Plantago

Scientific Name(s): Plantago arenaria Waldst. & Kit., Plantago lanceolata L., Plantago major L., Plantago ovata Forsk., Plantago psyllium L.
Common Name(s): Black psyllium, Blond plantago, Flea seed, French psyllium, Indian plantago, Ispaghula, Plantago psyllium, Plantain, Psyllium seed, Spanish psyllium

Medically reviewed by Drugs.com. Last updated on Sep 21, 2021.

Clinical Overview

Use

The psyllium in plantago has been used for GI conditions such as irritable bowel syndrome (IBS), diarrhea, constipation, and hemorrhoids. It has also been used to treat hyperlipidemia and for its anticancer effects, and it may be useful for glycemic control in patients with type 2 diabetes. Although some clinical data exist to support use of plantago in constipation, respiratory infections, and hyperlipidemia, clinical information regarding other potential uses is lacking.

Dosing

General Dosing: 3 to 6 g/day of psyllium.

Constipation: 1 teaspoon to 1 tablespoon of powder or granules mixed in 180 to 240 mL of liquid 1 to 3 times/day. Dosage varies according to product; see product labeling. Product is also available as capsules and wafers.

Glycemic Control in Type 2 Diabetic Patients: 6.8 to 13.6 g/day of psyllium for 6 to 12 weeks.

Hyperlipidemia: 10.2 g/day of psyllium in 2 to 3 divided doses.

Respiratory Infections: 3 to 6 g/day as a tea.

Contraindications

Because psyllium acts as a bulk laxative, patients with GI obstruction or fecal impaction should avoid use, as it may worsen these conditions. Additionally, patients with difficulty swallowing should avoid psyllium because there is a risk for choking and esophageal obstruction.

Pregnancy/Lactation

Avoid use. Adverse effects have been documented: uterine activity, laxative.

Interactions

Patients receiving prescription medications should be advised to consult their health care provider before taking psyllium or any other natural products. See Interactions section.

Adverse Reactions

Minor adverse reactions include flatulence, bloating, nausea, vomiting, indigestion, and sternum pain. More serious adverse effects include anaphylaxis, chest congestion, sneezing and watery eyes, and occupational asthma; a case of giant phytobezoar (a trapped mass composed of psyllium seed husks) has also been reported.

Toxicology

The pollen from plantago contains allergenic glycoproteins that react with concanavalin A, as well as components that bind immunoglobulin E (IgE). IgE antibodies have been demonstrated. IgE-mediated sensitization contributes to seasonal allergies.

Scientific Family

• Plantaginaceae

Botany

Plantago is a perennial weed with almost worldwide distribution. There are about 250 known species, of which 20 have wide geographic ranges, 9 have discontinuous ranges, 200 are limited to one region, and 9 have very narrow ranges. P. lanceolata and P. major are among the most widely distributed.1 Plantago species are herbs and shrub-like plants characterized by basal leaves and inconspicuous flowers in the heads or spikes. P. major can grow up to 15 cm in height.2 These species grow aggressively; plantago is wind-pollinated, which facilitates growth where there are no bees and few other plantago plants. The plant is also very tolerant of viral infections. P. major produces 13,000 to 15,000 seeds per plant, and the seeds are reported to remain viable in soil for up to 60 years. P. lanceolata produces 2,500 to 10,000 seeds per plant and has a somewhat shorter period of seed viability. Plantago seeds can survive passage through the gut of birds and other animals, which further facilitates their distributi...