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• The calorific content of cranberry juice should be borne in mind. Patients with diabetes
who wish to use cranberry juice should be advised to use sugar–free preparations.

• Patients using cranberry juice should be advised to drink sufficient fluids in order to
ensure adequate urine flow.

• It has been stated that cranberry should be used with caution in patients with benign
prostatic hypertrophy (BPH) or urinary obstruction, because there is the theoretical
possibility that cranberry may enhance the elimination of drugs excreted in urine.

• Patients with kidney stones or impaired kidney function should use products containing
the fruit only after consulting their health care provider

Pregnancy and lactation

There are no known problems with the use of cranberry during pregnancy. Doses of
cranberry greatly exceeding the amounts used in foods should not be taken during
pregnancy and lactation.

Drug interactions

The Medicines and Healthcare Products Regulatory Agency (MHPRA) in the United
Kingdom has reported numerous cases of a possible interaction between cranberry juice
and warfarin, leading to bleeding.

Chaste berry (Agnus castus, Vitex)

It consists of the dried, ripe fruits of Vitex agnus-castus L. Family Lamiaceae.

Synonyms: Agnus-castus vulgaris Carr., Vitex verticillata Lam.

Chemical Constituents

• Alkaloids: Viticin.
• Diterpenes: Rotundifuran, and vitexilactone.
• Flavonoids: Flavonol derivatives, the major constituent being casticin.
• Other constituents: Fatty acids, volatile oil, castin (a bitter principle).

Medicinal uses

Uses supported by clinical data

Orally for the symptomatic treatment of gynaecological disorders including corpus luteum
insufficiency and hyperprolactinaemia, premenstrual syndrome, menstrual irregularities
and also to treat hormonally-induced acne.

The German Commission E approved it for internal use for irregularities of the menstrual
cycle, premenstrual complaints and mastodynia.

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