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Vaccinium macrocarpon (Cranberry)

Uses: Traditional uses: 1) North American Indians taught Pilgrims many uses of cranberry 2) cranberry has been used extensively in American cooking since Thanksgiving Current uses: - treatment & prevention of urinary tract infections (UTI) [2,5] - prevention of symptomatic, culture-verified UTIs in women with recurrent UTIs, in children & persons susceptible to UTIs after interventions [10] - prevention of UTIs in women of all ages [11] - not effective for preventing bacteriuria plus pyuria in elderly women residing in nursing home [8] - not for use in elderly women, urinary retention or pregnancy [10] Dosage: 1) 300-400 mg of concentrated extract BID 2) 8-16 oz of cranberry cocktail/day Adverse effects: - possibly increased risk of renal stones - contains oxalate (7.5 mg/4 oz) [3] - acidifies urine Drug interactions: 1) cranberry inhibits cyt P450 2C9 [4], thus potentially interacts with any drug metabolized by cyt P450 2C9 2) does NOT interact with warfarin [5] 3) no drug interactions [7] Mechanism of action: 1) active ingredients: not known, ripe fresh fruit is needed 2) acidifies urine 3) commercial cocktails of cranberry do not acidify urine sufficiently for antibacterial effect 4) antibacterial affect not related to ability of cranberry to acidify urine 5) cranberry inhibits ability of microorganisms, especially E. coli to adhere to the epithelial cells of the bladder 6) does not appear to be effective in preventing UTI Clinical trials: - cranberry supplementation* for 12 weeks in elderly 50-80 years - associated with improvements in visual episodic memory - decrease LDL-cholesterol [9] * cranberry extract equivalent to 1 cup of cranberries

Interactions

drug interactions

General

pharmaceutical herb; medicinal herb; herbal supplement; botanical

References

  1. Victoria Rand, UCSF Fresno Lecture, 10/7/98
  2. Avorn J et al Reduction of bacteriuria and pyuria after ingestion of cranberry juice. JAMA. 1994 Mar 9;271(10):751-4. PMID: 8093138
  3. Prescriber's Letter 8(12):71 2001
  4. Prescriber's Letter 10(11):63 2003
  5. Prescriber's Letter 14(6): 2007 Does a Cranberry Juice-Warfarin Interaction Really Exist? Detail-Document#: 230614 (subscription needed) http://www.prescribersletter.com
  6. Journal Watch 21(17):138, 2001 Kontiokari T et al Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ 322:1571 2001 PMID: 11431298 - Barbosa-Cesnik C et al. Cranberry juice fails to prevent recurrent urinary tract infection: Results from a randomized placebo-controlled trial. Clin Infect Dis 2011 Jan 1; 52:23. PMID: 21148516
  7. Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
  8. Juthani-Mehta M, Van Ness PH, Bianco L et al Effect of Cranberry Capsules on Bacteriuria Plus Pyuria Among Older Women in Nursing Homes: A Randomized Clinical Trial. JAMA. Published online October 27, 2016 PMID: 27787564 http://jamanetwork.com/journals/jama/fullarticle/2576822 - Nicolle LE Cranberry for Prevention of Urinary Tract Infection? Time to Move On. JAMA. Published online October 27, 2016 PMID: 27787544 http://jamanetwork.com/journals/jama/fullarticle/2576821
  9. Brooks M A Cup of Cranberries a Day Tied to Better Memory. Medscape. May 20, 2022 https://www.medscape.com/viewarticle/974349 - Flanagan E, Cameron D, Sobhan R et al Chronic Consumption of Cranberries (Vaccinium macrocarpon) for 12 Weeks Improves Episodic Memory and Regional Brain Perfusion in Healthy Older Adults: A Randomised, Placebo-Controlled, Parallel-Groups Feasibility Study. Front. Nutr., 19 May 2022 PMID: 35662954 PMCID: PMC9160193 Free PMC article https://www.frontiersin.org/articles/10.3389/fnut.2022.849902/full
  10. Williams G, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2023 Apr 17;4(4):CD001321.. Update in: Cochrane Database Syst Rev. 2023 Nov 10;11:CD001321 PMID: 37068952 PMCID: PMC10108827 Free PMC article. Review.
  11. Broder J It's in the Juice: Cranberries for UTI Prevention. Medscape. August 7, 2024 https://www.medscape.com/viewarticle/its-juice-cranberries-uti-prevention-2024a1000ei4 - Moro C et al Cranberry Juice, Cranberry Tablets, or Liquid Therapies for Urinary Tract Infection: A Systematic Review and Network Meta-analysis. Eur Urol Focus. 2024 Jul 18:S2405-4569(24)00122-6 PMID: 39030132 Free article. Review. https://www.sciencedirect.com/science/article/pii/S2405456924001226
  12. Medscape: Cranberry (Herb/Suppl) https://reference.medscape.com/drug/american-cranberry-black-cranberry-cranberry-344568

Component-of

ascorbate/vaccinium macrocarpon/vitamin e milk thistle/vaccinium macrocarpon