toxylact: a05ba08 glycyrrizic acid

The first professional lActological database in the word

Glycyrrhizic acid (ATC A05BA08) is a hepatoprotective licorice‑derived compound used mainly for chronic liver diseases, but its mineralocorticoid‑like toxicity makes it problematic in pregnancy and requires caution during lactation.medpedia.framar+6

ATC Class And Pharmacological Profile

Glycyrrhizic acid (glycyrrhizin, glycyrrhizinic acid) is classified in ATC A05BA08, within “liver therapy” agents for the treatment of hepatic disorders.atcddd.fhi+1
It is a triterpenoid saponin glycoside extracted from licorice root (Glycyrrhiza glabra and related species), usually used as calcium, potassium or ammonium salts in medicinal preparations.pmc.ncbi.nlm.nih+2

Mechanism Of Action And Therapeutic Uses

Glycyrrhizic acid exhibits hepatoprotective, anti‑inflammatory, antioxidant and antiviral properties, including suppression of hepatitis B surface antigen production and modulation of hepatocyte membrane stability.drugbank+3
Clinically, glycyrrhizin‑containing preparations are used in some countries for chronic hepatitis, liver fibrosis and other chronic liver diseases, and they may accelerate healing of gastrointestinal mucosal lesions and ulcers when used orally.frontiersin+3

Dosage Forms And Administration

For oral use, glycyrrhizic acid is commonly formulated as chewable tablets, dragees or other solid dosage forms that are taken before meals to exert local gastroprotective and systemic hepatoprotective effects.medpedia.framar+1
Parenteral glycyrrhizin preparations (e.g. intravenous formulations) are also employed in some settings for chronic viral hepatitis, although dose and regimen vary by product and national authorization.pmc.ncbi.nlm.nih+1

General Toxicological Concerns

Glycyrrhizic acid can inhibit 11β‑hydroxysteroid dehydrogenase type 2, leading to elevated cortisol activity at mineralocorticoid receptors and a clinical picture of pseudohyperaldosteronism.sciencedirect+1
Chronic or high‑dose exposure may cause hypertension, sodium and water retention, hypokalemia, edema, cardiac arrhythmias and muscle weakness, and it can potentiate toxicity of diuretics and other drugs affecting electrolyte balance.catalysis+3

Organ‑System Toxicity

High or prolonged intake is associated with increased cardiovascular risk through blood pressure elevation and volume overload, particularly in older patients or those with pre‑existing heart disease.pubmed.ncbi.nlm.nih+3
Endocrine effects include disturbances in adrenal hormone regulation and possible anti‑prolactin and estrogenic activity, which may reduce milk production and influence reproductive outcomes.e-lactation+2

Drug–Drug And Food Interactions

By promoting potassium loss and sodium retention, glycyrrhizic acid may enhance the effects and adverse reactions of loop and thiazide diuretics, cardiac glycosides and other agents sensitive to electrolyte status.pmc.ncbi.nlm.nih+1
Concomitant use with antihypertensives, corticosteroids or drugs that prolong QT interval requires careful monitoring, as glycyrrhizin‑induced hypertension and hypokalemia can destabilize cardiovascular therapy.sciencedirect+2

Use In Pregnancy

Oral licorice and glycyrrhizic acid are generally considered contraindicated in pregnancy because of their capacity to induce hypertension, electrolyte disturbances and hormonal effects.vkm+1
Several observational data sets suggest that high prenatal exposure to glycyrrhizic acid from maternal licorice consumption may be associated with adverse fetal outcomes and long‑term neurodevelopmental effects, so avoidance is recommended.cleanconsciousbeauty+1

Lactation Safety And Milk Transfer

Glycyrrhizin has been detected in breast milk in some women consuming licorice products, although data on glycyrrhetinic acid levels and precise infant exposure are limited.e-lactation+1
Available lactation references (e.g. LactMed, E‑lactancia and expert reviews) advise avoiding chronic or high‑dose licorice/glycyrrhizic acid during breastfeeding because of potential mineralocorticoid toxicity and hormonal effects, while occasional low‑dose dietary exposure is considered low risk.consumerlab+3

Reported Effects In Breastfed Infants

Case reports describe severe lethargy in neonates whose mothers consumed very large volumes of herbal beverages containing licorice in combination with other galactagogue herbs, although causality for glycyrrhizin specifically cannot be isolated.e-lactation
Given the narrow safety margin and the possibility of additive toxicity when combined with other herbs or drugs, breastfed infants of mothers using high‑dose glycyrrhizic acid should be monitored for poor feeding, lethargy, edema and signs of electrolyte imbalance.pubmed.ncbi.nlm.nih+2

Practical Lactological Recommendations

For hepatoprotective therapy in breastfeeding women, alternatives with better characterized lactation safety profiles should generally be preferred instead of glycyrrhizic acid.consumerlab+1
If glycyrrhizin‑containing products are used despite cautions, clinicians should limit dose and duration, avoid additional licorice sources, monitor maternal blood pressure and serum electrolytes, and follow the infant for clinical signs of mineralocorticoid excess.pmc.ncbi.nlm.nih+2

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