Taxonomic class

Smilacaceae

Common Trade Names

Multi-ingredient preparations: Sarsaparilla, Sarsaparilla Root Extract

Common Forms

Available as capsules (425 mg, 520 mg), dried root powder, liquid (30 ml), solid root extract, tablets, and teas.

Source

The dried roots and rhizomes of various Smilax species (S. aristochiifolia, S. regelii, S. febrifuga, S. ornata) are used in commercial products. Smilax species are cultivated in Mexico, Jamaica, and South America.

Chemical Components

Saponins constitute] % to 3% of the chemical components of sarsaparilla, with the three main saponins being sarsaponin (parillin), smilasaponin (smilacin), and sarsaparilloside. Other saponins include sarsapogenin (parigenin), smilagenin, diosgenin, tigogenin, aspergenin, and laxogenin. Phytosterols, such as beta-sitosterol, may contribute to an anti-inflammatory effect. Resins, starch, trace volatile oils, and cetyl alcohol constitute the remainder of the compound.

Actions

Sarsaparilla’s pharmacologic effects have been attributed to the saponins, which are claimed to be blood purifiers or tonics that supposedly remove unwanted toxins from the body. This idea might have arisen from sarsaparilla’s supposed diaphoretic and diuretic effects. Other purported effects of saponins include an ability to bind serum cholesterol in the GI tract and a hemolytic effect if administered IV These pharmacologic effects are not well documented.

Sarsaparilla has shown in vitro activity against common dermatophytes . Significant anti-inflammatory activity and prevention of chemically induced hepatocellular damage have been noted in rodents . Sarsaparilla was found not to have any beneficial effects for improving the healing of bone fractures in rats.

Reported Uses

Sarsaparilla root is claimed to be useful for treating renal disease, rheumatism, and skin diseases such as psoriasis and eczema. Older research attempts to substantiate sarsaparilla for use in psoriatic disease.

The most notable trial involved patients with psoriasis vulgaris who received sarsaponin (a major component of sarsaparilla) or placebo . Although the study showed favorable results in terms of improved symptoms, duration of benefit, and reduced disease exacerbations, problems with study design led to questions regarding the final conclusions reached.

Because of its steroidal components, sarsaparilla has also been touted as an athletic performance-enhancing agent. These steroids have not been proven to be anabolic, and therefore, this claim remains unsubstantiated. Sarsaparilla has been promoted as an appetite and digestion aid and as a diuretic. Its extract has been evaluated as adjunctive therapy in leprosy .

The 1992 German Commission E monograph advocates the use of sarsaparilla in treating psoriasis, renal disease, and rheumatic complaints and for diaphoresis and diuresis.

Sarsaparilla is accepted by the FDA as a flavoring agent.

Dosage

For psoriasis, 1 to 4 g of dried root, 8 to 30 ml of concentrated sarsaparilla compound decoction, or 8 to 15 ml of liquid extract P.O. t.i.d. has been suggested.

Adverse Reactions

CV: hypotension.

GI: diarrhea, GI irritation.

GU: renal dysfunction.

Hematologic: hemolysis (I.V. use).

Metabolic: electrolyte imbalances.

Respiratory: asthma (inhalation of root dust).

Interactions

Bismuth: May increase absorption or elimination or both. Avoid administration with sarsaparilla.

Certain hypnotic drugs: Increased elimination. Monitor for lack of effectiveness.

Digitalis: Increased absorption. Do not use together.

Oral drugs: Saponins may affect absorption of other drugs. Other drugs should be taken 2 hours before or after taking sarsaparilla.

Contraindications and Precautions

Avoid using sarsaparilla in pregnant or breast-feeding patients; effects are unknown.

Special Considerations

• Inform the patient that therapeutic claims for sarsaparilla are weakly substantiated.
• Advise the patient with asthma to avoid inhaling sarsaparilla root dust or root particles.
• Caution the patient who is already taking a diuretic about excessive diuretic effects, fluid and electrolyte imbalances, and hypotension.

Points of Interest

• Since the] 6th century, sarsaparilla was thought to be an effective treatment for syphilis. It gained popularity in the Old West of the United States and was the drink of choice for cowboys. It was even listed for such uses in the USP from 1820 to 1910. Activity against syphilis has not been pharmacologically substantiated.

Commentary

The use of sarsaparilla for any condition needs further research. Mechanisms and properties are not clearly documented or adequately researched. The most notable clinical trial evaluated the herb’s use in study design and the presence of confounding variables placed the conclusions in question.

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