown to inhibit LDL oxidation. The extract also possesses anti-inflammatory properties via the inhibition of phospholipase A2 and the reduction of prostaglandin E2 production.
Common questions about Glycyrrhiza Glabra
Glycyrrhiza Glabra, commonly known as licorice, is used in several different medical capacities. Clinically, it is used as a non-standardized allergenic extract for skin testing to diagnose specific allergies. In its deglycyrrhizinated (DGL) form, it is frequently used to treat digestive issues like heartburn, acid reflux, and stomach ulcers by coating the stomach lining. It also serves as an expectorant in some cough remedies to help loosen mucus. However, its use must be carefully managed due to its potent effects on blood pressure and potassium levels.
The most common side effects associated with Glycyrrhiza Glabra are related to its ability to mimic the hormone aldosterone. This often leads to fluid retention, causing swelling (edema) in the hands and feet. Many people also experience a rise in blood pressure, even if they do not have a history of hypertension. Other frequent issues include headaches and a general feeling of fatigue. These effects are primarily seen with products that contain glycyrrhizin, rather than the DGL form.
It is generally advised to limit or avoid alcohol while taking Glycyrrhiza Glabra. Alcohol can worsen the potassium-depleting effects of licorice, which increases the risk of heart rhythm problems. Additionally, alcohol can irritate the stomach lining, which may counteract the benefits if you are taking licorice for digestive health. Since both substances are processed by the liver, combining them can put unnecessary stress on hepatic function. Always consult your doctor about your alcohol consumption habits when starting a new medication or supplement.
Glycyrrhiza Glabra is considered unsafe for use during pregnancy. Research has shown that high intake of glycyrrhizin can increase the risk of preterm labor and delivery. There are also significant concerns that it may affect the developing brain of the fetus, potentially leading to cognitive or behavioral issues later in life. This is thought to happen because licorice interferes with the placental enzymes that protect the baby from the mother's stress hormones. Pregnant women should avoid all licorice-containing supplements and candies.
The time it takes for Glycyrrhiza Glabra to work depends on the condition being treated. For digestive relief using DGL tablets, many patients notice an improvement in symptoms like heartburn within 30 to 60 minutes. If it is being used as an expectorant for a cough, the soothing effect on the throat is often immediate. However, the systemic effects, such as changes in blood pressure or electrolyte balance, typically develop over one to two weeks of regular use. It is important not to use it for more than four weeks without medical supervision.
Yes, you can generally stop taking Glycyrrhiza Glabra suddenly, as it does not cause a traditional withdrawal syndrome or physical dependence. However, because its effects on your body's salt and water balance can last for several days, your blood pressure and potassium levels may take a week or two to return to their normal baseline. If you have been taking it to manage a specific condition like an ulcer, your symptoms may return after discontinuation. It is always best to discuss stopping any long-term supplement with your healthcare provider to ensure a safe transition.
If you miss a dose of Glycyrrhiza Glabra, you should take it as soon as you remember. If it is almost time for your next scheduled dose, it is better to skip the missed dose entirely and continue with your regular timing. You should never take two doses at once to make up for a missed one, as this can increase the risk of acute side effects like a spike in blood pressure. Consistency is important for effectiveness, but safety should always come first. If you frequently miss doses, consider using a pill reminder app or box.
Glycyrrhiza Glabra can cause a rapid increase in weight, but this is usually due to water retention rather than an increase in body fat. Because the active ingredient glycyrrhizin causes the body to hold onto sodium and water, patients may notice the scale going up by several pounds in a short period. This 'water weight' is often accompanied by swelling in the legs or a bloated feeling. If you notice a sudden weight gain of more than 3 to 5 pounds in a week, you should contact your doctor, as it may indicate a strain on your heart or kidneys.
Glycyrrhiza Glabra has many serious drug interactions and should be used cautiously with other medications. It is particularly dangerous when taken with heart medications like digoxin or diuretics (water pills), as it can cause potassium levels to drop to life-threatening levels. It can also interfere with blood pressure medications, blood thinners like warfarin, and hormone therapies. Because of these risks, you must provide your doctor or pharmacist with a full list of all medications and supplements you are currently taking before starting licorice. Never start a new drug combination without professional guidance.
Glycyrrhiza Glabra is a botanical ingredient and is widely available as a generic herbal supplement and in various over-the-counter formulations. It is sold under many different brand names and as store-brand generics in health food stores and pharmacies. In the clinical setting, the allergenic extracts used for testing are also available from various manufacturers. While generic versions are common, the quality and concentration of active glycyrrhizin can vary significantly between products, so it is important to choose a reputable brand that provides standardized extracts.
Other drugs with the same active ingredient (Glycyrrhiza Glabra)
> Warning: Stop taking Glycyrrhiza Glabra and call your doctor immediately if you experience any of these serious symptoms:
Prolonged use of Glycyrrhiza Glabra (beyond 4 weeks) can lead to chronic suppression of the Renin-Angiotensin-Aldosterone System (RAAS). This results in persistent hypertension, chronic potassium depletion, and potential structural damage to the kidneys (nephropathy). Long-term use has also been linked to metabolic alkalosis, a condition where the blood becomes too alkaline, leading to confusion and muscle twitching.
No formal FDA black box warnings currently exist for Glycyrrhiza Glabra as a non-standardized allergenic extract. However, clinical literature and regulatory bodies (such as the WHO and EMA) have issued strong warnings regarding its use in patients with cardiovascular disease. The risk of life-threatening hypokalemia is considered a "hidden" danger for consumers who use licorice-containing products without medical supervision.
Report any unusual symptoms or persistent side effects to your healthcare provider immediately. Monitoring of electrolytes is essential for anyone taking non-DGL forms of this substance.
If your healthcare provider prescribes or approves the use of Glycyrrhiza Glabra for more than two weeks, the following monitoring is typically required:
Glycyrrhiza Glabra does not typically cause sedation. However, if a patient experiences a hypertensive crisis or severe electrolyte imbalance, dizziness and visual disturbances may occur. Patients should ensure they know how they react to the substance before driving or operating heavy machinery.
Alcohol should be used with caution. Alcohol can exacerbate the potassium-depleting effects of licorice and may further irritate the gastrointestinal lining, potentially counteracting the beneficial effects of DGL forms. Furthermore, chronic alcohol use often involves underlying liver or kidney stress, which increases the risk of licorice toxicity.
Upon discontinuing Glycyrrhiza Glabra after long-term use, the body may take several days to weeks to normalize the RAAS and electrolyte balance. There is no specific "withdrawal syndrome," but blood pressure and potassium levels should be monitored for at least 1-2 weeks post-discontinuation to ensure they return to baseline safely.
> Important: Discuss all your medical conditions, especially heart or kidney problems, with your healthcare provider before starting Glycyrrhiza Glabra.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A complete medication review is essential to prevent dangerous interactions.
Conditions requiring a careful risk-benefit analysis and intense monitoring include:
Patients with known allergies to other members of the Fabaceae (Leguminosae) family, such as peas, beans, soy, or peanuts, may exhibit cross-reactivity to Glycyrrhiza Glabra extracts. If you have a known legume allergy, skin testing should be approached with extreme caution.
> Important: Your healthcare provider will evaluate your complete medical history, including all allergies and chronic conditions, before prescribing or recommending Glycyrrhiza Glabra.
Patients over the age of 65 are significantly more sensitive to the mineralocorticoid effects of Glycyrrhiza Glabra. There is an increased risk of:
In patients with impaired renal function, the kidney's ability to compensate for the mineralocorticoid effects of licorice is diminished. This leads to a more rapid and severe onset of hypertension and edema. Glycyrrhiza Glabra is generally contraindicated in patients with a GFR (Glomerular Filtration Rate) below 30 mL/min.
Liver disease significantly impairs the metabolism of glycyrrhetinic acid. In patients with cirrhosis, the half-life of licorice components is prolonged, and the risk of pseudo-aldosteronism is markedly increased. These patients also often have baseline electrolyte disturbances that licorice will worsen.
> Important: Special populations require individualized medical assessment and often more frequent lab monitoring to ensure safety.
| Parameter | Value |
|---|---|
| Bioavailability | Variable (highly dependent on gut flora) |
| Protein Binding | >95% (Glycyrrhetinic acid) |
| Half-life | 10–30 hours (Terminal) |
| Tmax | 4–12 hours (for Glycyrrhetinic acid) |
| Metabolism | Hepatic (Glucuronidation) |
| Excretion | Fecal (>90%), Renal (<10%) |
Glycyrrhiza Glabra belongs to the class of Non-Standardized Food Allergenic Extracts. In a broader therapeutic context, it is considered a botanical mineralocorticoid agonist and a phytoestrogen. It is related to other saponin-containing plants but is unique in its specific potency regarding 11β-HSD2 inhibition.