Boldo

Last Editorial Review: 6/11/2021
Other Name(s):

Boldea fragrans, Boldine, Boldoak Boldea, Boldo Folium, Boldus, Boldus Boldus, Peumus boldus, Peumus fragrans.

Overview

Boldo is a tree that grows in the Andes mountains in South America. Interestingly, fossilized boldo leaves dating from over thirteen thousand years ago have been found in Chile. These fossils have imprints of human teeth, suggesting that boldo has a long history of dietary or medicinal use.

Boldo is used for mild gastrointestinal (GI) spasms, gallstones, achy joints (rheumatism), bladder infections, liver disease, and gonorrhea. It is also to increase urine flow to rid the body of excess fluids, reduce anxiety, increase bile flow, and kill bacteria.

How does it work?

Boldo contains chemicals that might increase urine output, fight bacterial growth in the urine, and stimulate the stomach.

QUESTION

Next to red peppers, you can get the most vitamin C from ________________. See Answer

Uses & Effectiveness

Insufficient Evidence to Rate Effectiveness for...

More evidence is needed to rate the effectiveness of boldo for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Side Effects

Boldo might be UNSAFE when used for medicinal purposes. Poisoning by ascaridole, a chemical that occurs naturally in boldo, has occurred in people taking boldo. Boldo might cause liver damage when taken by mouth. If you take boldo, use only ascaridole-free preparations. When applied to the skin, boldo can cause irritation.

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Vitamin D Deficiency: How Much Vitamin D Is Enough? See Slideshow

Special Precautions & Warnings

Pregnancy and breast-feeding: Boldo might be UNSAFE when used orally in medicinal amounts. Ascaridole, a chemical in boldo, can damage the liver.

Bile duct blockage: Boldo seems to be able to increase the flow of bile, a fluid produced by the liver and stored in the gallbladder. Bile passes through small channels (ducts) in the intestine where it plays an important role in digesting fats. These ducts can become blocked. There is a concern that the extra bile flow caused by boldo might be harmful in people with blocked bile ducts.

Liver disease: There is some concern that boldo can damage the liver, especially in people who have liver disease. Don't use boldo if you have liver problems.

Surgery: Boldo can slow blood clotting, so there is some concern that it might increase the chance of too much bleeding during and after surgery. Stop using boldo at least two weeks before a scheduled surgery.

Interactions


LithiumInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Boldo might have an effect like a water pill or "diuretic." Taking boldo might decrease how well the body gets rid of lithium. This could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.


Medications that can harm the liver (Hepatotoxic drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Boldo might harm the liver. Taking boldo along with medication that might also harm the liver can increase the risk of liver damage. Do not take boldo if you are taking a medication that can harm the liver.

Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.


Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Boldo might slow blood clotting. Taking boldo along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.


Tacrolimus (Prograf)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Tacrolimus is a medication used to prevent organ rejection in people with organ transplants. Taking boldo with tacrolimus might reduce the amount of tacrolimus in the body. This could decrease the effectiveness of tacrolimus and increase the chance for transplant rejection. Do not take boldo if you are taking tacrolimus after an organ transplant.


Warfarin (Coumadin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Warfarin (Coumadin) is used to slow blood clotting. Boldo might also slow blood clotting. Taking boldo along with warfarin (Coumadin) might increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Dosing

The appropriate dose of boldo for use as treatment depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for boldo. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

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References

Cederbaum, A. I., Kukielka, E., and Speisky, H. Inhibition of rat liver microsomal lipid peroxidation by boldine. Biochem.Pharmacol. 11-3-1992;44(9):1765-1772. View abstract.

Chulia, S., Moreau, J., Naline, E., Noguera, M. A., Ivorra, M. D., D'Ocon, M. P., and Advenier, C. The effect of S-(+)-boldine on the alpha 1-adrenoceptor of the guinea-pig aorta. Br J Pharmacol 1996;119(7):1305-1312. View abstract.

Gotteland, M., Espinoza, J., Cassels, B., and Speisky, H. [Effect of a dry boldo extract on oro-cecal intestinal transit in healthy volunteers]. Rev.Med Chil. 1995;123(8):955-960. View abstract.

Hu, J., Speisky, H., and Cotgreave, I. A. The inhibitory effects of boldine, glaucine, and probucol on TPA-induced down regulation of gap junction function. Relationships to intracellular peroxides, protein kinase C translocation, and connexin 43 phosphorylation. Biochem Pharmacol 11-9-1995;50(10):1635-1643. View abstract.

Ivorra, M. D., Martinez, F., Serrano, A., and D'Ocon, P. Different mechanism of relaxation induced by aporphine alkaloids in rat uterus. J Pharm Pharmacol 1993;45(5):439-443. View abstract.

Jang, Y. Y., Song, J. H., Shin, Y. K., Han, E. S., and Lee, C. S. Protective effect of boldine on oxidative mitochondrial damage in streptozotocin-induced diabetic rats. Pharmacol.Res. 2000;42(4):361-371. View abstract.

Kang, J. J. and Cheng, Y. W. Effects of boldine on mouse diaphragm and sarcoplasmic reticulum vesicles isolated from skeletal muscle. Planta Med 1998;64(1):18-21. View abstract.

Kang, J. J., Cheng, Y. W., and Fu, W. M. Studies on neuromuscular blockade by boldine in the mouse phrenic nerve-diaphragm. Jpn.J Pharmacol. 1998;76(2):207-212. View abstract.

Kringstein, P. and Cederbaum, A. I. Boldine prevents human liver microsomal lipid peroxidation and inactivation of cytochrome P4502E1. Free Radic.Biol.Med. 1995;18(3):559-563. View abstract.

Kubinova, R., Machala, M., Minksova, K., Neca, J., and Suchy, V. Chemoprotective activity of boldine: modulation of drug-metabolizing enzymes. Pharmazie 2001;56(3):242-243. View abstract.

Moreno, P. R., Vargas, V. M., Andrade, H. H., Henriques, A. T., and Henriques, J. A. Genotoxicity of the boldine aporphine alkaloid in prokaryotic and eukaryotic organisms. Mutat.Res. 1991;260(2):145-152. View abstract.

Reiniger, I. W., de Oliveira, J. F., Caldeira-de-Araujo, A., and Bernardo-Filho, M. Effect of Peumus boldus on the labeling of red blood cells and plasma proteins with technetium-99m. Appl Radiat.Isot. 1999;51(2):145-149. View abstract.

Reiniger, I. W., Ribeiro, da Silva, Felzenszwalb, I., de Mattos, J. C., de Oliveira, J. F., Silva Dantas, F. J., Bezerra, R. J., Caldeira-de-Araujo, A., and Bernardo-Filho, M. Boldine action against the stannous chloride effect. J Ethnopharmacol 12-15-1999;68(1-3):345-348. View abstract.

Schmeda-Hirschmann, G., Rodriguez, J. A., Theoduloz, C., Astudillo, S. L., Feresin, G. E., and Tapia, A. Free-radical scavengers and antioxidants from Peumus boldus Mol. ("Boldo"). Free Radic.Res 2003;37(4):447-452. View abstract.

Speisky, H., Cassels, B. K., Lissi, E. A., and Videla, L. A. Antioxidant properties of the alkaloid boldine in systems undergoing lipid peroxidation and enzyme inactivation. Biochem Pharmacol 6-1-1991;41(11):1575-1581. View abstract.

Speisky, H., Rocco, C., Carrasco, C., Lissi, E. A., and Lopez-Alarcon, C. Antioxidant screening of medicinal herbal teas. Phytother Res 2006;20(6):462-467. View abstract.

Teng, C. M., Hsueh, C. M., Chang, Y. L., Ko, F. N., Lee, S. S., and Liu, K. C. Antiplatelet effects of some aporphine and phenanthrene alkaloids in rabbits and man. J Pharm Pharmacol 1997;49(7):706-711. View abstract.

Agarwal SC, Crook JR, Pepper CB. Herbal remedies -- how safe are they? A case report of polymorphic ventricular tachycardia/ventricular fibrillation induced by herbal medication used for obesity. Int J Cardiol 2006;106:260-1. View abstract.

Carbajal R, Yisfalem A, Pradhan N, et al. Case report: Boldo (Peumus boldus) and tacrolimus interaction in a renal transplant patient. Transplant Proc 2014;46(7):2400-2. View abstract.

Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182

Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.

Lambert J, Cormier J. Potential interaction between warfarin and boldo-fenugreek. Pharmacotherapy 2001;21:509-12. View abstract.

Monzon S, Lezaun A, Saenz D, et al. Anaphylaxis to boldo infusion, a herbal remedy. Allergy 2004;59:1019-20. View abstract.

Piscaglia F, Leoni S, Venturi A, et al. Caution in the use of boldo in herbal laxatives: a case of hepatotoxicity. Scand J Gastroenterol 2005;40:236-9. View abstract.