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Coleus (generic name)

treats Breathing aid for intubation, Cardiomyopathy, Glaucoma, Erectile dysfunction, Depression and schizophrenia, Asthma, Anti-inflammatory ac...
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Alternate Title

Coleus forskohlii

Category

Herbs & Supplements

Synonyms

Coleon U-quinone coleus, coleonol, Coleus amboinicus Lour (CA), Coleus barbatus Benth, Coleus blumei, Coleus blumei Benth, Coleus carnosifolius, Coleus galeatus, Coleus kilimandschari, Coleus parvifolius, Coleus scutellarioides, coleus solenostemon rotundifolius, Coleus xanthanthus, colforsin, colforsin daropate hydrochloride, forscolin, forskoditerpenoside A, forskoditerpenoside B, forskolin, forskolin G, forskolin H, HL 362, FSK88, Labiatae (family), Lamiaceae (family), L-75-1362B, NKH477, Plectranthus barbat us, Plectranthus forskohlii, rosmarinic acid, rosmarinic acid, xanthanthusin E, xanthanthusins F-K.

Background

Coleus species have been used in the Asian traditional medicine to treat angina, asthma, bronchitis, epilepsy, insomnia, skin rashes, and a wide range of digestive problems. Since the 1970s, research was predominantly concentrated on forskolin, a root extract of Coleus forskohlii. Early study suggests that forskolin may have clinical use in treating heart, lung and eye conditions.

Although most studies have used the isolated forskolin extract, it is believed that the whole coleus plant may be more effective, due to the presence of multiple compounds that may act synergistically. Generally, coleus appears to be well tolerated with few adverse effects.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Asthma: There is a lack of sufficient data to recommend for or against the use of coleus in the treatment of bronchial asthma.
Grade: B

Cardiomyopathy: Forskolin may improve heart function in patients with cardiomyopathy. However, additional study is needed to confirm these findings.
Grade: B

Glaucoma: Some evidence suggests that coleus improves glaucoma. More studies are needed.
Grade: B

Anti-inflammatory action after cardiopulmonary bypass: There is a lack of sufficient data to recommend for or against the use of coleus, to patients recovering after cardiopulmonary bypass, for its anti-inflammatory effects.
Grade: C

Breast milk stimulant: Coleus has been used as a breast milk stimulant for hundreds of years, however, the traditional use has not been well documented and scientific evidence is limited.
Grade: C

Breathing aid for intubation: Pretreatment with coleus before intubation may be beneficial, especially for middle-aged smokers. More research is needed.
Grade: C

Depression and schizophrenia: Limited evidence suggests that coleus may be useful in the management of depression or schizophrenia.
Grade: C

Erectile dysfunction: Forskolin may enhance smooth muscle relaxation. More study is needed to assess the use of coleus in the treatment of erectile dysfunction.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Abdominal colic, abdominal cramps, abortion, allergies, angina (chest pain), anti-HIV 1, antioxidant, atherosclerosis (hardening of the arteries), atopic dermatitis, autoimmune diseases, bladder infection, bladder pain, bloating, bronchitis, cancer, cataract, cerebral vascular insufficiency, circulatory tonic, congestive heart failure, convulsions, diabetes, digestion, dysmenorrhea (painful menstruation), eczema, epilepsy, gas, gastric diseases, high blood pressure, hypothyroidism (underactive thyroid), immunostimulant, inflammatory disease, insomnia, irritable bowel syndrome (IBS), ischemic heart disease, liver diseases, malabsorption, menstrual cramps, metastatic cancer, obesity, painful urination, peptic ulcer, poor sperm motility, psoriasis (chronic skin disease), skin rashes, spasmolytic spastic colon, stroke, thrombosis (blood clots), urinary tract infection (UTI), weight-loss, worms.

Dosing

Adults (18 years and older)

There is no proven safe or effective dose for coleus. Many natural medicine experts recommend 50 milligrams of coleus extract (18% forskolin), taken 1-3 times daily by mouth, although the safety or efficacy of these doses has not been demonstrated. A dose of 250 milligrams of less-concentrated coleus extract (1% forskolin) taken 1-3 times daily has also been commonly used. As a dried root, 6-12 grams daily has been used, and as a fluid extract, 6-12 milliliters daily has been used.

Colforsin daropate 0.5-0.75mcg/kg-1/min-1 has been used for its anti-inflammatory action after cardiopulmonary bypass and to aid in airway resistance after tracheal intubation. Although coleus has been studied for depression, schizophrenia, cardiomyopathy and glaucoma, no commercially available products have been proven safe for these uses.

Children (younger than 18 years)

There is no proven safe or effective dose for coleus in children.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to Coleus forskohlii and related species. Rash may occur in sensitive individuals.

Side Effects and Warnings

Coleus is generally regarded as safe, although long-term safety data are lacking. Inhalation of forskolin may cause sore throat, upper respiratory tract irritation, mild to moderate cough, tremor, or restlessness. Coleus eye drops may produce a milky covering over the eyes.

Coleus may lower blood sugar and stimulate the thyroid gland. Use cautiously in patients with thyroid disorders. Also use cautiously in diabetic patients. Colenol, a compound isolated from coleus, stimulates insulin release.

Theoretically, coleus may increase the risk of bleeding. Use cautiously in patients with a history of bleeding, hemostatic disorders or drug-related hemostatic problems. Discontinue use in patients at least two weeks prior to surgical or dental procedure, due to risk of bleeding. Avoid use in patients with active bleeding.

Use cautiously in patients with low blood pressure or those at risk for hypotension. Also use cautiously in patients with heart disease or asthma.

Avoid during pregnancy due to possibility of abortifacient (abortion inducing) effects.

Pregnancy and Breastfeeding

Coleus is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. It is unknown if coleus is excreted in the breast milk.

Interactions

Interactions with Drugs

When used with other blooding thinning agents, such as aspirin, ibuprofen, and naproxen, coleus may increase the risk of bleeding.

Although not well studied in humans, forskolin may interact with antidepressants, antihistamines, blood pressure altering agents, asthma medications, beta-blockers, inotropic agents or thyroid medications. It may also interact with drugs used for cancer and weight loss, or drugs that are processed through the liver.

Coleus should be used cautiously when taken concurrently with agents that are dependent on pH and gastric action for breakdown and activation such as newer cephalosporin antibiotics, itraconazole, ketoconazole, and warfarin.

Although not well studied in humans, topical forskolin may significantly reduce intra-ocular pressure (IOP). When used with other medications that decrease IOP, it may result in additive effects.

Colenol, a compound isolated from coleus, stimulates insulin release and its use with blood sugaring lowering agents or exogenous insulin may result in additive effects.

Interactions with Herbs and Dietary Supplements

When used with other blooding thinning herbs or supplements, such as Ginkgo biloba and garlic, coleus may increase the risk of bleeding.

Although not well studied in humans, forskolin may interact with antidepressants, antihistamines, blood pressure altering agents, asthma agents, heart agents, inotropic agents or thyroid medications. It may also interact with herbs or supplements used for cancer and weight loss, or drugs that are processed through the liver.

Although not well studied in humans, topical forskolin may significantly reduce intra-ocular pressure (IOP). When used with other herbs or supplements that decrease IOP, it may result in additive effects.

Colenol, a compound isolated from coleus, stimulates insulin release, and its use with blood sugar lowering herbs or supplements, such as bitter melon, may result in additive effects.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Rae Abrams, PharmD (University of Rhode Island); Chi Dam, PharmD (Northeastern University); Cathy DeFranco Kirkwood, MPH, CCCJS-MAC (MD Anderson Cancer Center); Dana A. Hackman, BS (Northeastern University); Jo Hermans, PhD (University of Leiden, the Netherlands); Tamara Milkin, PharmD (Northeastern University); Phuong Ngo, PharmD (Massachusetts College of Pharmacy); Erica Seamon, PharmD (Nova Southeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration); Lisa Wendt, PharmD (Albany College of Pharmacy); Jen Woods, BS (Northeastern University).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

al Sereiti MR, Abu-Amer KM, Sen P. Pharmacology of rosemary (Rosmarinus officinalis Linn.) and its therapeutic potentials. Indian J Exp Biol 1999;37(2):124-130.

Almeida FC, Lemonica IP. The toxic effects of Coleus barbatus B. on the different periods of pregnancy in rats. J Ethnopharmacol 2000;73(1-2):53-60.

Bersudsky Y, Kotler M, Shifrin M, et al. A preliminary study of possible psychoactive effects of intravenous forskolin in depressed and schizophrenic patients. Short communication. J Neural Transm 1996;103(12):1463-1467.

Bryld LE. Airborne contact dermatitis from Coleus plant. Am J Contact Dermat 1997;8(1):8-9.

Cahn D, Melman A, Valcic M, et al. Forskolin: a promising new adjunct to intracavernous pharmacotherapy. J Urol 1996;155(5):1789-1794.

Hayashida N, Chihara S, Tayama E, et al. Antiinflammatory effects of colforsin daropate hydrochloride, a novel water-soluble forskolin derivative. Ann Thorac Surg 2001;71(6):1931-1938.

Ishikawa Y. Isoform-targeted regulation of cardiac adenylyl cyclase. J Cardiovasc Pharmacol 2003;41 Suppl 1:S1-S4.

Maeda H, Ozawa H, Saito T, et al. Potential antidepressant properties of forskolin and a novel water- soluble forskolin (NKH477) in the forced swimming test. Life Sci 1997;61(25):2435-2442.

Maeda N, Tamagawa T, Niki I, et al. Increase in insulin release from rat pancreatic islets by quinolone antibiotics. Br J Pharmacol 1996;117(2):372-376.

Mei SX, Jiang B, Niu XM, et al. Abietane diterpenoids from Coleus xanthanthus. J Nat Prod 2002;65(5):633-637.

Mulhall JP, Daller M, Traish AM, et al. Intracavernosal forskolin: role in management of vasculogenic impotence resistant to standard 3-agent pharmacotherapy. J Urol 1997;158(5):1752-1758.

Tewtrakul S, Miyashiro H, Nakamura N, et al. HIV-1 integrase inhibitory substances from Coleus parvifolius. Phytother Res 2003;17(3):232-239.

Wajima Z, Shiga T, Yoshikawa T, et al. Effect of prophylactic bronchodilator treatment with intravenous colforsin daropate, a water-soluble forskolin derivative, on airway resistance after tracheal intubation. Anesthesiology 2003;99(1):18-26.

Yanagihara H, Sakata R, Shoyama Y, et al. Rapid analysis of small samples containing forskolin using monoclonal antibodies. Planta Med 1996;62(2):169-172.

Yousif MH, Thulesius O. Forskolin reverses tachyphylaxis to the bronchodilator effects of salbutamol: an in-vitro study on isolated guinea-pig trachea. J Pharm Pharmacol 1999;51(2):181-186.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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