Sage

Quick Guide to Dementia

What other names is Sage known by?

Common Sage, Dalmatian Sage, Feuille de la Bergère, Garden Sage, Herbe Sacré, Meadow Sage, Salvia lavandulaefolia, Salvia officinalis, Sauge, Sauge Ananas, Sauge des Prairies, Sauge Divinatoire, Sauge Divine, Sauge Domestique, Sauge Officinale, Scarlet Sage, Spanish Sage, True Sage, Vraie Sauge.

What is Sage?

Sage is an herb. The leaf is used to make medicine.

Sage is used for digestive problems, including loss of appetite, gas (flatulence), stomach pain (gastritis), diarrhea, bloating, and heartburn. It is also used for reducing overproduction of perspiration and saliva; and for depression, memory loss, and Alzheimer's disease.

Women use sage for painful menstrual periods, to correct excessive milk flow during nursing, and to reduce hot flashes during menopause.

Sage is applied directly to the skin for cold sores; gum disease (gingivitis); sore mouth, throat or tongue; and swollen, painful nasal passages.

Some people inhale sage for asthma.

In foods, sage is used as a commonly used spice.

In manufacturing, sage is used as a fragrance component in soaps and cosmetics.

Possibly Effective for...

  • Alzheimer's disease. Taking extracts of two different sage species (Salvia officinalis and Salvia lavandulaefolia) for 4 months seems to improve learning, memory and information processing in people with mild to moderate Alzheimer's disease.
  • Mental performance. Taking a single dose of common sage (Salvia officinalis) or Spanish sage (Salvia lavandulaefolia) by mouth seems to improve memory, alertness, and attention in healthy adults. When used as aromatherapy, these sage species seem to improve alertness, but not attention and memory.
  • Cold sores, when applied as a cream containing sage and rhubarb. Applying a cream containing common sage (Salvia officinalis) and rhubarb (Rheum officinale and Rheum palmatum) to cold sores may be about as effective as acyclovir (Zovirax) cream. Acyclovir cream heals the cold sores in about 6 days; it takes the sage and rhubarb cream about 7 days to heal them. Sage and rhubarb together work faster than sage alone.
  • High cholesterol. Taking common sage (Salvia officinalis) three times per day for 2 months seems to reduce "bad" low-density lipoprotein (LDL) cholesterol and blood fats called triglycerides, and increase "good" high-density lipoprotein (HDL) cholesterol, in people with high cholesterol.
  • Memory. Taking a single dose of common sage (Salvia officinalis) or Spanish sage (Salvia lavandulaefolia) by mouth seems to improve memory in healthy adults. However, these sage species do not seem to improve memory when used as aromatherapy.
  • Menopausal symptoms. Early research suggests that taking extract of common sage (Sage Menopause, Bioforce AG) for 8 weeks improves symptoms of menopause, especially hot flashes. Also, other developing research suggests that taking a combination of common sage (Salvia officinalis) and alfalfa extract for 3 months reduces hot flashes and night sweats.

Insufficient Evidence to Rate Effectiveness for...

  • Lung cancer. People who regularly use sage as a spice seem to have a 54% lower chance of developing lung cancer compared to those who don't use sage.
  • Sore throat. Using a specific spray containing 15% common sage extract (Valverde Salvia Rachenspray) seems to reduce throat pain in people with a sore throat. However, sprays containing higher (30%) and lower (5%) amounts of common sage extract do not seem to reduce throat pain. Other early research suggests that spraying the throat with a specific product containing common sage and echinacea for up to 5 days improves sore throat symptoms similarly to a commonly used drug spray.
  • Pain after surgery. Early research suggests that taking common sage (Salvia officinalis) along with the drugs ibuprofen or diclofenac is less effective for reducing pain after surgery compared to using the drug benzydamine hydrochloride. Also, using common sage seems to increase the risk of infections after surgery compared to benzydamine hydrochloride.
  • Sunburn. Applying 2% common sage (Salvia officinalis) extract to the skin after UV exposure seems to reduce the development of skin redness.
  • Swelling of the tonsils (tonsillitis). Early research suggests that spraying the throat with a specific product containing common sage and echinacea for up to 5 days improves symptoms of tonsillitis similarly to a commonly used drug
  • Loss of appetite.
  • Stomach pain.
  • Dry mouth.
  • Painful periods.
  • Asthma.
  • Diarrhea.
  • Gas.
  • Bloating.
  • Indigestion.
  • Excessive sweating.
  • Other condition.
More evidence is needed to rate sage for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Quick GuideDementia, Alzheimer's Disease, and Aging Brains

Dementia, Alzheimer's Disease, and Aging Brains

How does Sage work?

Sage might help chemical imbalances in the brain that cause symptoms of Alzheimer's disease.

Are there safety concerns?

Sage is LIKELY SAFE in amounts typically used in foods. It is POSSIBLY SAFE when taken by mouth or applied to the skin in medicinal amounts short-term (up to 4 months).

However, sage is POSSIBLY UNSAFE when taken by mouth in high doses or for a long time. Some species of sage, such as common sage (Salvia officinalis), contain a chemical called thujone. Thujone can be poisonous if you get enough. This chemical can cause seizures and damage to the liver and nervous systems. The amount of thujone varies with the species of plant, the time of harvest, growing conditions, and other factors.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Taking sage during pregnancy is LIKELY UNSAFE because of the possibility of consuming thujone, a chemical found in some sage. Thujone can bring on a woman's menstrual period, and this could cause a miscarriage. Avoid sage if you are breast-feeding, too. There is some evidence that thujone might reduce the mother's milk supply.

Diabetes: Sage might lower blood sugar levels in people with diabetes. Watch for signs of low blood sugar (hypoglycemia) and monitor your blood sugar carefully if you have diabetes and use sage. The dose of your diabetes medications may need to be adjusted by your healthcare provider.

Hormone-sensitive condition such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Spanish sage (Salvia lavandulaefolia) might have the same effects as the female hormone estrogen. If you have any condition that might be made worse by exposure to estrogen, don't use Spanish sage.

High blood pressure, low blood pressure: Spanish sage (Salvia lavandulaefolia) might increase blood pressure in some people with high blood pressure, while common sage (Salvia officinalis) might lower blood pressure in people with blood pressure that is already low. Be sure to monitor your blood pressure.

Seizure disorders: One species of sage (Salvia officinalis) contains significant amounts of thujone, a chemical that can trigger seizures. If you have a seizure disorder, don't take sage in amounts higher than those typically found in food.

Surgery: Common sage might affect blood sugar levels. There is a concern that it might interfere with blood sugar control during and after surgery. Stop using common sage as a medicine at least 2 weeks before a scheduled surgery.

Are there any interactions with medications?



Drying medications (Anticholinergic drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) might increase levels of certain chemicals in the body that work in the brain, heart, and elsewhere. Some drying medications called "anticholinergic drugs" can also these same chemicals, but in a different way. These drying medications might decrease the effects of these sage species, and these sage species might decrease the effects of drying medications.

Some of these drying medications include atropine, scopolamine, some medications used for allergies (antihistamines), and some medications used for depression (antidepressants).



Estrogens
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Geraniol, a chemical in Spanish sage (Salvia lavandulaefolia), might have some of the same effects as estrogen. However, geraniol found in Spanish sage isn't as strong as estrogen pills. Taking Spanish sage along with estrogen pills might decrease the effects of estrogen pills.

Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.



Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Sage might decrease how quickly the liver breaks down some medications. Taking sage along with some medications that are broken down by the liver might increase the effects and side effects of some medications. Before taking sage as a medicine, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.



Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Sage might decrease how quickly the liver breaks down some medications. Taking sage along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking sage as a medicine, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others.



Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Sage might decrease how quickly the body breaks down some medications. Taking sage along with some medications that are changed by the liver can increase the effects and side effects of your medication. Before taking sage as a medicine, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the body include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), fluoxetine (Prozac), ondansetron (Zofran), tramadol (Ultram), and others.



Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Common sage might increase how quickly the liver breaks down some medications. Taking common sage along with some medications that are changed by the liver might decrease the effects and side effects of your medication. Before taking common sage as a medicine, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include acetaminophen, chlorzoxazone (Parafon Forte), ethanol, theophylline, and drugs used for anesthesia during surgery such as enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), and methoxyflurane (Penthrane).



Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Sage might decrease how quickly the liver breaks down some medications. Taking sage along with some medications that are broken down by the liver might increase the effects and side effects of these medications. Before taking sage as a medicine, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Medications that might be affected include certain heart medications called calcium channel blockers (diltiazem, nicardipine, verapamil), cancer drugs (etoposide, paclitaxel, vinblastine, vincristine, vindesine), fungus-fighting drugs (ketoconazole, itraconazole), glucocorticoids, alfentanil (Alfenta), cisapride (Propulsid), fentanyl (Sublimaze), lidocaine (Xylocaine), losartan (Cozaar), midazolam (Versed), and others.



Medications for Alzheimer's disease (Acetylcholinesterase (AChE) inhibitors)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) might increase certain chemicals in the brain, heart, and elsewhere in the body. Some medications used for Alzheimer's disease also affect these chemicals. Taking these species of sage along with medications for Alzheimer's disease might increase effects and side effects of medications used for Alzheimer's disease.



Medications for diabetes (Antidiabetes drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Sage might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking sage along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.



Medications for high blood pressure (Antihypertensive drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Common sage (Salvia officinalis) seems to lower blood pressure. Taking common sage along with medications for high blood pressure might cause your blood pressure to go too low. On the other hand, Spanish sage (Salvia lavandulaefolia) might increase blood pressure. Taking Spanish sage along with medications for high blood pressure might reduce the effects of these medications.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.



Medications moved by pumps in cells (P-glycoprotein substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are moved by pumps into cells. Common sage (Salvia officinalis) might make these pumps less active and increase how much of some medications get absorbed by the body. This might increase the side effects of some medications.

Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.



Medications used to prevent seizures (Anticonvulsants)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Medications used to prevent seizures affect chemicals in the brain. Sage may also affect chemicals in the brain. By affecting chemicals in the brain, sage may decrease the effectiveness of medications used to prevent seizures.

Some medications used to prevent seizures include phenobarbital, primidone (Mysoline), valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), phenytoin (Dilantin), and others.



Sedative medications (Benzodiazepines)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Common sage (Salvia officinalis) might cause sleepiness and drowsiness. Medications that cause sleepiness and drowsiness are called sedatives. Taking common sage along with sedative medications might cause too much sleepiness.

Some of these sedative medications include clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), and others.



Sedative medications (CNS depressants)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Sage might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking sage along with sedative medications might cause too much sleepiness.

Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.



Various medications used for glaucoma, Alzheimer's disease, and other conditions (Cholinergic drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) might increase certain chemicals in the brain, heart, and elsewhere in the body. Some medications used for glaucoma, Alzheimer's disease, and other conditions also affect these chemicals. Taking these species of sage with these medications might increase the chance of side effects.

Some of these medications used for glaucoma, Alzheimer's disease, and other conditions include pilocarpine (Pilocar and others), donepezil (Aricept), tacrine (Cognex), and others.

Dosing considerations for Sage.

The following doses have been studied in scientific research:

BY MOUTH:
  • For treating Alzheimer's disease: 1 gram of sage per day. A dose of sage extract, gradually increased over time to 2.5 mg three times daily, has also been used.
APPLIED TO THE SKIN:
  • For treatment of herpes labialis (cold sores): A cream containing 23 mg/gram each of sage extract and rhubarb extract has been applied every 2 to 4 hours while awake, with treatment starting within 1 day of the first symptoms and continuing for 10 to 14 days.
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Reviewed on 3/29/2011 12:35:40 PM

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