PLANTAIN

Botanical names: Plantago lanceolata, Plantago major

Parts used and where grown: These green, weedy plants are native to Europe and Asia, but now grow practically anywhere in the world where there is sufficient water. Plantain should not be confused with the banana-like vegetable of the same name. The leaves of plantain are primarily used as medicine. The seeds of plantain can also be used medicinally, having mild laxative effects similar to the seeds of psyllium, a close relative of plantain.

Plantain has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating	Health Concerns
	Chronic bronchitis
	Burns (topical) Cough Dermatitis (topical) Insect bites or stings (topical) Peptic ulcer Urinary tract infections Wounds (topical)
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Historical or traditional use (may or may not be supported by scientific studies): Plantain has long been considered by herbalists to be a useful remedy for cough, wounds, inflamed skin or dermatitis, and insect bites.¹ Bruised or crushed leaves have been applied topically to treat insect bites and stings, eczema, and small wounds or cuts. It was considered by herbalists to be a gentle, soothing expectorant, and additionally to have a mild astringent effect said to help remedy hemorrhoids or bladder infections with mild amounts of blood in the urine.²

Active constituents: The major constituents in plantain are mucilage, iridoid glycosides (particularly aucubin), and tannins. Together these constituents are thought to give plantain mild anti-inflammatory, antimicrobial, antihemorrhagic, and expectorant actions.^{3 4} Plantain is approved by the German Commission E for internal use to ease coughs and mucous membrane irritation associated with upper respiratory tract infections as well as topical use for skin inflammations.⁵ Two Bulgarian clinical trials have suggested that plantain may be effective in the treatment of chronic bronchitis.^{6 7} Insufficient details were provided in these reports to determine the quality of the trials or their findings. Although plantain was thought to possess diuretic properties, one double-blind trial failed to show any diuretic effect for this plant.⁸ A preliminary trial found that topical use of a plantain ointment (10% ground plantain in a base of petroleum jelly) was helpful as part of the treatment of people with impetigo and ecthyma, two inflammatory skin disorders.⁹ Insufficient details were provided in this report, however, to determine the quality of the study or its findings.

How much is usually taken? The German Commission E recommends using 1/4–1/2 teaspoon (1–3 grams) of the leaf daily in the form of tea made by steeping the herb in 1 cup (250 ml) of hot water for 10–15 minutes (making three cups (750 ml ) per day).¹⁰ The fresh leaves can be applied directly three or four times per day to minor injuries, dermatitis, and insect stings.¹¹ Syrups or tinctures, approximately 1/2 teaspoon (2–3 ml) three times per day, can also be used, particularly to treat a cough.¹² Finally, 1/2–1 1/4 teaspoons (2–6 grams) of the fresh plant can be juiced and taken in three evenly divided oral administrations throughout the day.¹³

Are there any side effects or interactions? Plantain is not associated with any common side effects and is thought to be safe for children.¹⁴ There is no information available about its use by pregnant or nursing women, though topical application appears to be safe. Adulteration of plantain with digitalis leading to dangerous side effects has been reported in Switzerland and the United States.¹⁵ Although rare, it points to the need for consumers to purchase herbs from companies that carefully test their herbal products for adulteration.

At the time of writing, there were no well-known drug interactions with plantain.

1. Weiss RF. Meuss AR (trans). Herbal Medicine. Gothenberg, Sweden: Ab Arcanum and Beaconsfield: Beaconsfield Publishers Ltd., 1985, 198–9.

2. Hoffmann D. The New Holistic Herbal, 3rd ed. Shaftesbury, Dorset, UK: Element, 1990, 224.

3. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 186–7.

4. Wichtl M, Bisset N (eds). Herbal Drugs and Phytopharmaceuticals. Stuttgart: Medpharm Scientific Publishers and Boca Raton, FL: CRC Press, 1994, 378–81.

5. Blumenthal M, Busse WR, Goldberg A, et al (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 186–7.

6. Koichev A. Complex evaluation of the therapeutic effect of a preparation from Plantago major in chronic bronchitis. Probl Vatr Med 1983;11:61–9.

7. Matev M, Angelova I, Koichev A, et al. Clinical trial of Plantago major preparation in the treatment of chronic bronchitis. Vutr Boles 1982;21:133–7 [In Bulgarian].

8. Doan DD, Nguyen NH, Doan HK, et al. Studies on the individual and combined diuretic effects of four Vietnamese traditional herbal remedies (Zea mays, Imperata cylindrica, Plantago major and Orthosiphon stamineus). J Ethnopharmacol 1992;36:225–31.

9. Aliev RK. A wound healing preparation from the leaves of the large plantain (Plantago major L). Am J Pharm 1950;122:24–6.

10. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 186–7.

11. Weiss RF. Meuss AR (trans). Herbal Medicine. Gothenberg, Sweden: Ab Arcanum and Beaconsfield: Beaconsfield Publishers Ltd., 1985, 198–9.

12. Hoffmann D. The New Holistic Herbal, 3rd ed. Shaftesbury, Dorset, UK: Element, 1990, 224.

13. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 186–7.

14. Schilcher H. Phytotherapy in Paediatrics: Handbook for Physicians and Pharmacists. Stuttgart: Medpharm Scientific Publishers, 1997, 33.

15. Blumenthal M (ed). Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications, 2000, 307–10.

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