Baikal skullcap (Scutellaria barbata) Dosing and Safety

safety

Allergies

Avoid with known allergy or hypersensitivity to Baikal skullcap (Scutellaria baicalensis), its constituents, or members of the Lamiaceae family.

Side Effects and Warnings

Baikal skullcap may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Baikal skullcap may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs (such as metformin), herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Baikal skullcap may cause low blood pressure. Caution is advised in patients taking drugs, herbs, or supplements that lower blood pressure.
Baikal skullcap may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased or decreased in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Use cautiously in patients using central nervous system (CNS) depressants. Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.
Use cautiously in patients taking rosuvastatin (Crestor®), according to pharmacokinetic research that baicalin, a constituent of Baikal skullcap, can decrease concentrations of rosuvastatin, likely by promoting the transportation of rosuvastatin into the liver.
Use cautiously in patients with autoimmune disorders or those receiving immunosuppressants, as Baikal skullcap and its constituents may have effects on the immune system.
Avoid in patients who are pregnant or breastfeeding, as Scutellaria baicalensis has the potential to cause maternal toxicity and uterine relaxation.
Avoid in patients with known allergy or hypersensitivity to Scutellaria baicalensis, its constituents, or members of the Lamiaceae family.
Baikal skullcap may also cause fever, liver damage, pneumonia, and reduced white cell count.
Note: Baikal skullcap is an ingredient in PC-SPES, a product that has been recalled from the U.S. market; PC-SPES should not be used.

Pregnancy and Breastfeeding

Avoid in patients who are pregnant or breastfeeding, as Scutellaria baicalensis has the potential to cause maternal toxicity and uterine relaxation.

dosing

Adults (18 years and older)

In general, a typical dose of toasted Baikal skullcap is 6-15 grams.
For cancer (adjunct to chemotherapy), one tablet of Baikal skullcap extract (the amount of extract per tablet is unknown) has been taken by mouth three times daily, starting 5-6 days before chemotherapy and every day thereafter.

Children (under 18 years old)

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

interactions

Interactions with Drugs

Baikal skullcap may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar, including metformin. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Baikal skullcap may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Baikal skullcap may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.
Baikal skullcap may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Baikal skullcap may increase the amount of drowsiness caused by some drugs. Examples include CNS depressants, benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
Because Baikal skullcap contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
Baikal skullcap also interacts with 5-fluorouracil, Alzheimer's agents, analgesics, antiasthmatics, antibiotics, anticancer drugs, antifungals, antihistamines (allergy medicine), anti-inflammatories, antivirals, cholesterol-lowering drugs (including rosuvastatin), cisplatin, cyclophosphamide, drugs that weaken the immune system, HIV/AIDS drugs, osteoporosis drugs, p-glycoprotein-regulated agents, and weight loss drugs.

Interactions with Herbs and Dietary Supplements

Baikal skullcap may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Baikal skullcap may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Baikal skullcap may cause low blood pressure. Caution is advised in patients taking herbs or supplements that lower blood pressure.
Baikal skullcap may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.
Baikal skullcap may increase the amount of drowsiness caused by some herbs or supplements.
Because Baikal skullcap contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
Baikal skullcap also interacts with Alzheimer's agents, analgesics, antibacterials, anticancer herbs and supplements, antifungals, antihistamines (herbs and supplements for seasonal allergies), anti-inflammatories, antioxidants, antivirals, berberine, cholesterol-lowering agents, Coptis, garlic, grape seed, herbs and supplements for osteoporosis, herbs and supplements that affect the immune system, PC-SPES, p-glycoprotein-regulated agents, vitamin C, vitamin C-containing foods, and weight loss agents.