Monograph: Garlic

Date: 2023-03-31

NHPID name

Allium sativum ( Germplasm Resources Information Network Taxonomy )

Proper name(s)

Allium sativum ( USDA 2008 )

Common name(s)

• Garlic ( McGuffin et al. 2000 )
• Garlic essential oil ( Unavailable )

Source material

Bulb ( ESCOP 2003 , Bradley 1992 )

Route Of administration

Oral

Dosage form(s)

Those suited to the allowable route(s) of administration. This monograph is not intended to include food-like dosage forms such as bars, chewing gums or beverages.

Use(s) or purpose(s)

Statement(s) to the effect of:

• Traditionally used in Herbal Medicine to help relieve the symptoms associated with upper respiratory tract infections and catarrhal conditions (such as nasal congestion/buildup of excess mucuous).  (Mills and Bone 2005, ESCOP 2003, Bradley 1992, Felter and Lloyd 1983[1898])
• Used in Herbal Medicine to help reduce elevated blood lipid levels (hyperlipidaemia) in adults.  (Kojuri et al. 2007, Macan et al. 2006, Mills and Bone 2005, ESCOP 2003, Kannar et al. 2001, Blumenthal et al. 2000, Bradley 1992)
• Used in Herbal Medicine to help maintain cardiovascular health in adults.  (Kojuri et al. 2007, Macan et al. 2006, Mills and Bone 2005, ESCOP 2003, Kannar et al. 2001, Blumenthal et al. 2000, Bradley 1992)

Dose(s)

Adults:

• Adolescents and adults include breastfeeding women
• Adult dose for allicin supported by the following references: Kojuri et al. 2006; Mills and Bone 2005; ESCOP 2003; Kannar et al. 2001; Bradley 1992. Adult dose for alliin calculated based on the conversion ratio of 0.45 mg allicin: 1 mg alliin (ESCOP 2003).
• Adult dose supported by the following references: Kojuri et al. 2006; Mills and Bone 2005; ESCOP 2003; Kannar et al. 2001; Blumenthal et al. 2000; Bradley 1992.
• Children and adolescent doses were calculated as a proportion of the adult dose (JC 2012).
• See Appendix 1 for examples of appropriate dosage preparations and frequencies of use, according to cited references. The purpose of Appendix 1 is to provide guidance to industry.
• The use of garlic in children is supported by the following references: McIntyre 2005; Schilcher 1997; Bove 2001.

Duration of use

No statement is required

Risk information

Statement(s) to the effect of:

Caution(s) and Warning(s):

• Consult a health care practitioner/health care provider/health care professional/doctor/ physician if symptoms persist or worsen.
• Consult a health care practitioner/health care provider/health care professional/ doctor/physician prior to use if you are pregnant or have diabetes.  (Brinker 2010)
• Consult a health care practitioner/health care provider/health care professional/ doctor/physician prior to use if you are taking blood thinners or protease inhibitors.  (Brinker 2010, Mills and Bone 2005)

Contraindication(s): No statement is required Known Adverse Reaction(s): Stop use if hypersensitivity/allergy occurs.  (Brinker 2010, Mills and Bone 2005)

Non-medicinal ingredients

Must be chosen from the current Natural health products ingredients database and must meet the limitations outlined in the database.

Specifications

• The finished product specifications must be established in accordance with the requirements described in the NHPD Quality of natural health products guide.
• The medicinal ingredient must comply with the requirements outlined in the Natural health products ingredient database (NHPID).
• For products containing fresh garlic in oil, the preparations must meet at least one of the following conditions in order to prevent the growth of the bacterial spores associated with botulism: (i) Products are subjected to a validated treatment, such as heat treatment, with equivalent effect to the 12 D canning process (a thermal process designed to reduce the probability of survival of a single, heat-resistant spore of Clostridium botulinum by a factor of 1012) to inactivate spores of C. botulinum (FAO 1985), or (ii) The water activity of the garlic bulb is reduced to 0.94 or less before adding it to the oil, or (iii) Ensure that the pH of the plant material is adjusted to 4.6 or less before adding it to the oil (HC 2007).
• The medicinal ingredient may comply with the specifications outlined in the following pharmacopoeial monographs: Garlic, Powdered Garlic, Powdered Garlic Extract or Garlic Fluid Extract of the British Pharmacopoeia, Garlic Powder Monograph of the European Pharmacopoeia and Garlic Powder Monograph of the US Pharmacopoeia

References cited

• Blumenthal M, Goldberg A, Brinckmann J, editors. Herbal Medicine: Expanded Commission E Monographs. Boston (MA): Integrative Medicine Communications; 2000.
• Bove M. 2001. An Encyclopedia of Natural Healing for Children and Infants, 2nd edition. Toronto (ON): McGraw-Hill.
• Bradley PR, editor. 1992. British Herbal Compendium: A Handbook of Scientific Information on Widely Used Plant Drugs, Volume 1. Bournemouth (GB): British Herbal Medicine Association.
• Brinker F. 2010. Online Updates and Additions to Herb Contraindications and Drug Interactions, 3rd edition. Sandy (OR): Eclectic Medical Publications. [Updated 2010 July 13; Accessed 2013 January 30]. Available from: http://www.eclecticherb.com/emp/updatesHCDI.html
• ESCOP 2003: ESCOP Monographs: The Scientific Foundation for Herbal Medicinal Products, 2nd edition. Exeter (UK): European Scientific Cooperative on Phytotherapy and Thieme; 2003.
• FAO 1985. Food and Agriculture Organization of the United Nations. Planning and engineering data 2: Fish canning [online]. Myrseth A, editor. Fisheries Circular - C784; 1985. Rome (I): Food and Agriculture Organization of the United Nations Document Repository. Available at: http://www.fao.org/DOCREP/003/R6918E/R6918E02.HTM [Accessed 09 May 2008].
• Felter HW, Lloyd JU. King's American Dispensatory, Volume 1, 18th edition. Sandy (OR): Eclectic Medical Publications; 1983 [Reprint of 1898 original].
• HC 2007: Health Canada. Natural Health Products Directorate Monthly Communiqué Volume 3, Issue 4, December 2007 [online]. Ottawa (ON): Natural Health Products Directorate, Health Canada. Available at: http://www.hc-sc.gc.ca/dhp-mps/prodnatur/bulletins/_communiques/communique_dec07_e.html [Accessed 09 May 2008].
• JC 2008: Justice Canada. Food and Drug Regulations. (C.01.021). Ottawa (ON): Health Canada; 2008. [Accessed 2008-01-31] Available from: http://laws.justice.gc.ca/en/F-27/C.R.C.-c.870/text.html
• Kannar D, Wattanapenpaiboon N, Savige G, Wahlqvist M. 2001. Hypocholesterolemic effect of an enteric-coated garlic supplement. Journal of the American College of Nutrition 20(3):225-231.
• Kojuri J, Vosoughi A, Akrami M. 2007. Effects of anethum graveolens and garlic on lipid profile in hyperlipidemic patients. Lipids in Health and Disease 6(5):1476-1511.
• Macan H, Uykimpang R, Alconel M, Takasu J, Razon R, Amagase H, Niihara Y. 2006. Significance of garlic and its constituents in cancer and cardiovascular disease: aged garlic extract may be safe for patients on warfarin therapy. Journal of Nutrition 136:793S-795S.
• McGuffin M, Kartesz JT, Leung AY, Tucker AO, editors. 2000. Herbs of Commerce, 2nd edition. Austin(TX): American Herbal Products Association.
• McIntyre A. Herbal Treatment of Children - Western and Ayurvedic Perspectives. Toronto (ON): Elsevier Limited; 2005.
• Mills S, Bone K. 2005. The Essential Guide to Herbal Safety. St. Louis (MO): Elsevier Churchill Livingstone.
• Schilcher H. Phytotherapy in Paediatrics: Handbook for Physicians and Pharmacists. Stuttgart (D): Medpharm Scientific Publishers; 1997.
• USDA 2008: ARS, National Genetic Resources Program. Germplasm Resources Information Network (GRIN). National Germplasm Resources Laboratory, Beltsville (MD). [Accessed 2008-01-21]. Available at http://www.ars-grin.gov/cgi-bin/npgs/html/tax_search.pl

References reviewed

• BHP 1983: British Herbal Pharmacopoeia. Cowling (GB): British Herbal Medical Association; 1983.
• BHP 1996: British Herbal Pharmacopoeia. Bournemouth (UK): British Herbal Medical Association; 1996.
• Budoff M. 2006. Aged garlic extract retards progression of coronary artery calcification. The Journal of Nutrition 136(3 Suppl):741S-744S.
• CDC 2007: Centers for Disease Control and Prevention. Update: International Outbreak of Restaurant-Associated Botulism -- Vancouver, British Columbia, Canada [online]. Morbidity and Mortality Weekly Report (MMWR) October 18, 1985 / 34(41);643. Atlanta (GA): Centers for Disease Control and Prevention (CDC), United States Department of Health and Human Services. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00000627.htm [Accessed 09 May 2008].
• Gardner CD, Lawson LD, Block E, Chatterjee LM, Kiazand A, Balise RR, Kraemer HC. 2007. Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia. Archives of Internal Medicine 167(4):346-353.
• HC 2006. Health Canada. Health Products and Food Branch (HPFB) Standards and Guidelines for Microbiological Safety of Food - An Interpretive Summary [online]. Ottawa (ON): Food Directorate Evaluation Division, Bureau of Microbial Hazards, Health Canada. Available at: http://www.hc-sc.gc.ca/fn-an/res-rech/analy-meth/microbio/volume1/intsum-somexp_e.html [Accessed 09 May 2008].
• HC 2009: Health Canada. Natural Health Products Directorate Guidance Document for the Evidence for Quality of Finished Natural Health Products, Version 2.0 [online]. Ottawa (ON): Health Canada. Available from: http://www.hc-sc.gc.ca/dhp-mps/prodnatur/legislation/docs/eq-paq_e.html [Accessed 19 October 2009].
• Lund B. 1993. Quantification of factors affecting the probability of development of pathogenic bacteria, in particular Clostridium botulinum, in foods. Journal of Industrial Microbiology 12(3-5):144-155.
• Mills S, Bone K. 2000. Principles and Practice of Phytotherapy. Toronto (ON): Churchill Livingstone.
• NLM 2009: United States National Library of Medicine. ChemIDplus advanced [online]. Chemical name. RN: 000-00-0. Bethesda (MD): Specialized Information Services, United States National Library of Medicine, National Institutes of Health, United States Department of Health & Human Services. [Accessed 2009 May 19]. Available from: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?CHEM
• Ziaei S, Hantoshzadeh P, Rezasoltani P, Lamyian M. 2001. The effect of garlic tablet on plasma lipids and platelet aggregation in nulliparous pregnants at high risk of preeclampsia. European Journal of Obstetrics & Gynecology and Reproductive Biology 99(2):201-206.