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Black psyllium is a plant. People use the seed to make medicine. Be careful not to confuse black psyllium with other forms of psyllium including blond psyllium.

Black psyllium is found in some over-the-counter medicines and is effective for treating and preventing constipation. It is also used for diarrhea, obesity, diabetes, and for reducing the risk of heart disease, but there is less evidence that it is effective for these conditions.

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

Black psyllium adds bulk to the stool which might help with constipation, diarrhea, and irritable bowel syndrome. It also controls how quickly sugars are absorbed from the gut, which might help control blood sugar levels in people with diabetes.

When taken by mouth: Black psyllium is LIKELY SAFE for most people when taken with plenty of water. Drink at least 8 ounces of fluids for every 3-5 grams of husk or 7 grams of seed. Mild side effects include bloating and gas. In some people, black psyllium can cause allergic reactions such as runny nose, red eyes, rash, and asthma, or, rarely, a life-threatening reaction called anaphylaxis.

Black psyllium is LIKELY UNSAFE when taken by mouth without enough water. Be sure to take black psyllium with plenty of water. Otherwise, it might cause choking or block the gastrointestinal (GI) tract.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Taking black psyllium during pregnancy or breast-feeding seems to be LIKELY SAFE, as long as enough water is taken with the dose.

Intestinal problems: Don't use black psyllium if you have impacted stools, a complication of constipation in which the stool hardens in the rectum and can't be moved by usual movement of the bowel. Don't use black psyllium if you have any condition that increases your risk of getting blockages in your intestines. The concern is that when black psyllium absorbs water and swells up, it might block the GI tract in people with these types of conditions.

Allergies: Some people are severely allergic to black psyllium. This is more likely to happen to people who have been exposed to black psyllium on the job, such as nurses who prepare doses of powdered laxatives, or workers in factories that process psyllium. These people shouldn't use black psyllium.

Phenylketonuria: Some black psyllium products might be sweetened with aspartame (NutraSweet). If you have phenylketonuria, avoid these products.

Surgery: Because black psyllium might affect blood sugar levels, there is a concern that it might interfere with blood sugar control during and after surgery. Stop using black psyllium at least 2 weeks before a scheduled surgery.

Swallowing disorders: People who have trouble swallowing might be more likely to choke on black psyllium. If you have an esophageal problem or swallowing disorder, don't use black psyllium.

Carbamazepine (Tegretol)

Interaction Rating=Moderate Be cautious with this combination.

Black psyllium contains large amounts of fiber. Fiber can decrease how much carbamazepine (Tegretol) the body absorbs. By decreasing how much carbamazepine (Tegretol) the body absorbs black psyllium might decrease the effectiveness of carbamazepine (Tegretol).

Digoxin (Lanoxin)

Interaction Rating=Moderate Be cautious with this combination.

Black psyllium is high in fiber. Fiber can decrease the absorption and decrease the effectiveness of digoxin (Lanoxin). As a general rule, any medications taken by mouth should be taken one hour before or four hours after black psyllium to prevent this interaction.

Lithium

Interaction Rating=Moderate Be cautious with this combination.

Black psyllium contains large amounts of fiber. Fiber can decrease how much lithium the body absorbs. Taking lithium along with black psyllium might decrease the effectiveness of lithium. To avoid this interaction take black psyllium at least 1 hour after lithium.

Medications for diabetes (Antidiabetes drugs)

Interaction Rating=Moderate Be cautious with this combination.

Black psyllium might decrease blood sugar by decreasing how much sugar your body absorbs from foods. Diabetes medications are also used to lower blood sugar. Taking black psyllium with diabetes medications might cause your blood sugar to be 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.

Iron: Use of psyllium with iron supplements can reduce the amount of iron that the body absorbs. Take iron supplements one hour before or four hours after psyllium to avoid this interaction.
Riboflavin: Psyllium seems to slightly reduce the amount of riboflavin that the body absorbs, but it's probably not important.

Fats and fat-containing foods: Psyllium can make it difficult to digest fat from the diet. This can increase the amount of fat lost in the stool.
Nutrients: Taking black psyllium with meals over a long period of time might alter nutrient absorption. In some cases, taking vitamins or mineral supplements might be necessary.

It's important to take enough water when taking black psyllium. Not taking enough fluid could lead to choking or obstruction of the gastrointestinal (GI) tract. Take at least 240 mL of fluid for every 5 grams of psyllium husk or 7 grams of psyllium seed. Black psyllium should be taken at least 30-60 minutes after taking other drugs.

The following doses have been studied in scientific research:

BY MOUTH:

  • For constipation: The typical dose of black psyllium is 10-30 grams per day in divided amounts. Take each dose with plenty of water. Otherwise, black psyllium might cause choking. The FDA labeling recommends at least 8 ounces (a full glass) of water or other fluid with each dose.
  • For heart disease: At least 7 grams of psyllium husk (soluble fiber) daily, as part of a low-fat, low-cholesterol diet.

African Plantain, Brown Psyllium, Dietary Fiber, Erva-das-pulgas, Fibre Alimentaire, Fleaseed, Fleawort, Flohkraut, Flohsamen, French Psyllium, Glandular Plantain, Graine de Psyllium, Herbe aux Puces, Œil-de-Chien, Pilicaire, Plantain, Plantago afra, Plantago arenaria, Plantago indica, Plantago psyllium, Plantain, Plantain Pucier, Psyllii Semen, Psyllion, Psyllios, Psyllium, Psyllium arenarium, Psyllium Brun, Psyllium d'Espagne, Psyllium indica, Psyllium Noir, Psyllium Seed, Pucière, Pucilaire, Scharzer Flohsame, Spanish Psyllium, Zaragatona.

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