Clinical Overviews,

.
d-

Patient Information Sheets,

and Single Herb
Monographs

Echinacea Illzi\tr~~tiot~
02003 I'eggy I h k e
(This page intentionally lef? blank.)
 Bilberrv J
Vaccinium myrtillus L.
[Fam. Ericaceae]

DOSAGE
AND
Bilberry is the name of a small European ADMINISTRGTION
blueberry. Dietary supplements made from Ranges from 160-480 mg daily depend-
the standardized extract of bilberry have ing on the conditions being treated.
become popular in the U.S. over the past Therapeutic benefits appear to take effect
decade. Sales in the mainstream retail mar- in 4-8 weeks.
kets ranked 13th of all herbs in 2000. The DRIED,RIPE FRUIT: 20-60 g daily ( 6 8 g
standardized, concentrated extract of bil- with water, several times daily).
berry fruit is used by consumers primarily
for ocular, microcirculatory and vascular- INFUSION/DECOCTION: 20-60 g daily.
related disorders. COLDMACERATE: 20-60 g daily.
GARGLE:Mouthwash containing 10%
PRIMARY
USES decoction.
Retinopathy, hypertensive
FLUID EXTRACT 2 - 4 ml, 3 times daily
Retinopathy, diabetic [l:l (g/mlj].
Peripheral vascular disorders, blood FOR DIARRHEA: Crude preparations (non-
purpuras standardized) for no more than 3-4 days.
Venous insufficiencies, varicose veins, DRYSTANDARDIZED EXTRACT: (25% antho-
capillary fragility, kidney capillary cyanidins) 80-160 rng, 3 times daily.
fragility
Diarrhea (the bilberry fruits, not the CONTRAINDICATIONS
standardized extracts) None known.
photo o 2002 stevenfostercorn PREGNANCY AND LACTATION: No known
OTHER
POTENTIAL
USES restrictions.
Blindness, night and day
Cataracts ADVERSE
EFFECTS
Macular degeneration None known (at therapeutic dosages).
Retinitis pigmentosa DRUGINTERACTIONS
Retinopathy, hemorrhagic Pharmacological studies suggest that very high doses (>I70 mg
Dysmenorrhea anthocyanins per day for 30-60 days) may interact with warfarin
Reduction of surgical bleeding or other antiplatelet drugs. Bilberry (form unstated) reportedly
may reduce insulin requirements; therefore, conventional antidi-
I?-COLOGICAL ACTIONS abetic therapy would need close monitoring or dosage adjust-
Astringent; antiplatelet aggregation; collagen-stabilizing activity; n~ent.
decreased vascular permeability associated with injury.

1
f i e ARC Cliiticul Guide to l f c r b , ~
 REVIEW
CLINICAL night contrast sensitivity. One DB, PC study conducted on
Fifteen clinical studies on bilberry that included a total of 694 peripheral vascular disorder concluded positive results for
participants were reviewed. All but one of the studies demon- Raynaud's sufferers. Another DB, PC study on chronic dysmen-
strated positive effects for indications, including various ocular orrhea was positive and further supports pharmacological find-
conditions (night/day vision and retinopathy), and vascular con- ings. One single-blind
" (SB),
. - PC studv on venous insufficiencies
ditions, including venous insufficiencies and micro- and macro- inu60 participants furthkr supported ;he findings of four similar
peripheral circulation. Two double-blind, placebo-controlled studies, including two open studies and two using pregnant sub-
(DB, PC) studies focused on retinopathy and confirmed results jects. Bleeding was investigated in a SB, PC study finding bilber-
of two earlier open studies. One DB, PC study on nighttime ry reduced intra- and postoperative bleeding and prevented sub-
vision confirmed preliminary findings of five previous open stud- sequent hemorrhaging. Another study focused on bleeding asso-
ies. A recent DB, PC, crossover study failed to find that bilberry ciated with intrauterine devices.
extract (25% antho~~anosides) had an effect on night vision or

1 The ARC Clinical Guide to Herbs

Vaccinium myrtillus L.
Bilberry
Vucciniunl r??\/rtillirsL.
[Fam.Ericciceae]

OVERVIEW
Bilberry is the name of a small, European blueberry. The
standardized, concentrated extract of bilberry fruit is used
by consumers mainly for disorders of the eyes and circu-
latory system. Sales in the mainstream retail markets
ranked 13th of all herbs in 2000. Some concentrated
extracts of the berry are standardized for an exact amount
of water-soluble substances called anthocyanidins.

USES
Visual problems such as circulatory disorders of the reti-
na; vein and circulatory disorders, including varicose
veins, inadequate vein strength, and fragile capillaries.

DOSAGE
Ranges from 160-480 mg daily depending on the condi-
tions being treated. Therapeutic benefits appear to take
effect in 4-8 weeks.
FOR DIARRHEA: Non-standardized preparations for no
more than 3-4 days.
DRIED,RIPE FRUIT: 20-60 g daily (4-8 g with water, sev-
eral times daily).
INFUSION/DECOCTION: 20-60 g daily.
COLDMACERATE: 20-60 g daily. ADVERSE
EFFECTS
GARGLE: Mouthwash containing 10% decoction. Bilberry is not known to cause adverse effects in normal-
ly recommended therapeutic doses.
FLUIDEXTRACT: 2-4 ml, 3 times daily [1:1 (g/m1)].
DRYSTANDARDIZED EXTRACT: 80-160 mg, 3 times daily DRUGINTERACTIONS
[25% anthocyanidins]. There are no known drug interactions in therapeutic
doses. However, very high doses (more than 170 mg
CONTRAINDIC~IONS anthocyanins daily for 30-60 days) may interact with
None known. anticoagulating drugs such as warfarin (Coumadin,
PREGNANCY AND LACTATION:
None known. Sofarin). Bilberry reportedly may reduce daily insulin
requirements. Patients who are simultaneously taking
antidiabetic medications and bilberry may need to be
monitored or have the dosage of their antidiabetic drugs
adjusted.

Comments

When using a dietary supplement, purchase it from a reliable source. T h e information contained on this sheet has been
For best results, use the same brand of product throughout the period excerpted from The ABC Clinical Guide to Herbs
of use. As with all medications and dietary supplements, please inform O 2003 by the American Botanical Council (ABC).
your healthcare provider of all herbs and medications you are taking. ABC is an independent member-based educational
Interactions may occur between medications and herbs or even among organization focusing on the medicinal use of herbs.
different herbs when taken at the same time. Treat your herbal supple- For more detailed information about this herb please
ment with care by taking it as directed, storing it as advised on the consult the healthcare provider who gave you this sheet.
label, and keeping it out of the reach of children and pets. Consult your To order The ABC Clinical Guide to Herbs or become a
healthcare prorider with any questions. member of ABC, visit their website at
www.herbalgrarn.org.

The ABC C1iiric;il Guide to I-lerbs

1
 J
Vaccinium myrtillus L.
[Fam. Ericaceae]

Vascular
Peripheral vascular disorders and blood purpuras (Allegra

B ilberry is the name of a small European blueberry. Dietary

supplements made from the standardized extract of bil-
berry have become popular in the United States over the
past decade. Sales in the mainstream retail markets ranked 13th
of all herbs in 2000 (Blumenthal, 2001). The standardized, con-
et a l , 1982)
Venous insufficiencies (Gatta et a l , 1988; Teglio et al.,
1987), varicose veins (Ghiringhelli et al., 1978), capillary
fragility (Coget and Merlen, 1980; Grismondi et al., 1980;
centrated extract of bilberry is used by consumers to help treat or Mian et al., 1977; Neumann, 1973; Treviso et al., 1979),
orevent ocular, microcircu~latorv,and vascular-related disorders. and kidney capillary fragility (Pennarola et al., 1980)
Bilberry leaf extract (not the fruit that is covered in this mono-
prauh)
o r '
was used as a treatment for diabetes before the availabili- OTHER
POTENTIAL
USES
ty of insulin. It was found effective in adult onset diabetes as a Blindness, night and day (Jayle et al., 1965; Gloria and
method of reducing glycosuria and postprandial hyperglycemia Peria, 1966; Sala e t a [ , 1979; Caselli, 1985; Vannini eta!.,
(Allen, 1927). For that reason, the leaf extract is contraindicated 1986; Zavarise et a/., 1987)
for diabetes patients taking insulin (Bailey and Day, 1989). Cataracts (Bravetti et al., 1989)
Gargle for inflamed oral and pharyngeal - mucous mem-
branes (Blumenthal et al., 1998)
Macular degeneration, retinitis pigmentosa, hemorrhagic
retinopathy (Scharrer and Ober, 1981)
Dysmenorrhea (Colombo and Vescovini, 1985)
Reduction of intra- and post-operative bleeding (Gentile et
aL, 1987; Cerutti et al., 1984)
DOSAGE
Crude Preparations
DRIED,RIPE FRUIT: 20-60 g daily (4-8 g with water, several times
daily) (Braun et a l , 1993; Meyer-Buchtela, 1999; Wichtl and
Bisset, 1994).
INFUSIO~~/DECOCTION: 20-60 g daily. The berries are prepared
by placing 5-10 g crushed, dried fruit in 150 ml cold water. This
Photo O 2002 stevenfostet:com
mixture is boiled for approximately 10 minutes; then strained
while hot. The preparation is drunk cold several times daily until
the diarrhea subsides (Braun et a l , 1993; Meyer-Buchtela, 1999;
DESCRIPTION Wichtl and Bisset, 1994).
Bilberry preparations consist of the whole, dried, ripe, black or
COLDMACERATE: 20-60 g daily. T h e berries are prepared by
bluish-black fruit of Vaccinium myrtillus L. [Fam. Ericaceae].
soaking 5-10 g crushed dried fruit in 150 ml cold water for
Some concentrated extracts are standardized to anthocyanosides,
2 hours, allowing the fruit to swell. T h e preparation is drunk
calculated as 25% anthocyanidins, but may actually contain
cold several times daily (Braun et a/., 1993; Meyer-Buchtela,
about 37% by weight (Pizzorno and Murray, 1999).
1999; Wichtl and Bisset, 1994).
PRIMARY
USES GMGLE: Liouthwash containing 10% decoction (prepared as
Gastrointestinal described above) for local application in the treatment of mild
Diarrhea: The German Commission E approved crude (i.e. inflammation of oral and pharyngeal mucous membranes
non-concentrated) fruit preparations for acute diarrhea (Blumenthal et dl., 2000).
(Blumenthal et dl., 1998), particularly i n children FLUIDEXTRACT:1:l (g/ml), 2-4 ml, 3 times daily (Anderhuber,
(Blumenthal et al., 1998; Ofek et al., 1996) 1991; Cunio, 1993).
Ophthalmic Standardized Preparations
Retinopathy, hypertensive (Repossi et al., 1987), and dia- DRYSTAND.UDIZED FXTRACT: (25% anthocyanidins) 80-1 60 mg,
betic (Ghiringhelli et aL, 1978; Treviso et al., 1979; 3 cimes daily (Pizzorno and Murray, 1999).
Scharrer et al., 1981 ; Grismondi et al., 1981; Orsucci et NC~TE: Doses may range from 1 6 0 4 8 0 mg daily depending on
al., 1983; Perossini et al., 1987; Repossi et al., 1987) the conditions being treated (see the following table, "Clinical

1 7 1 ABC
~ Clitlicdl Glride to Herl~s
 Studies on Bilberry"). Therapeutic benefits appear to take effect plasma, and cardiac isoenzymes (Marcollet et al., i 970)
in 4-8 weeks. May result in retinal protection due to the inhibition of
retinal phosphoglucomutase and glucose-6-phosphatase
DURATION
OF ADMINISTMION (Cluzel et al., 1969)
Crude Preparations Reduces microvascular impairments due to ischemia reper-
Not more than 3-4days.
DIARRHEA: fusion injury, with preservation of endothelium, attenua-
Standardized Preparations tion of leukocyte adhesion, and improvement of capillary
VASCULAR A N D OCULAR-RELATED DISORDERS: 2-6 months perfusion (Bertuglia et a/., 1995)
depending on the condition. Produces dose-dependent inhibition of platelet aggregation
and clot retraction (Bottecchia, 1987)
CHEMISTRY
Dried bilberries contain 5 - 1 0 s catechins (tannins), ca. 30% CONTRAINDICATIONS
invertose (invert sugar) (Schulz et al., 2001), and flavonoids. None known.
Bilberry contains a small amount of anthocyanosides (0.1-0.2596
PREGNANCY A N D LACTATION:
No known restrictions.
in fresh fruit) consisting of 3-O-glycosides of cyanidin, delphini-
din, malvidin, peonidin, and petunidin (Baj et al., 1983), and ADVERSE
EFFECTS
proanthocyanidins B 1-B4 (Bruneton, 1999).

PHARMACOLOGICAL
ACTIONS
None known (at therapeutic doses). x
0
DRUGINTERACTIONS
Crude Preparations None known. I t has been inferred, based on pharmacological 5
Astringent (Blumenthal et. al., 2000). studies, that very high doses (>I70 mg anthocyanins per day for +$
Standardized Preparations 30-60 days) may interact with warfarin or other antiplatelet 5^
Human drugs (Bone and Morgan, 1997). Leaf only: There have also been
Anti-platelet aggregation (Pulliero et al., 1989) (ex viuo); colla- claims that bilberry leaf; as mentioned in the overview, may
gen-stabilizing activity (Mian et al., 1977); decreased vascular reduce insulin requirements. Therefore, conventional antidiabet-
permeability associated with injury (Mian et al., 1977). ic therapy would require close monitoring or adjustment (De
Animal Smet et al., 1993; Bailey and Day, 1989).
Antiplatelet aggregation (Morazzoni and Magistretti, 1990;
Zaragoza etal., 1985; Bottecchia et al., 1987); anti-ulcer (Cristoni AMERICANHERBAL ASSOCIATION
PRODUCTS
and Magistretti, 1987); decreased capillary fragility (anti-inflam- FZATING
(AHPA) SAFETY
matory activity) (Detre et al., 1986; Lietti et al., 1976); collagen- CLASS1: Can be safely consumed when used appropriately
stabilizing (Detre et al., 1986); vascular smooth muscle relaxant (McGuffin et al., 1997).
(Bettini et al., 1984a; Bettini et al., 1984b); vascular permeability
regulator (Detre et al., 1986; Lietti and Forni, 1976); increased REGUMORY
STATUS
regeneration of rhodopsin (a light-sensitive pigment found in rods AUSTRIA:Dried fruit official in the 1990 Austrian Pharmacopoeia,
and retina) (Alfieri et al., 1966; Cluzel et al., 1969). 199 1 Addendum I1 (Meyer-Buchtela, 1999; OAB, 1991; Wichtl
In vitro and Bisset, 1994).
Antioxidant (Meunier et al., 1989); free radical scavenger (Pietta CANADA:Multiple-ingredient Traditional Herbal Medicines
et al., 1998; Martin-Aragon et al., 1998); inhibits CAMP phos- (THMs) containing bilberry, in tea infusion form, and homeo-
phodiesterases (Ferretti et al., 1988); chemopreventative (Bomser pathic mono-preparations of bilberry are scheduled O T C drugs
etal., 1996); inhibits lipid peroxidation (Meunier et al., 1989). requiring premarket registration and assignment of a drug identi-
NOTE:The pharmacological actions - antioxidant, anti-inflam- fication number (DIN) (Health Canada, 2001).
matory, decreases in capillary permeability, and stabilization of FRANCE: Fresh or dried fruits are permitted for oral or topical use
collagen - are further supported by research conducted on (Bruneton, 1999).
flavonoids in general (Gabor, 1972; Kuhnau, 1976; Havsteen, GERMANY: Dried fruit, for tea infusions and other equivalent
1983; Monboisse et al., 1983). galenical dosage forms, is an approved nonprescription drug of
the German Commission E monographs (Blumenthal et al.,
MECHANISM
OF ACTION
1998). Dried fruit is official in the German Drug Codex supple-
Inhibits enzymatic cleavage of collagen by enzymes secreted ment to the German Phamzacopoeiu (DAC, 1998). Bilberry
by leukocytes during inflammation (Mian et al., 1977) dried-fruit tea is an approved nonprescription drug listed in the
- -
Increases the endothelium barrier effect through stabilizing
the membrane phospholipids and increasing the biosynthe-
German Standzrd License (St. Zul.) monographs (Braun et a!.,
1993). The fresh, ripe fruit for preparation of hydro-alcoholic
sis of the acid muco~olvsaccharides
, , of the connective mother tincture and liquid dilutions is an official drug of the
.. ,
ground substance, thus restoring the altered mucopolysac- Gemzan Homeopathic Pharmacopoeia (GHP, 1993).
charide pericapillary sheath (Mian et al., 1977) ITALY:Dried hydro-alcoholic extract is listed in the Italian
Decreases basement membrane collagen hydrolysis by sig- Pharmacopoeia (Morazzoni and Bombardelli, 1996).
nificantly reducing permeability of the blood-brain barrier SWEDEN:Classified as foodstuff (De Smet et al., 1993). As of
(BBB), and increases recovery rate of the BBB caused by January 2001, no bilberry products are listed in the Medical
permeability-increasing agents (Robert et al., 1977) Products Agency (MPA) "Authorised Natural Remedies" (MPA,
Prevents the liberation of lactate dehydrogenase in heart, 2001).
The AllC Clini~alGuide to 1 ferbs
1
 Dried fruit is official in the
SWI.I-ZI~R~.ANII: Swiss Pharmacopoeia REFERENCES
(Meyer-Buchtela, 1999; Ph.Helv.VI1, 1987-1 997; Wichtl and Alfieri R, Sole I? Influence of anthocyanosides, in oral-perlingual administration, on
Bisset, 1994). A semipurified extract (Myrtaveno), standardized the adapto-electroretinogram (AERG) in red light In humans. [in Italian]. C R
to 58 mg anth~c~anosides per capsule, is a Category C nonpre- Seances Soc Biol Fil 1966:160:1590-3.
Allegra C , Pollari G. Criscuolo A, Bonifacio M. Antocianosidi e sistema microvascu-
scription drug with sale limited to pharmacies (Morant and lotessutale. Minerua Angiol 1982;7:39-44.
Ruppanner, 2001). Allen FM. Blueberry leaf extract: physiologic and clinical properties in relation to car-
U.K.: Not listed in GenemlSale List ( G S L ) . No monograph in the bohydrate metabolism. JAMA 1927;89: 1577-8 1.
Bailey CJ, Day C. Traditional Plant Medicine as Treatment for Diabetes. Diabetes
British Pharmacopoeia. Care 1989;12(8):553-64.
U.S.: Dietary Supplement (USC, 1994). Tincture of the ripe Baj A, Bombardelli E, Gaherta D, Martinelli EM. Qualitative and quantitative evalu-
berries is a Class D over-the-counter drug of the Homeopathic ation of Vaccinium myrtillur anthocyanins by high-resolution gas chromatography
Pharmacopoeia of the United States (HPUS, 1993). and high-performance liquid chr~marogra~hy. / Chromatogr 1983;279:365-72.
Belleoud L, Leluan D, Boyer Y. A study on the effect of anthocyanosides on nocrur-
nal vision in air traffic controllers. [in French]. Rev Med Aeronaut Spat
REVIEW
CLINICAL 1966; 18:3-7.
Fifteen studies are outlined in the following table, "Clinical Belleoud L, Leluan D. Boyer Y. A study on the effect of anthocyanosides on noctur-
Studies on Bilberry," including a total of 694 participants. All but nal vision in ship personnel. [in French]. Soc Franc Pllyiol Med Aeronaut
one of the studies (Muth etal., 2000) demonstrate positive effects Cosmonaut 1967; May.
Bertuglia S. Malandrino S, Colantuoni A. Effect of Vaccinium myrtillzu anthocyano-
for indications, including various ocular conditions (night/day sides on ischaemia reperfusion injury in hamster cheek pouch microcirculation.
vision and retinopathy), and vascular conditions, including Pharmacol Res 1 9 9 5 31: 183-7.
venous insufficiencies and micro- and macroperipheral circula- Bettini V, Aragno R, Bettini M, et al. Vasodilator and inhibitory effects of Vzccinium
tion. Two double-blind, placebo-controlled (DB, PC) studies myrtillus anthocyanosides on the contractile responses of coronary artery segments
to acetylcholine: role of the prostacyclins and of the endothelium-derived relaxing
(Perossini et al., 1987; Repossi et al., 1987) focused on retinopa-
factor. Fitoterapia 1991 ;62: 15-28.
thy and confirmed results of two earlier open studies (Orsucci et Bettini V, Aragno R, Bettini MB, cz al. Facilitating influence of Vaccinium myrtillus
al., 1983; Scharrer and Ober, 1981). One DB, PC study anthocyanosides on the acetylcholine-induced relaxation of isolated coronary arter-
(Vannini et al., 1986) on nighttime vision confirmed preliminary ies: role of the endothelium-derived relaxing factor. Fitoterapia 1993;64:45-57.
findings of five previous open studies (Jayle and Auber, 1964; Bettini V, Guerra B, Martino R, etal. Contractile responses of isolated rat stomach to
stimulation of postganglionic cholinergic fibers in the presence of kccinium myr-
Jayle et al., 1965; Gloria and Peria, 1966; Sala et a[., 1979;
tillus anthocyanosides. Fitotrrapia 1986;57:211-6.
Terrasse et al., 1966). A recent DB, PC, crossover study (Muth et Berrini V, Mayellaro F, Pilla I, Terribile Weil Marin V. Mechanical responses of isolat-
dl., 2000) failed to find an effect of a bilberry extract (25% ed coronary arteries to barium in the presencc of kccinium myrtillus anthocyano-
antho~~anosides) on night vision or night contrast sensitivity. sides. Fitoterapia 1985;56:3-10.
One DB, PC study conducted on peripheral vascular disorder Bemini V, Mayellaro F, Ton P, Zanella I? Effects of kccinium myrtillzu anthocyano-
sides on vascular smooth muscle. Fituterapia 1984a;55:265-72.
(Allegra et al., 1982) concluded positive results for Raynaud's suf- Berrini V, Mayellaro F, Ton P, Zogno M. Interactions between Vaccinium myrtillus
ferers. Another DB, PC study (Colombo and Vescovini, 1985) on anthocyanosides and serotonin o n splenic artery smooth muscle. Fitoterapia
chronic dysmenorrhea was positive and further supports pharma- 1984b;55:20 1-8.
cological findings (Bettini et al., 1984a, Bettini et al., 1984b). Bever B, Zahnd G. Plants with oral hypoglycemic action. Quart/ Crude Drug Rer
One single-blind, PC study on venous insufficiencies in 60 par- 1979;17:139-96.
Bilyk A, Sapers GM. Varietal differences in the quercetin, kaempferol, and myricetin
ticipants (Gatta et dl., 1988) further supported the findings of contents of highbush blueberry, cranberry, and thornless blackberry fruits. / Agric
four similar studies, including two open studies (Ghiringhelli et Food Chnn 1986;34:585-8.
al., 1977; Mian et dl., 1977), and two using pregnant subjects Blumenthal M. Herb sales down 15% in mainstream market. HerbalGram
(Teglio et al., 1987; Grismondi etal., 1980). Bleeding was inves- 2001;51:69.
tigated in a SB, PC study (Gentile et al., 1987), finding bilberry Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister
RS (eds.). Klein S, Rister RS (trans.). The Complete Goman Commission E
reduced intra- and postoperative bleeding and prevented subse- Monographs-Therapeutic Guide to Herbal Medicines Austin, TX: American
quent hemorrhaging. Another study (Cerutti et al., 1984) Botanical Council; Boston: Integrative Medicine Communication; 1998: 88.
focused on bleeding associated with intrauterine devices. The Blumenthal M, Goldberg A, Brinckmann J. (eds.) Herbal Medicine: Expanded
most comprehensive review of research and clinical information CommissionE Monographs. Newton, MA: Integrative Medicine Communications;
2000: 16-21.
on bilberry was compiled by Morazzoni and Bombardelli (1996).
Bomser J, Madhavi DL, Singletary K, Smith MA. In u i m anticancer activity of fruit
extracts from kccinium species. Phnta Med 1996;62:212-6.
BRANDED
PRODUCTS* Bone K, Morgan M. Bilberry: the vision herb. MediHcrb ProfRm 1997;59:14.
Difrarel 100TM:Laboratoires Chibret / c/o Societe Anonyme Boniface R, Robert AM. Effect of Anthocyanosides on Human Connective Tissue
Corporation / 200 Boulevard Etienne-Clementel Clermont- Metabolism. Klin MonatsblAugenheilkd 1996;209:368-72.
Bottecchia D, Bettini V, Martino R, Camerra G. Preliminary report o n the inhibito-
Ferrand / Puy-de-Dome / France. No product information avail-
ry effect of Varcinium myrtilus anthocyanosides on platelet aggregation and clot
able; no longer manufactured. retraction. Fitoterapia 1987;58:3-8.
Myrtocyane: Indena S.p.A. / Viale Ortles 12 / 20139 Milano / Braun R, Surmann R, Wendt R, Wichtl M, Ziegenmeyer J (eds.). Stanrtrrdzuhsungen
Italy / Tel: +39-02-57-4961 / Fax: +39-02-57-4046-20 / Email: f;ir Fertigarzneimittel: Tmt und Kommmtar - 8. Erganzungslieferung. Smttgart,
Germany: Deutscher Apotheker Verlag, Oct 1993;Nr.:1009.99.99.
indenami@tin.it. Extract standardized to 25% anthocyanidins Bravetti G, Fraboni E, Maccolini E. Preventive medical treatment of senile cataract
containing 36% anthocyanosides. with vitamin E and Vaccinium myrtillus anthocyanosides: clinical evaluation. [in
TegensTM:Synthelabo-Pharma SA of France I 11 Rue de Veyrot, Italian]. Ann Orralmol Clin Ocul1989;115:109-16.
Bruneton J. Pharma~o~nory Pbytocbemistry Medieina( Phnts, 2nd ed. Paris, France:
1217 Meyrin 1 France / Tel: +33-02-29-89-0147 / Fax: +33-02- Lavoisier Publishing; 1999:361-3.
29-89-0188. The product is standardized to 25% anthocyanidins Caselli L. Clinic, electroretinographic trial on the action of of anthocyanosides. Arch
containing 36% anthocyanosides by the extract Myrtocyane. Med Interna 1985;37:29-35.
Cerurti R et al. Value of Vdrcinium myrtillus anthocyanosides in the prophylaxis of
American equivalents, if any, are found in the Product Table
minor side effects with copper intrauterine device contraception. Ginecol Clin
beginning on page 398. 1984;(3-4):244-9.

I 7 % ~ARC Clinicul Glridc to H r r h ~

Cluzel C , Bastide P, Tronche P. I'hosphoglucomutase and glucose-6-phosphatase activ- Martin-Aragon 5, Basabe B, et al. Antioxidant action of Vaccinium myrtillus L.
ities of the retina and anrhocyanoside extracts from VRccinium myrtillus (study I I I Phytother Res 1998;12:s 1 0 4 4 .
vitro and vivo). [in Italian]. C R Seances So( Biol Fil 1969;163:147-50. Martinelli E, Scilingo A, Pifferi G. Computer-aided evaluation of the relative stabili-
Coget J, Merlen J. Anthocyanosides and microcirculation. [in Italian]. J Ma1 k c ty of Vaccinium myrtillus anthocyanins. Anal Chim Acta 1992;259:109.
1980;5:43-6. McGufin M. Hobbs C , Upton R, Goldberg A. American HerbalProduct Associationi
Coget J. Merlen J. Clinical study of a new chemical agent for vascular protection, Botanical Sakiy Handbook. Boca Raton, FL: CRC Press; 1997.
Difrarel 20, compound of anthocyanosides extracted from Vaccinum myrtillus. [in Medical Products Agency (MPA). Naturk3kernedel: Authorised Natural Remedies (as of
Italian]. Phkbologie 1968;21:221-8. January 24, 2001). Uppsala, Sweden: Medical Products Agency; 2001.
&>lomho D. Vescovini R. Controlled clinical trial of anrhocyanosides from Vaccinium Meunier M, Duroux E, Bastide P. Antioxidizing action of procyanidolic oligomers
myrtiflw in primary dysmenorrhea. G Ital Obstet Ginecol 1985;7:1033-8. and anthocyanosides. Plant Midicin Phytothir 1989;23(4):267-74.
Cristoni A, Magistretti MJ. Antiulcer and healing activity of Vaccinium myrtillus Meyer-Buchtela E. Tee-Rezepturen - Ein Handbuch f i r Apotheker und h z t e .
anthocyanosides. Farmaco [Prat] 1987;42:29-43. Stuttgart, Germany: Deutscher Apotheker Verlag; 1999;Heidelbeeren.
DAC. Sec: Deutscher Arzneimittel-Codex. Mian E, Curri S, Lietti A, Bombardelli E. Anthocyanosides and the walls of the
De Smet P, Keller K, Hansel R, Chandler R. Aduerse Effects of Herbal Drugs, Vol. 2. microvessels: further aspects of the mechanism of action of their protective effect
Berlin: Germany. Springer-Verlag; 1993;85:307-14. in syndromes due to abnormal capillary fragility. [in Italian]. Minerva Med
Detre Z. Jellinek H , Miskulin M, Robert A. Studies on vascular permeability in 1977;68:3565-81.
hypertension: action of anthocyanosides. Clin PhysiolBiochem 1986;4:143-9. Monboisse J, Braquet P, Borel J. Oxygen-free radicals as mediators of collagen break-
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1970;163:1786-9.

The ABC Clinical Guide to Herbs

1
Treviso A. Therapeutic value of rlie association of anrhocyanin glucosides with gluta- Wang H , Cao G, Prior R. Oxygen radical absorbing capaciry of anrhocyanins. JAgric
mine and phosphorylserine in the trearment of learning disturbances at different Food Chem 1997;45:304-309.
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1 The ABC Clinzcal Guide to Hcrl~s

Clinical Studies on Bilberry (Vaccinium myrtillus) (coot.)

Vascular (micro and peripheral circulation, venous disorderslinsufficiencies, etc.)

AuthorNear Subject Results/Conclusion
Gatta et ol., Venous Decreased severity of edema, sensations of pressure.
1988 insufficiency paresthesia, and cramp-like pain were observed in the
,..--:- ..-
[vdrloua bilberry group (pCO.01 for all outcomes).
causes)

Gentile et al., Preventive Reduced intra- and postoperative bleeding and prevent-
1987. unpub- bleeding ed subsequent hemorrhaging when treated with bilber-
lished due t o otor r y before surgery. (No statistics reported.)
nolaryngolo
cal surgery

Teglio. 1987 venous Reduction in symptoms of pruritus (94.6%), paresthesia

insuffic~ency
symptoms ir
pregnant
women

480 mglday MyrtocyanB Decreased edema. paresthesia, and pain while increasing
joint mobility in patients with Raynaudf disease.

Grismondi e t Phlebopathi Improvements in burning and itching (p<O.OOI), heavi-

al., 198 1 induced by ness (p<O.OOl), and pain (p<O.OOl) were observed in
PregnancY bilberry users, as well as in diurnal and nocturnal
cramps (p<O.O I). and a reduction in edema and in capil-
lary fragility (p<O.OO I).

Bilberry signmcantly improved symptoms such as limb

edema and dyschromic skin phenomena as well as heav-
iness. paresrhesia. and pain.

Mian eta/., Ulcerative Bilberry reduced the protein content of the exudate
produced by venous occlusion and stasis. a symptom of
post-thrombotic and varicose veins stasis. (No statistics
reported.)

Other
Subject
Colombo. Chron~c Bilbeny s~gnificantlyreduced dysmenorrhea symptoms
1985 dysmenorrt Including headache, heav~nessof lower I~mbs,mammary
tenslon, sickness and emesls. and pelvic and lumbosacral
paln by the second month

Decreased incidents of spottlng and hyperpoly-menor-

rhea were observed In b~lberryusers.

cohort MA - meta-analysis.M C - mulo-center. n -number of pattents.0 -open, OB - observanonal, OL - open label, OR - odds rano. P - pmpecove. PB - patlent-bllnd. PC - placebo-controlled.
PC - parallel group. PS - ptlor study, R - randomtzed. RC - reference-controlled. RCS - retrospective cross-sectional RS - retrospective. S - surveillance. SB - stngle-blind. SC - single-center,
U - uncontmlled. UP - unpubl~shed.VC - vehlcle-controlled