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Uva ursi (Arctostaphylos uva-ursi)
Natural Standard Bottom Line Monograph, Copyright © 2011 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
Arberry, arbusier (French), arbutin, Arbutus uva ursi, arctostaphylos, Arctostaphylos adenotricha, Arctostaphylos coactilis, Arctostaphylos coactylis, Arctostaphylos uva-ursi, arctuvan, barentraube (German), bearberry, bear grape, bear's grape, bearsgrape, beerendruif (Holland), bousserole (French), common bearberry, common beargrape, coralillo (Spanish), creeping manzanita, crowberry, Cystinol akut®, Dunih'tan (Carrier people), Ericaceae (family), foxberry, gayuba (Spanish), hog berry, hydroquinone, kanya'ni, kwica (American Indian), kinnikinnick (American Indian), macnicy (Polish), manzanita, mealberry, mehlberre (German), melbaerblad (Norweigan), melbarrisblade (Danish), methyl arbutin, mjolonrisblad (Swedish), mossberre (German), mountain box, mountain cranberry, phenolic glycoside, ptarmigan berry, raisin d'ours (French), redberry, red bearberry, rock berry, rockberry, sagsckhomi (American Indian), sand berry, sandberry, Solvefort, s'qaya'dats, tannin, toloknianka (Russian), upland cranberry, Uroflux, uva d'orso (Italian), UVA-E, Uvae ursi folium, Uvalyst, uva-ursi, uva ursi leaf, whortle berry, wilder Buchsbaum (German), Wolfstraube (German).
Uva ursi (bearberry) is described as a small evergreen shrub with clusters of small white or pink bell-shaped flowers and dull orange berries. Although the berries do not seem to possess any medicinal benefits, the leaves have been used traditionally as an herbal remedy for mild, uncomplicated cystitis (inflammation of the bladder).
Grown throughout Asia, North America and Europe, uva ursi has a long history of medicinal use dating back to the 13th century. The leaves have been used worldwide as a diuretic, astringent, antiseptic and a treatment for urinary tract infections (UTIs). A tea brewed with the leaves has also been used as a laxative.
Arbutin, the main chemical constituent of uva ursi, is a phenolic glycoside that becomes hydrolyzed to hydroquinone. Both chemicals contribute to the antiseptic effects in the urinary tract. Arbutin alone has been reported to relieve pain from kidney stones, cystitis (bladder infection) and nephritis (kidney inflammation). However, due to its high tannin content, uva ursi may cause acute nausea and intestinal irritation.
Uva ursi leaf was listed on the U.S. National Formulary as a urinary antiseptic from 1820 to 1950 but it is no longer listed in the United States Pharmacopoeia. The European Scientific Cooperative on Phytotherapy (ESCOP) lists uva ursi as a treatment for uncomplicated cystitis where antibiotics are not warranted. The German Commission E Monographs recommend it for inflammatory conditions of the lower urinary tract.
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.
The chemical constituents of the herbal product uva ursi have been used for a variety of conditions such as chloasma, a skin condition that appears as a blotchy, brownish discoloration on the skin, especially the face. Females are usually targeted for the condition because it occurs as a result of oral contraception use, or during pregnancy or menopause. The clinical usefulness of uva ursi has not been well established in the current literature.
Urinary tract infection (UTI)
Uva ursi has long been used as a folk remedy to treat urinary tract infection. The active ingredients in the herb are believed to be ursolic acid and isoquercitrin. Additional study is needed to make a strong recommendation.
*Key to grades:
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. 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 health care professional.
- Allergic reactions, antimicrobial, antiseptic, arthritis, astringent, benign prostate hyperplasia (enlarged prostate), bronchitis, child-birth cramps, catarrh (inflammation of the mucous membrane), cystitis (chronic), dermatitis, diabetes, diuretic, dysentery (severe diarrhea) (astringent), dysmenorrhea (painful menstruation), flavoring agent, gonorrhea (antiseptic), hematuria (blood in the urine), hypertension (high blood pressure), incontinence (mild), kidney disease, kidney infection (pyelonephritis), kidney stones (pain), kidney stone prevention, laxative, leukorrhea (vaginal discharge) (antiseptic), menorrhagia (heavy menstrual bleeding), menopause (tension, edginess), nephritis (inflammation of the kidney), postpartum hemorrhage, prostatitis (inflammation of the prostate), tonic, urethritis (inflammation of the urethra), vaginal ulceration (antiseptic), weight loss.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
There is no proven safe or effective dose for uva ursi. Cystinol akut® is one brand that has been studied. A typical dose taken by mouth is 3 grams of uva ursi (or 400-800 milligrams of hydroquinone derivatives) steeped in water and taken as a tea, or taken in powder form, four times a day for inflammatory conditions. For urinary tract infection (UTI), 250-500 milligrams of uva ursi powdered extract (20% arbutin) has been taken three times a day (for no more than four days). When applied on the skin, a 2% or 5% hydroquinone cream has been used for hyperpigmentation. A topical preparation containing 3% arbutin (glycoside in uva ursi) over a 12-week period has also been used.
Children (younger than 18 years)
There is no proven safe or effective dose of uva ursi in children, and use is not recommended.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid in individuals with a known allergy or hypersensitivity to Arctostaphylos uva-ursi or its constituents.
Side Effects and Warnings
Uva ursi is generally well tolerated in short-term, traditional doses, but available human trial data is limited. Uva ursi may cause tachycardia (fast heartbeat), cardiac arrhythmias (abnormal heart rate), skin irritations, nausea, vomiting, diarrhea, stomach upset, greenish-brown urine color, irritation and inflammation of the urinary tract mucous membranes, hepatotoxicity (liver damaging), insomnia, convulsions, seizures, irritability, motor restlessness, cyanosis (bluish skin discoloration due to lack of oxygen in the blood), headaches, shortness of breath, or tinnitus (ringing in the ears).
Long-term ingestion of uva ursi has caused bilateral bull's-eye maculopathy, and may be considered a potential retinal toxic herb. Use cautiously in patients with renal (kidney) or hepatic (liver) dysfunction, due to risk of inflammation of the urinary tract and hepatoxicity. Avoid in patients with kidney disease. Use cautiously in patients with gastrointestinal distress because the preparation can be irritating to the mucous membrane of the stomach and the intestine due to high amounts of tannins. Use cautiously in patients taking diuretics, which may promote electrolyte imbalance. Use cautiously in patients suffering from gallstones.
Pregnancy and Breastfeeding
Uva ursi is not recommended in pregnant or breastfeeding women due to a lack of sufficient available evidence. Large amounts of uva ursi may induce labor.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Uva ursi may increase the inhibitory effect of prednisolone on swelling. The arbutin in uva ursi may potentiate the effects of prednisolone and dexamethasone on contact dermatitis. Caution is advised when using uva ursi with corticosteroids (steroids).
Uva ursi may increase urine flow, and may interact with other agents that increase urine flow (diuretics).
The arbutin in uva ursi may increase the anti-inflammatory activity of indomethacin on contact dermatitis, hypersensitivity, and arthritis. Caution is advised when taking uva ursi with non-steroidal anti-inflammatory drugs (NSAIDs) due to theoretical interactions.
Concomitant use of uva ursi and urine acidifiers may result in decreasing the effects of uva ursi.
Concomitant use of uva ursi and products that can alkalinize the urine can enhance the antibacterial activity of uva ursi.
Interactions with Herbs and Dietary Supplements
Combination of uva ursi and aloesin inhibits tyrosinase activity in a synergistic manner by combined mechanisms of noncompetitive and competitive inhibitions.
Herbs containing arbutin, a constituent of uva ursi, may result in increases in serum and urinary levels of hydroquinone and its metabolites. Arbutin is found in sweet marjoram, damiana, and other herbs.
Uva ursi may increase urine flow, and interact with other herbs and supplements with diuretic effects.
Concomitant use of uva ursi and products that can acidify the urine (e.g., vitamin C) can potentially reduce the antibacterial activity of uva ursi.
Concomitant use of uva ursi and products that can alkalinize the urine may enhance the antibacterial activity of uva ursi.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
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.
- Beaux D, Fleurentin J, Mortier F. Effect of extracts of Orthosiphon stamineus Benth, Hieracium pilosella L., Sambucus nigra L. and Arctostaphylos uva-ursi (L.) Spreng. in rats. Phytother Res 1999;13(3):222-225. View Abstract
- Chakraborty AK, Funasaka Y, Komoto M, et al. Effect of arbutin on melanogenic proteins in human melanocytes. Pigment Cell Res 1998;11(4):206-212. View Abstract
- Chung YK, Heo HJ, Kim EK, et al. Inhibitory effect of ursolic acid purified from Origanum majorana L on the acetylcholinesterase. Mol Cells 2001;11(2):137-143. View Abstract
- Deisinger PJ, Hill TS, English JC. Human exposure to naturally occurring hydroquinone. J Toxicol Environ Health 1996;47(1):31-46. View Abstract
- Hsu HY, Yang JJ, Lin CC. Effects of oleanolic acid and ursolic acid on inhibiting tumor growth and enhancing the recovery of hematopoietic system postirradiation in mice. Cancer Lett 1997;111(1-2):7-13. View Abstract
- Jin YH, Lee SJ, Chung MH, et al. Aloesin and arbutin inhibit tyrosinase activity in a synergistic manner via a different action mechanism. Arch Pharm Res 1999;22(3):232-236. View Abstract
- Kashiwada Y, Nagao T, Hashimoto A, et al. Anti-AIDS agents 38. Anti-HIV activity of 3-O-acyl ursolic acid derivatives. J Nat Prod 2000;63(12):1619-1622. View Abstract
- Kruszewska H, Zareba T, Tyski S. Examination of antimicrobial activity of selected non-antibiotic drugs. Acta Pol Pharm 2004;61 Suppl:18-21. View Abstract
- Parejo I, Viladomat F, Bastida J, et al. A single extraction step in the quantitative analysis of arbutin in bearberry (Arctostaphylos uva-ursi) leaves by high-performance liquid chromatography. Phytochem Anal 2001;12(5):336-339. View Abstract
- Quintus J, Kovar KA, Link P, et al. Urinary excretion of arbutin metabolites after oral administration of bearberry leaf extracts. Planta Med 2005;71(2):147-152. View Abstract
- Schindler G, Patzak U, Brinkhaus B, et al. Urinary excretion and metabolism of arbutin after oral administration of Arctostaphylos uvae ursi extract as film-coated tablets and aqueous solution in healthy humans. J Clin Pharmacol 2002;42(8):920-927. View Abstract
- Shimizu M, Shiota S, Mizushima T, et al. Marked potentiation of activity of beta-lactams against methicillin-resistant Staphylococcus aureus by corilagin. Antimicrob Agents Chemother 2001;45(11):3198-3201. View Abstract
- Siegers C, Bodinet C, Ali SS, et al. Bacterial deconjugation of arbutin by Escherichia coli. Phytomedicine 2003;10 Suppl 4:58-60. View Abstract
- Wang L, Del Priore LV. Bull's-eye maculopathy secondary to herbal toxicity from uva ursi. Am J Ophthalmol 2004;137(6):1135-1137. View Abstract
- Yarosh DB, Both D, Brown D. Liposomal ursolic acid (merotaine) increases ceramides and collagen in human skin. Horm Res 2000;54(5-6):318-321. View Abstract
Copyright © 2011 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.