Aloes folii succus siccatus

Aloes is the common name for the dried juice of leaves from the plants Aloe barbadensis Miller and Aloe (various species, mainly Aloe ferox Mill. and its hybrids).

The HMPC conclusions only cover aloes preparations which are obtained by cutting the leaf near the base to allow the juice to flow out. The dried juice is put in a water to dissolve compounds and form a liquid extract. The water is then evaporated to obtain a dry extract.

Herbal medicines containing this aloes preparation are usually available in solid and liquid forms to be taken by mouth.

Aloes preparations may also be found in combination with other herbal substances in some herbal medicines. These combinations are not covered in this summary.

The HMPC concluded that aloes preparations can be used short-term to treat occasional constipation.

Aloes medicines should only be used in adults and adolescents over the age of 12 years and should not be taken for longer than 1 week. If constipation continues or worsens whilst taking the medicine, a doctor or a pharmacist should be consulted. Detailed instructions on how to take aloes medicines and who can use them can be found in the package leaflet that comes with the medicine.

Aloes medicines contain anthranoids. The way aloes works is not fully known, but it is thought from laboratory studies that the anthranoids may stimulate peristalsis (wave-like movements) of the muscle wall in the large intestine and so push the stool forward. It may also increase the amount of water in the gut and so soften the stool, allowing it to pass along the gut more easily.

The HMPC conclusions on the use of these aloes medicines for constipation are based on their 'well-established use'. This means that there are bibliographic data providing scientific evidence of their effectiveness and safety when used in this way, covering a period of at least 10 years in the EU.

In its assessment, the HMPC based their conclusions on laboratory studies with aloes and clinical studies with other anthranoid-containing laxatives such as senna leaf preparations showing a positive effect on constipation.

For detailed information on the studies assessed by the HMPC, see the HMPC assessment report.

Allergic reactions to aloes medicines may occur. Side effects reported with aloes medicines include stomach and gut disorders such as abdominal (belly) pain and spasm with liquid stools, particularly in patients with irritable colon. These symptoms may be due to a too high dose and in these cases the dose should be reduced. Long-term use may cause colouration of the lining of the gut which usually returns to normal when the patient stops the medicine.

Long-term use of aloes medicines may lead to water and salt imbalance and may result in albumin (a protein) and blood in the urine. Yellow or red-brown discolouration of urine may occur during treatment.

Aloes medicines must not be taken by patients with gut obstructions or stenosis (narrowing), atony (lack of normal muscle movement), appendicitis, inflammatory bowel diseases (such as Crohn's disease or ulcerative colitis), unexplained abdominal (belly) pain or severe dehydration. They must also not be taken during pregnancy or breastfeeding and by children under 12 years of age.

Further information on the risks associated with these aloes medicines, including the appropriate precautions for their safe use, can be found in the monograph under the tab 'All documents'.

Any applications for the licensing of medicines containing aloes have to be submitted to the national authorities responsible for medicinal products, which will assess the application for the herbal medicine and take into account the scientific conclusions of the HMPC.

Information on the use and licensing of aloes medicines in EU Member States should be obtained from the relevant national authorities.

Further information on the HMPC assessment of aloes medicines, including details of the Committee's conclusions, can be found under the tab 'All documents'.

For more information about treatment with aloes medicines, read the package leaflet that comes with the medicine or contact your doctor or pharmacist.