Gotu Kola - Uses and Side Effects

Gotu kola has been widely used to treat a variety of illnesses, especially in traditional Eastern medicine. It's derived from the leaves, stem, and aerial parts of Centella asiatica. Gotu kola contains madecassol, madecassic acid, asiatic acid, asiaticentoic acid, centellic acid, centoic acid, isothankuniside, flavonoids including quercetin and kaempferol, and various glycosides such as asiaticoside, brahminoside, brahmoside, centelloside, and madecassoid. It also contains fatty acids, amino acids, phytosterols, and tannin.

Asiaticoside promotes wound healing, brahminoside and brahmoside possess sedative properties, and madecassoid exerts anti-inflammatory action. Gotu kola is available as ampules, capsules, ointment, powder, tablets, tinctures, and extract. Common trade names include Centalase, Centasium, Emdecassol, Gotu Kola Gold Extract, Gotu Kola Herb, and Madecassol.

Reported uses

Gotu kola is used for its anticarcinogenic, antifertility, and antihypertensive effects. It's also used to treat chronic venous in sufficiency, chronic hypertension, and chronic hepatic disorders. Gotu kola is used topically to treat psoriasis and burns and to promote wound healing in patients with chronic lesions such as cutaneous ulcers, leprosy sores, fistulas, and Surgical and gynecologic wounds.

Administration

Capsules: 400 to 500 mg by mouth every day

Creams, ointments: Applied to affected area every day, up to two times a day

Dried leaves: 0.6 g of dried leaves or infusion by mouth three times a day

Standardized extract (40% asiaticoside, 29% to 30% asiatic acid and madecassic acid, respectively, and 1 % to 2% madecassoside): 20 to 40 mg by mouth three times a day.

Hazards

Adverse effects associated with gotu kola include sedation with higher doses, hy­percholesterolemia, hyperglycemia, con­tact dermatitis, burning, and pruritus. The plant extracts appear to have very lit­tle toxicity, although hypersensitivity re­actions may still occur. Large doses of gotu kola may interfere with the effect of hypoglycemics. Large doses of gotu kola may interfere with the effect of choles­terol-lowering drugs.

Pregnant patients, breast-feeding patients, young children, and patients with severe renal or hepatic disease should avoid use. Patients with a history of contact dermatitis should use with caution.

Safety Risk Do not confuse gotu kola with kola or kola plant. They are different plants. The latter species has stimulant activities.

Clinical considerations

Topical asiaticoside may cause cancer.

Monitor patient for CNS depression, including drowsiness and increased sleep time.

Monitor blood glucose and serum cholesterol levels with long-term use.

Warn patient about potential for sedation. Advise him to avoid driving until he knows how the herb affects him.

If patient is using the herb for contra­ception, recommend another method.

Recommend that patient not use the herb for more than 6 weeks at a time.

Tell patient to take capsules with meals.

Advise patient to report planned or suspected pregnancy.

Tell patient to notify pharmacist of any herbal or dietary supplement that he's taking when obtaining a new prescription.

Advise patient to consult his health care provider before using an herbal preparation because a conventional treat­ment with proven efficacy may be avail­able.

Research summary

Studies support claims for gotu kola's ef­ficacy in wound healing, topical uses for psoriasis, antihypertensive effects, effects on varicose veins, and chronic hepatic disorders.