There is no proven safe or effective dose for bupleurum. Bupleurum is typically taken in combination formulas with other herbs, and has not been well studied alone. Traditionally, 1.5-9 grams of bupleurum root have been used per day. Also, 1.5-3 milliliters of a fluid extract have been used daily. For hepatitis, doses of 5.4 grams of combination therapy sho-saiko-to daily have been studied for 12 weeks. For prevention of hepatocellular carcinoma, sho-saiko-to has been administered at a dose of 7.5 grams daily in combination with conventional treatment.
There is no proven safe or effective dose for bupleurum in children, and use is not recommended. Bupleurum is typically taken in combination formulas with other herbs, and has not been well studied alone.
Avoid in individuals with a known allergy or hypersensitivity to Bupleurum species, any of its constituents, the Apiaceae or Umbelliferae (carrot) families, snakeroot, cow parsnip, or poison hemlock. There are some reports that mention allergic reactions occurring in patients given intramuscular injections of bupleurum.
In recommended doses, many practitioners agree that bupleurum is well tolerated. However, available safety data is lacking. Reports of adverse effects are largely theoretical and based on side effects from combination therapy; it is difficult to attribute the adverse effects to bupleurum alone.
Reported side effects include decreased appetite, nausea, reflux, abdominal distension, gas, and increased bowel movements following large doses of bupleurum. Rare instances of nausea, loss of appetite, and abdominal fullness have been reported following treatment with the combination therapy sho-saiko-to. Combinations containing bupleurum have been associated with eosinophilic pneumonia, pulmonary edema, and multiple cases of pneumonitis (inflammation of the lungs). Use cautiously in patients with hypertension (high blood pressure), diabetes, or edema, due to possibility of adrenal stimulation.
There have been unverified reports of sedation, drowsiness, and lethargy, which are noted as frequent side effects. Rare instances of fatigue and paresthesia (abnormal sensations) were noted in one study that investigated the combination therapy sho-saiko-to. Use cautiously in patients operating motor vehicles or hazardous machinery, due to a possible risk of sedation.
Although not well studied in humans, bupleurum may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Use cautiously in patients with diabetes. Saikosaponins, constituents of Bupleurum, may increase blood sugar levels.
Bupleurum is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.