Bearberry leaves contain the hydroquinone derivatives arbutin and methyl arbutin in levels ranging from 5% to 15%. Arbutin is hydrolyzed to hydroquinone when it comes in contact with gastric fluid, which acts as a mild astringent and antimicrobial in alkaline urine. Large amounts of bearberry must be ingested to achieve a significant antiseptic effect. The herb is effective against Escherichia coli, Proteus mirabilis, P. vulgaris, Pseudomonas aeruginosa, Staphylococcus aureus, and 70 other urinary tract bactena.

Bearberry also contains ursolic acid and isoquercetin, which contribute to the plant’s mild diuretic effect. Bearberry may help treat hepatitis; reduce polyphagia, polydipsia, and weight gain resulting from diabetes; and inhibit melanin production. It may also have anti-inflammatory effects. Bearberry is available as capsules, dried leaves, liquid extract, and tea bags.

Benefits And Uses of Bearberry

Bearberry is used as a urinary antiseptic and a mild diuretic. It’s also used to treat contact dermatitis, allergic type hypersensitivity reactions, and arthritis.

Administration

• Capsules: varies depending on formulation; taken with a meal or a glass of water
• Cold maceration: 3 g in 5 oz of water by mouth up to four times a day or 400 to 840 mg of hydroquinone derivatives calculated as water-free arbutin .
• Concentrated infusion: 2 to 4 ml by mouth .
• Dried leaves infusion: 2.5 g (1 teaspoon) of finely cut or coarse powdered herb in cold water, rapidly brought to a boil, then strained after 15 minutes .
• Liquid extract: 1.5 to 4 ml 0:1 in 25% alcohol) by mouth three times a day or 5 to 10 gtt of extract mixed in a small amount of spring or purified water two to three times a day .
• Tea (1 tea bag in 6 oz of boiling water steeped for 3 minutes): 1.5 to 4 g three times a day.
• For infusions, cold water may be used instead of hot water to minimize the tannin content; the tea is steeped for 12 to 24 hours before the patient drinks it.

Side Effects of Bearberry

Adverse effects associated with bearberry include seizures, tinnitus, nausea, vomiting, inflammation and irritation of the bladder and urinary tract mucous membranes, green-brown urine, hepatotoxicity, cyanosis, and collapse.

Arbutin increases the inhibitory action of prednisolone and dexamethasone on contact dermatitis, allergic type hypersensitivity reactions, and arthritis. Bearberry may enhance the effect of diuretics. Drugs known to acidify urine, such as ascorbic acid or methenamine, or to increase uric acid levels, such as diazoxide, diuretics, or pyrazinamide, may inhibit bearberry’s effects because bearberry needs an alkaline environment. Foods known to increase uric acid levels in the bladder, such as those rich in vitamin C, may inhibit bearberry’s effects because bearberry needs an alkaline environment and the urinary acidifier may inhibit the conversion of herb’s arbutin to the active hydro quinone component.

Patients with kidney disease should avoid use of bearberry because tannin components are believed to be excreted in the urine. Breast-feeding patients and children younger than age 12 should also avoid use.

Clinical considerations

• Caution patient not to use bearberry for longer than 10 days at a time or more than five times per year.
• Bearberry contains 15% to 20% tannin, which may produce nausea and vomiting.
• Bearberry 9 g is equivalent to 400 to 700 mg of arbutin.
• Signs and symptoms of overdose include inflammation and irritation of the bladder and urinary tract mucous membranes.
• Tinctures containing alcohol may cause a disulfiram like reaction.
• Hepatotoxicity may occur with prolonged use, especially in children.
• If patient has kidney disease or is pregnant or breast-feeding, advise against using bearberry.
• Advise patient to take bearberry with a meal or a glass of water.
• Information patient that urine PH must be alkaline for bearberry to be effective and that a diet high in milk vegetable ( especially tomatoes), fruit, fruit juice, and potatoes can help keep urine alkaline.
• Tell him that he may also take 6 to 8 g of sodium bicarbonate a day to help keep his urine alkaline.
• Inform patient that the hydroquinone in the herb may discolor urine green brown.
• Advise patient to consult his health care provider if symptoms persist for more than 7 days or if high fever, chills, nausea, vomiting, diarrhea, or severe back pain occurs.
• Inform patient that pouring hot water over the leaves when preparing a bearberry beverage may increase the tannin content of the infusion and, thus, increase the risk of stomach discomfort. Instead, advise pouring cold water over the leaves and allowing the mixture to steep for 12 to 24 hours before drinking it.
• Tell patient to remind prescriber and pharmacist of any herbal or dietary supplement that he’s taking when obtaining a new prescription.
• Advise patient to consult his health care provider before using an herbal preparation because a treatment with proven efficacy may be available.

Research summary

No double-blind studies have evaluated the clinical effectiveness of bearberry. However, two studies have evaluated the antibacterial power on the urine of study participants and found activity against most major bacteria that infect the urinary tract.

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