| Gotu kola has been widely used to treat a variety of | | | | pruritus. The plant extracts appear to have very |
| illnesses, especially in traditional Eastern medicine. It's | | | | little toxicity, although hypersensitivity |
| derived from the leaves, stem, and aerial parts of | | | | reactions may still occur. Large doses of gotu |
| Centella asiatica. Gotu kola contains madecassol, | | | | kola may interfere with the effect of hypoglycemics. |
| madecassic acid, asiatic acid, asiaticentoic acid, centellic | | | | Large doses of gotu kola may interfere with the |
| acid, centoic acid, isothankuniside, flavonoids including | | | | effect of cholesterol-lowering drugs. |
| quercetin and kaempferol, and various glycosides such | | | | Pregnant patients, breast-feeding patients, young |
| as asiaticoside, brahminoside, brahmoside, centelloside, | | | | children, and patients with severe renal or hepatic |
| and madecassoid. It also contains fatty acids, amino | | | | disease should avoid use. Patients with a history of |
| acids, phytosterols, and tannin. | | | | contact dermatitis should use with caution. |
| Asiaticoside promotes wound healing, brahminoside | | | | Safety Risk Do not confuse gotu kola with kola or kola |
| and brahmoside possess sedative properties, and | | | | plant. They are different plants. The latter species has |
| madecassoid exerts anti-inflammatory action. Gotu | | | | stimulant activities. |
| kola is available as ampules, capsules, ointment, | | | | Clinical considerations |
| powder, tablets, tinctures, and extract. Common trade | | | | Topical asiaticoside may cause cancer. |
| names include Centalase, Centasium, Emdecassol, | | | | Monitor patient for CNS depression, including |
| Gotu Kola Gold Extract, Gotu Kola Herb, and | | | | drowsiness and increased sleep time. |
| Madecassol. | | | | Monitor blood glucose and serum cholesterol levels |
| Reported uses | | | | with long-term use. |
| Gotu kola is used for its anticarcinogenic, antifertility, | | | | Warn patient about potential for sedation. Advise him |
| and antihypertensive effects. It's also used to treat | | | | to avoid driving until he knows how the herb affects |
| chronic venous in sufficiency, chronic hypertension, and | | | | him. |
| chronic hepatic disorders. Gotu kola is used topically to | | | | If patient is using the herb for contraception, |
| treat psoriasis and burns and to promote wound | | | | recommend another method. |
| healing in patients with chronic lesions such as | | | | Recommend that patient not use the herb for more |
| cutaneous ulcers, leprosy sores, fistulas, and Surgical | | | | than 6 weeks at a time. |
| and gynecologic wounds. | | | | Tell patient to take capsules with meals. |
| Administration | | | | Advise patient to report planned or suspected |
| Capsules: 400 to 500 mg by mouth every day | | | | pregnancy. |
| Creams, ointments: Applied to affected area every | | | | Tell patient to notify pharmacist of any herbal or |
| day, up to two times a day | | | | dietary supplement that he's taking when obtaining a |
| Dried leaves: 0.6 g of dried leaves or infusion by mouth | | | | new prescription. |
| three times a day | | | | Advise patient to consult his health care provider |
| Standardized extract (40% asiaticoside, 29% to 30% | | | | before using an herbal preparation because a |
| asiatic acid and madecassic acid, respectively, and 1 % | | | | conventional treatment with proven efficacy may |
| to 2% madecassoside): 20 to 40 mg by mouth three | | | | be available. |
| times a day. | | | | Research summary |
| Hazards | | | | Studies support claims for gotu kola's efficacy in |
| Adverse effects associated with gotu kola include | | | | wound healing, topical uses for psoriasis, |
| sedation with higher doses, hypercholesterolemia, | | | | antihypertensive effects, effects on varicose veins, |
| hyperglycemia, contact dermatitis, burning, and | | | | and chronic hepatic disorders. |