PROPOLIS

http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-propolis.html
Februari 2008
Background
Bees create propolis, a natural resin, to build their hives. Propolis is made from the buds of conifer and poplar trees, beeswax, and other bee secretions. Historically, propolis was used in Greece to treat abscesses. The Assyrians also used propolis to heal wounds and tumors, while the Egyptians used it for mummification. Today, propolis is commonly found in chewing gum, cosmetics, creams, lozenges, and skin creams. It is frequently used in foods and beverages with the claim that it can maintain or improve health.
Propolis has shown promise in dentistry for dental caries and as a natural sealant and enamel hardener. The effectiveness of propolis against herpes simplex virus types 1 and 2 and parasitic infections has been demonstrated in early studies. However, well-designed studies are lacking, and further evidence is warranted in order to determine if propolis is effective for any health condition.
Numerous case reports have demonstrated propolis to be a potent allergen and sensitizing agent. Therefore, it should be used cautiously in allergic people. Toxicity with propolis is rare, although there are multiple case reports of skin irritation and itching, as well as blood vessel inflammation.
Synonyms
Apis mellifera L., bee glue, bee propolis, bee putty, Bienenharz (German), Brazilian green propolis, Brazilian propolis, Bulgarian propolis, caffeic acid phenethyl ester (CAPE), cera alba, chizukit, cinnamic acid, flavonoids, galangin, Greek propolis, hive dross, Propolin H, propolis balsam, propolis resin, propolis wax, propolisina (Spanish), Russian penicillin, Taiwanese propolis, terpenes, WSDP.
Evidence
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Uses based on scientific evidence Grade*

Acute cervicitis
Several studies suggest that using propolis as a cream or ointment may help heal an inflamed cervix, the narrow passage at the lower end of the uterus. These studies, however, have been small, low quality, and not fully convincing. Better studies are needed. C
Burns
Propolis may have a beneficial effect on the healing of minor burns. More studies are needed before propolis can be recommended as a burn treatment. C
Canker sores (aphthous ulcers)
There is some evidence that propolis taken by mouth may help reduce outbreaks of canker sores. Further research is needed to confirm this. C
Colds (prevention and treatment)
There is some evidence that propolis may help prevent infections with the virus that causes the common cold. Propolis nasal sprays have been suggested as a treatment for runny nose, congestion, and fever in children with nose or throat infections. However, there is not enough clinical evidence to support this use of propolis. C
Cornea complications from zoster
Laboratory studies suggest that propolis has anti-viral and anti-inflammatory effects. There is limited research of propolis for the treatment of eye complications of Varicella zoster , the virus that causes chicken pox or shingles. Some evidence suggests that propolis may speed up healing and improve sight. However, human research is needed before a recommendation can be made. C
Dental pain
There is early evidence suggesting that propolis (e.g., propolis gel) may reduce dental pain. Additional research is needed before a clear recommendation can be made. C
Dental plaque and gingivitis (mouthwash)
Early studies suggest that using a propolis mouthwash may reduce plaque formation, reduce bacteria in the mouth, relieve dental pain and gum inflammation (periodontitis), be useful as a sealant after root canal surgery, and help heal dental wounds. Early study using a gel prepared with propolis and caffeic acid phenethyl ester (CAPE) applied to the gums found that the gel provided comfort and was accepted by the volunteers. Although there has been promising research, particularly in the area of plaque reduction, most studies have been small, low quality, and not fully convincing. Better studies are needed before a recommendation can be made. C
Dental wound healing
In animals, propolis helped the mouth heal after teeth were removed. Human research is needed before a recommendation can be made. C
Fungal infections (of the mouth)
A Brazilian commercial ethanol propolis extract, formulated to ensure physical and chemical stability, was found to inhibit oral candidiasis, a fungal infection of the mouth. More studies are needed to determine if propolis is safe and effective for treating oral candidiasis. C
Genital herpes simplex virus (HSV) infection
Laboratory studies report that propolis may have action against viruses, including herpes simplex virus types 1 and 2. Early results from poorly designed human studies suggest that propolis used on the skin may improve lesions from genital herpes virus infections. However, without better human research, including comparisons to prescription drugs, firm conclusions cannot be drawn. C
Infections
Animal and laboratory studies suggest that propolis may help treat various types of infections. Initial human research reports possible benefits against bacteria in the mouth, genital herpes, urine bacteria, intestinal giardia infections, or H . pylori . Additional research is needed before a recommendation can be made. C
Legg-Calve-Perthes disease/avascular hip necrosis
These diseases are characterized by the death of bone at the hip joint (called the femoral head). Limited human research has tested propolis injections into the joint after hip replacement surgery for these conditions. However, without additional human study of safety and effectiveness, no clear conclusions can be drawn. C
Rheumatic diseases
Based on anti-inflammatory effects observed in laboratory research, propolis has been proposed as a possible treatment for rheumatic and other inflammatory diseases. However, there is currently not enough scientific human study to make a clear recommendation. C
Stomach ulcers caused by Helicobacter pylori bacteria
Some evidence suggests that propolis and some of its components may stop the growth of Helicobacter pylori , the bacterium that causes stomach ulcers. Further studies are needed to determine safe and effective doses of propolis to treat stomach ulcers. C
Vaginitis
Propolis may be an effective treatment for vaginal inflammation. However, more research is needed before propolis can be recommended. C
*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.
Grading rationale
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Academic performance, acne, anticoagulant, anti-inflammatory, anti-oxidant, anti-spasm, blood clots, bowel diseases, cancer, colorectal cancer, corneal regeneration, Crohn's disease, dermatitis, dilation of veins (vasorelaxant), diverticulitis, duodenal ulcers, eczema, HIV, hyperglycemia (high blood sugar levels), immune stimulation, immunomodulatory, laryngitis, leukemia, liver protection, low blood pressure, nasopharyngeal carcinoma, osteoporosis, prostate carcinoma, pruritus (itching), psoriasis, rheumatoid arthritis, skin rejuvenator, thyroid disease, tissue healing after surgery (tissue regeneration), tuberculosis, ulcerative colitis, UV-induced erythema prevention/sunburn, wound healing.

Dosing
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
There is no proven effective medicinal dose of propolis. However, a wide range of doses has been studied for various conditions. A 5% ointment/cream/aqueous solution of propolis applied in the form of vaginal dressings/douche daily has been used for 7-10 days for acute cervicitis or vaginitis. To treat recurring canker sores, a dose of 500 milligrams of propolis has been taken orally daily. A dose of 10 milliliters of 0.2% to 10% propolis ethanol extract mouthwash (swished in the mouth for 60-90 seconds, then spit out) has been used once or twice daily for dental plaque. For genital herpes simplex virus infection, a 3% propolis skin cream (made from 75-85% concentrated propolis extract) has been applied to the skin four times daily for 10 days. In cases of cervical or vaginal lesions, the same amount of ointment has been applied to the tip of a tampon and inserted vaginally four times daily for 10 days. Safety and effectiveness have not been established.
A dose of two 250 milligram propolis capsules has been taken by mouth three times daily for three days to treat bacteria in the urine. A 20-30% propolis extract has been taken by mouth for five days to treat giardiasis (milligram dosing not clearly described). Safety and effectiveness have not been established.
A dose of 2 milliliters of aqueous propolis extract has been injected every 14 days for up to seven months for Legg-Calve-Perthes disease/avascular necrosis of the hip. Effectiveness and safety have not been established, and dosing should only be under the supervision of a qualified healthcare professional.
Children (younger than 18 years)
A 10% ethanol extract of propolis has been taken by mouth over five days for giardiasis (milligram dosing not established). Note that ethanol (alcohol) preparations should be used cautiously in children. Safety and effectiveness have not been established.
A 0.5 milliliter propolis nasal spray (Nivcrisol®) has been used once weekly for five months in preschool children (average age six years) and school-age children (mean age nine years) over a five-month period to treat respiratory infections. Safety and effectiveness have not been established. An herbal preparation (Chizukit) containing 50 milligrams per milliliter (mg/mL) of echinacea, 50 mg/mL of propolis, and 10 mg/mL of vitamin C, or placebo (5 milliliters and 7.5 milliliters twice daily for ages 1-3 years and 4-5 years, respectively) has been used for 12 weeks. Currently there is not enough scientific evidence to support the use of propolis for respiratory tract infections.
Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
Patients should avoid propolis if they have had allergic/hypersensitivity reactions to propolis, Populus nigra L. (black poplar), poplar bud, bee stings/bee products (including honey), or Balsam of Peru. There are multiple reports of swelling, fluid collection, redness, burning, eczema, swelling, fever, and other allergic reactions (including a severe allergic reaction called anaphylaxis) with repeated use of propolis on the skin. Propolis has been linked to several cases of contact dermatitis in beekeepers. Allergic contact stomatitis has been associated with the therapeutic use of propolis.
Side Effects and Warnings
The safety of propolis has not been thoroughly studied. Although there are several case reports of allergic reactions to propolis, it is generally believed to be well tolerated in most adults. Allergic reactions may cause swelling, redness, eczema, or fever. Propolis may irritate the skin and may cause burning, peeling lips, irritation, lesions, itching, swelling, psoriasis, or eczema. Case reports of irritation in and around the mouth have occurred after use of propolis lozenges or extract taken by mouth.
Toxicity data for propolis are limited. Early studies have found propolis to be relatively non-toxic. There has been one report of kidney failure with the ingestion of propolis that improved upon discontinuing therapy and worsened with re-exposure.
Pregnancy and Breastfeeding
There is not enough scientific evidence to recommend the use of propolis during pregnancy or breastfeeding. Many tinctures contain high levels of alcohol and should be avoided during pregnancy.
Propolis may protect against male infertility, although this use has not been thoroughly studied.
Interactions
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Many tinctures contain high levels of alcohol and may cause nausea or vomiting when taken with metronidazole (Flagyl®) or disulfiram (Antabuse®).
Propolis may produce additive effects when taken with antimicrobial drugs.
Propolis may interact with the following: anticoagulants, H . pylori agents, antibiotics, anti-cancer agents (antineoplastics), antifungals, anti-inflammatories, infertility agents, anti-HIV agents (antiretrovirals), immunosuppressants, and osteoporosis agents.
Interactions with Herbs and Dietary Supplements
Balsam of Peru and propolis are both known to cause allergic sensitization in some people and have multiple compounds in common, such as benzyl benzoate, benzyl cinnamate, benzyl alcohol, benzoic acid, cinnamic acid, caffeic acid, cinnamic alcohol, and vinallin. An increased risk of allergic sensitization may occur if both products are used together.
Propolis may interact with the following herbs and supplements: anticoagulants (such as coumarin and licorice), antibacterials, anti-cancer agents (antineoplastics), antifungals, anti-inflammatories, antioxidants, fertility agents, anti-HIV agents, immunostimulants, immunosuppressants, and osteoporosis agents.
Methodology
This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Steve Bent, MD (University of California, San Francisco); Wendy Chao, PhD (Natural Standard Research Collaboration); Richard Philip Cohan, DDS, MS, MBA (School of Dentistry, University of the Pacific); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Sadaf Hashmi, MD, MPH (Natural Standard Research Collaboration); Jamie Nelsen, PharmD (University of Rhode Island); Adrianne Rogers, MD (Boston University School of Medicine); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Natural Standard Research Collaboration).