Birch

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Note: The archived version of this monograph has been temporarily removed. For an electronic copy of this archived version, please contact the Natural Health Products Directorate (NHPD) at NHPD_DPSN@hc-sc.gc.ca.

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Date: April 24, 2008

Proper and common name(s):

Table 1: Proper and common name(s)

Proper name(s)	Common name(s)
Betula pendula Roth. (Betulaceae) (USDA 1998)	Birch, European white birch, silver birch, weeping birch (McGuffin et al. 2000)
Betula pubescens Ehrh. (Betulaceae) Synonym: Betula alba L. (Betulaceae) (USDA 1998)	Birch, downy birch, white birch (McGuffin et al. 2000)

Source material(s): Leaf (Bradley 2006; ESCOP 2003)

Route(s) of administration: Oral

Dosage form(s): Those suited to the allowable route(s) of administration.
This monograph is not intended to include food-like dosage forms such as bars, chewing gums or beverages.

Use(s) or Purpose(s): Statement(s) to the effect of

Used in Herbal Medicine as a diuretic (Bradley 2006; ESCOP 2003; Hoffmann 2003; Blumenthal et al. 1998).

Dose(s): Preparations equivalent to 0.6-9 g dried leaf, per day (Bradley 2006; ESCOP 2003; Hoffmann 2003; Blumenthal et al. 1998).

See Appendix 1 for examples of appropriate dosage preparations, frequencies of use and directions for use, according to cited references. The purpose of Appendix 1 is to provide guidance to industry.

Duration of use: Statement(s) to the effect of:

For occasional use only (Berardi et al. 2002; CPA 2002)

Risk information: Statement(s) to the effect of:

Caution(s) and warning(s):

• Consult a health care practitioner if symptoms persist or worsen.
• Consult a health care practitioner prior to use if you are pregnant or breastfeeding (ESCOP 2003).
• Consult a health care practitioner prior to use if you have oedema due to a kidney or cardiovascular disorder (Bradley 2006; ESCOP 2003; Brinker 2001; Blumenthal et al. 1998).

Contraindication(s): No statement required.

Known adverse reaction(s): Hypersensitivity (e.g. allergy) has been known to occur; in which case, discontinue use (Brinker 2001).

Non-medicinal ingredients: Must be chosen from the current NHPD List of Acceptable Non-medicinal Ingredients and must meet the limitations outlined in the list.

Specifications:

• The finished product must comply with the minimum specifications outlined in the current NHPD Compendium of Monographs.
• The medicinal ingredient may comply with the specifications outlined in the Birch Leaf Monographs published in the European or British Pharmacopoeias.

References cited:

Berardi RR, DeSimone EM, Newton GD, Oszko MA, Popovich NG, Rollins CJ, Shimp LA, Tietze KJ, editors. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care, 13^th edition. Washington (DC): American Pharmaceutical Association; 2002.

Blumenthal M, Busse W, Goldberg A, Gruenwald J, Hall T, Riggins C, Rister R, editors. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin (TX): American Botanical Council; 1998.

Bradley PR, editor. British Herbal Compendium: A Handbook of Scientific Information on Widely Used Plant Drugs, Volume 2. Bournemouth (UK): British Herbal Medicine Association; 2006.

Brinker F. Herb Contraindications and Drug Interactions, 3rd edition. Sandy (OR): Eclectic Medical Publications; 2001.

CPA 2002: Canadian Pharmacists Association. Patient Self-Care. Helping Patients Make Therapeutic Choices. Ottawa (ON): Canadian Pharmacists Association; 2002.

ESCOP 2003: ESCOP Monographs: The Scientific Foundation for Herbal Medicinal Products, 2^nd edition. Exeter (UK): European Scientific Cooperative on Phytotherapy and Thieme; 2003.

Hoffmann D. Medical Herbalism. Rochester (VT): Healing Arts Press; 2003.

McGuffin M, Kartesz JT, Leung AY, Tucker AO, editors. Herbs of Commerce, 2^nd edition. Silver Spring (MD): American Herbal Products Association; 2000.

USDA 1998: United States Department of Agriculture, Agricultural Research Service, National Genetic Resources Program. Germplasm Resources Information Network (GRIN). Betula pendula Roth., Betula alba L./Betula pubescens Ehrh. National Germplasm Resources Laboratory, Beltsville (MD). [Accessed 2008-04-24]. Available from: http://www.ars-grin.gov/cgi-bin/npgs/html/tax_search.pl

References reviewed:

Brinker F. Online Updates and Additions to Herb Contraindications and Drug Interactions, 3^rd edition. Sandy (OR): Eclectic Medical Publications; 2008. [Accessed 2008-04-24]. Available from: http://www.eclecticherb.com/emp/updatesHCDI.html

Grieve M. A Modern Herbal, Volume 1. New York (NY): Dover Publications; 1971 [Reprint of 1931 Harcourt, Brace & Company publication].

McGuffin M, Hobbs C, Upton R, Goldberg A, editors. American Herbal Products Association's Botanical Safety Handbook. Boca Raton (FL): CRC Press; 1997.

Appendix 1: Examples of appropriate dosage preparations, frequencies of use and directions for use

Dried leaf: 2-3 g, several times per day [not to exceed 9 g per day] (Blumenthal et al. 1998)

Infusion:

• 2-3 g dried leaf, several times per day [not to exceed 9 g per day] (Bradley 2006)
• 2-3 g dried leaf, 2-3 times per day (ESCOP 2003)

Directions for use: Pour 250 ml of boiling water on dried leaf and steep for 10 minutes (Hoffmann 2003).

Tincture:

• 0.2 g dried equivalent, 3 times per day
  (1:10, 2 ml) (ESCOP 2003)
• 0.2-0.4 g dried equivalent, 3 times per day
  (1:5, 25% alcohol, 1-2 ml) (Hoffmann 2003)