sage
Patient Counselling
Patient Counselling
- Sage is a popular European treatment for inflammation of the mouth and throat <1>.
- Sage has a long history of use against inflammation of the oral cavity and throat when used as a mouthwash or gargle <1>. As such, use of a mouthwash/gargle or topical spray is recommended of the treatment of sore throat <1,2,3>.
- Use of sage for the treatment of acute sore throat should be initiated at the first sign of symptom onset and continued for 2 to 3 days <1>. Patients should be advised if they do not experience improvement within that time or if symptoms get worse at any time, they should contact their physician.
- Salvia officinalis is the species of sage more commonly used in medicine <1>. It is this species of sage which is associated with the most preliminary evidence. Therefore, in patients looking to use sage for the treatment and symptomatic relief of acute sore throat, a product containing S. officinalis should be recommended. Caution patients that various formulations of sage (S. officinalis) exist for purchase.
- Preliminary clinical evidence suggests sage, specifically S. officinalis, is efficacious and safe for the treatment and symptomatic relief of acute sore throat although additional investigation is required to support or refute this claim <1>.
- Natural Standard evidence rating of sage for sore throat is C; Unclear scientific evidence <1>.
- Sage has been demonstrated to possess antibacterial, antifungal, anti-inflammatory, antimicrobial, antioxidant, and antiviral properties <1>. However, the exact mechanism of action by which sage is acts for the treatment and/or symptomatic relief of sore throat is unclear.
- Sage may work synergistically with other herbal ingredients such as echinacea for the treatment of sore throat.
- Sage is considered possibly safe by Natural Standard when used as a mouthwash or gargle for sore throat, due to a long history of use particularly in Europe <1>. It is important to note, sage is considered unsafe when large amounts of the essential oil or tinctures are ingested, due to the possibility of seizure induction as observed in case reports <1>. As such, the use of sage should be AVOIDED in patient with a history of seizure disorders.
- The use of sage should be AVOIDED in those patients with a known allergy/hypersensitivity to sage species, their constituents, or to members of the Lamiaceae family <1,4>.
- Sage should be used with caution in those with hypertension, asthma, and diabetes due to the potential for worsening these conditions <1,4>. Caution should also be exercise when using sage in patients taking anticoagulants or antiplatelets as it may increase their bleeding risk. Monitoring is important in these patient groups.
- Sage appears to be safe and well tolerated in most patients <1>. Common side effects of using a topical sage spray are gastrointestinal in nature and include minor dry mouth and mild burning <1>.
- Adverse effects include restlessness, vomiting, tachycardia, tremors, seizures and kidney damage <1>. However, these only affects observed when sage is used at high doses or for prolonged periods of time <1>.
- The exact optimal dose of sage for the treatment and symptomatic relief of acute sore throat is unclear <1>. Patients should also be advised that formulations of products vary from manufacturer to manufacturer which may influence effectiveness for sore throat treatment.
- Recommended Dosage (Adults ≥ 18 yrs): A 15% spray containing 140 mcL of S. officinalis extract per dose has been used 6 to 9 times daily for three days and demonstrated effectiveness for sore throat symptomatic relief <1,3>.
- Recommended Dosage (Children ≤ 18 yrs): There is currently a lack of evidence to recommend the used of sage in those younger than the age of 18 years <1>.
- The use of sage in pregnancy and lactation should be AVOIDED due to the lack of evidence of use in this patient population <1>.
References
1. Adams J.D. et. al. Sage (Salvia officinalis, Salvia lavandulaefolia, Salvia lavandulifolia). Natural Standard Professional Monograph. accessed at: www.naturalstandard.com on March 26, 2013.
2. Schapowal A, Berger D, Klein P, Suter A. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: A randomized double-blind trial. Eur J Med Res 2009; 14: 406-412.
3. Hubber M, Sievers H, Lehnfeld R, Kehrl W. Efficacy and Tolerability of a Spray with Salvia Officinalis in the Treatment of Acute Pharyngitis – A Randomized, Double-Blinded, Placebo-Controlled Study with Adaptive Design and Interim Analysis. Eur J Med Res. 2006;11:20-6.
4. Micromedix. Sage. http://www.micromedexsolutions.com/micromedex2/librarian/ND_T/ evidencexpert/ND_PR/evidencexpert/CS/1BA191/ND_AppProduct/evidencexpert/DUPLICATIONSHIELDSYNC/8A7F7F/ND_PG/evidencexpert/ND_B/evidencexpert/ND_P/evidencexpert/PFActionId/evidencexpert.IntermediateToDocumentLink?docId=1000737048&contentSetId=47&title=Sage&servicesTitle=Sage. Accessed March 28, 2013.
- Sage is a popular European treatment for inflammation of the mouth and throat <1>.
- Sage has a long history of use against inflammation of the oral cavity and throat when used as a mouthwash or gargle <1>. As such, use of a mouthwash/gargle or topical spray is recommended of the treatment of sore throat <1,2,3>.
- Use of sage for the treatment of acute sore throat should be initiated at the first sign of symptom onset and continued for 2 to 3 days <1>. Patients should be advised if they do not experience improvement within that time or if symptoms get worse at any time, they should contact their physician.
- Salvia officinalis is the species of sage more commonly used in medicine <1>. It is this species of sage which is associated with the most preliminary evidence. Therefore, in patients looking to use sage for the treatment and symptomatic relief of acute sore throat, a product containing S. officinalis should be recommended. Caution patients that various formulations of sage (S. officinalis) exist for purchase.
- Preliminary clinical evidence suggests sage, specifically S. officinalis, is efficacious and safe for the treatment and symptomatic relief of acute sore throat although additional investigation is required to support or refute this claim <1>.
- Natural Standard evidence rating of sage for sore throat is C; Unclear scientific evidence <1>.
- Sage has been demonstrated to possess antibacterial, antifungal, anti-inflammatory, antimicrobial, antioxidant, and antiviral properties <1>. However, the exact mechanism of action by which sage is acts for the treatment and/or symptomatic relief of sore throat is unclear.
- Sage may work synergistically with other herbal ingredients such as echinacea for the treatment of sore throat.
- Sage is considered possibly safe by Natural Standard when used as a mouthwash or gargle for sore throat, due to a long history of use particularly in Europe <1>. It is important to note, sage is considered unsafe when large amounts of the essential oil or tinctures are ingested, due to the possibility of seizure induction as observed in case reports <1>. As such, the use of sage should be AVOIDED in patient with a history of seizure disorders.
- The use of sage should be AVOIDED in those patients with a known allergy/hypersensitivity to sage species, their constituents, or to members of the Lamiaceae family <1,4>.
- Sage should be used with caution in those with hypertension, asthma, and diabetes due to the potential for worsening these conditions <1,4>. Caution should also be exercise when using sage in patients taking anticoagulants or antiplatelets as it may increase their bleeding risk. Monitoring is important in these patient groups.
- Sage appears to be safe and well tolerated in most patients <1>. Common side effects of using a topical sage spray are gastrointestinal in nature and include minor dry mouth and mild burning <1>.
- Adverse effects include restlessness, vomiting, tachycardia, tremors, seizures and kidney damage <1>. However, these only affects observed when sage is used at high doses or for prolonged periods of time <1>.
- The exact optimal dose of sage for the treatment and symptomatic relief of acute sore throat is unclear <1>. Patients should also be advised that formulations of products vary from manufacturer to manufacturer which may influence effectiveness for sore throat treatment.
- Recommended Dosage (Adults ≥ 18 yrs): A 15% spray containing 140 mcL of S. officinalis extract per dose has been used 6 to 9 times daily for three days and demonstrated effectiveness for sore throat symptomatic relief <1,3>.
- Recommended Dosage (Children ≤ 18 yrs): There is currently a lack of evidence to recommend the used of sage in those younger than the age of 18 years <1>.
- The use of sage in pregnancy and lactation should be AVOIDED due to the lack of evidence of use in this patient population <1>.
References
1. Adams J.D. et. al. Sage (Salvia officinalis, Salvia lavandulaefolia, Salvia lavandulifolia). Natural Standard Professional Monograph. accessed at: www.naturalstandard.com on March 26, 2013.
2. Schapowal A, Berger D, Klein P, Suter A. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: A randomized double-blind trial. Eur J Med Res 2009; 14: 406-412.
3. Hubber M, Sievers H, Lehnfeld R, Kehrl W. Efficacy and Tolerability of a Spray with Salvia Officinalis in the Treatment of Acute Pharyngitis – A Randomized, Double-Blinded, Placebo-Controlled Study with Adaptive Design and Interim Analysis. Eur J Med Res. 2006;11:20-6.
4. Micromedix. Sage. http://www.micromedexsolutions.com/micromedex2/librarian/ND_T/ evidencexpert/ND_PR/evidencexpert/CS/1BA191/ND_AppProduct/evidencexpert/DUPLICATIONSHIELDSYNC/8A7F7F/ND_PG/evidencexpert/ND_B/evidencexpert/ND_P/evidencexpert/PFActionId/evidencexpert.IntermediateToDocumentLink?docId=1000737048&contentSetId=47&title=Sage&servicesTitle=Sage. Accessed March 28, 2013.